High TSH: Clinical Manifestations, Symptoms, Causes, Optimal Levels and Treatment

The thyroid-stimulating hormone usually coincides with its acronym in English and is manufactured by the pituitary gland.

The release of TSH stimulates the thyroid to produce T3 and T4, the hormones responsible for thyroid function.

TSH levels increase as the body tries to “force” the thyroid to produce hormones if the thyroid stops working.

This reaction, known as a feedback loop, causes TSH levels to rise above their normal range.

According to the Merck Manual, high levels of TSH in the blood indicate an underactive thyroid or hypothyroid, a condition that affects up to 10 percent of women and six percent of men over 65 and causes various symptoms.

Clinical manifestations

Tegumentary symptoms:

High TSH levels due to an underactive thyroid cause many changes in the skin and hair.

The skin often becomes dry, scaly, thick, and pale.


The palms and soles of the feet may appear yellowish due to the deposit of carotene.

The hair becomes thin and becomes dry and rough.

Fluid retention and weight gain can occur, along with swelling of the face and swelling around the eyes.

The facial expression may seem tedious, and the eyelids may fall.

The nails become brittle and break easily. The tongue can increase its size.

Mental changes:

People with high TSH often experience mental changes.

They may become depressed, suffer memory loss, and have difficulty processing information.

Speech may be slow, and dementia may occur.

If TSH hormone levels are deficient for long periods, a life-threatening condition called myxedema coma may occur.

Musculoskeletal symptoms:

The high TSH levels of thyroid disease cause muscle and joint pain, stiffness, and swelling.

There may be weakness and loss of deep tendon reflexes.

Numbness and tingling in the extremities are recurring effects.

Systemic symptoms:

The underactive thyroid’s systemic symptoms of high TSH include sensitivity to cold due to low body temperature, slowness, and fatigue.

If a myxedema coma develops, seizures may occur.

Cardiopulmonary symptoms:

High levels of TSH in the low-functioning thyroid can increase cholesterol levels.

Heart enlargement and heart failure can occur even in people with subclinical thyroid disease, with few symptoms.

Fluid can accumulate around the heart and lungs, and the heart rate can become bradycardic or slower than usual.

Gynecological symptoms:

Women with high TSH levels may have heavier than regular periods or no periods.

Infertility can occur due to a lack of ovulation. Sexual desire often decreases.


Several possible causes can influence TSH levels:

  • Poisonous substances and exposure to radiation.
  • Inflammation of the thyroid gland
  • Deficiency or excess of iodine in the body.
  • Genetics.
  • The pregnancy.
  • Certain medications such as antidepressants, medications to reduce cholesterol, chemotherapy drugs, and steroids.
  • Thyroid cancer.


Hypothyroidism is one of the most common causes of elevated TSH levels, according to the National Institute of Diabetes and Digestive and Kidney Disorders.

The pituitary produces TSH to stimulate the production of thyroid hormones.

These hormones, in turn, inhibit the production of TSH by the pituitary, which allows the pituitary gland to decrease TSH production when there are adequate amounts of thyroid hormone in the blood.

This type of system, where the presence of a hormone inhibits the production of another hormone, is known as a feedback loop.

When there are insufficient levels of thyroid hormones in the blood, the pituitary gland will produce additional TSH to start the thyroid.

The most common cause of hypothyroidism is called Hashimoto’s disease, in which the immune system attacks the thyroid.

The thyroid can also become inflamed, resulting in low thyroid hormone production.

Certain medications can also cause low secretion of thyroid hormone.

Finally, some people have thyroid glands that do not work correctly for reasons that doctors do not fully understand.

Adenoma pituitary:

Pituitary adenomas are a form of brain cancer that arises from hormone-secreting cells.

In most cases, the Department of Neurosurgery at UCLA explains that pituitary adenomas secrete a growth hormone, prolactin, or the adrenocorticotropin-releasing hormone.

However, in some cases, a pituitary adenoma will secrete TSH, resulting in high levels of TSH and high thyroid hormone levels.

In such cases, the pituitary adenoma does not stop secreting TSH in the presence of high levels of thyroid hormone.

Resistance to the Thyroid Hormone:

Resistance to thyroid hormone is a condition in which the body does not respond adequately to thyroid hormones, says the Manager of Thyroid Diseases.

In most cases, resistance to thyroid hormone is caused by a mutation in the gene that encodes the thyroid hormone receptor, a protein responsible for binding and detecting the hormone.

If this protein does not work correctly, the pituitary gland will behave as if there were low thyroid hormone levels even in the presence of normal or elevated decks.

All this results in high levels of TSH in the blood.

Normal levels of TSH

Normal TSH levels for the average adult range between 0.4 and 4.0 mIU / l (milli-international units per liter).

However, many organizations agree that a reading of 2.5 or less is ideal than 2.6 to 4.0 mIU / L considered “a risk.”

The target TSH level is 0.5 to 2.5 mU / L for thyroxine patients.

The reference ranges change slightly as we get older and if you are pregnant.

Normal levels of TSH during pregnancy:

  • First quarter: 0.3-4.5 mIU / L.
  • Second trimester: 0.3-4.6 mIU / L.
  • Third trimester: 0.8-5.2 mUI / L.

Results may vary depending on the laboratory, the time of day your blood was taken, and the methods used.

Niveles altos de TSH

A TSH reading above 4.0 mIU / L is considered high (elevated).

High levels of TSH usually indicate an underactive thyroid gland, which produces too little thyroid hormone.

This is medically known as hypothyroidism.

Common causes of hypothyroidism include:

  • Autoimmune disease (known as Hashimoto’s disease).
  • Radiation therapy.
  • Surgical removal of the thyroid gland.

For a safe and effective treatment of an underactive thyroid, it is crucial to replace the thyroid hormone and alter your diet.

TSH in infants

TSH levels in babies should be regulated to keep them healthy and develop properly.

Normal ranges:

TSH levels are measured during the first days of a baby’s life by drawing blood.

Because the mother’s thyroid hormones cross the placenta, it may not be immediately apparent if her baby’s TSH is within the normal range just after birth.

Your newborn baby may need another series of blood tests between 2 and 6 weeks to confirm the readings; your TSH level in this age range should be between 1.7 and 9.1 milliunits per liter – mU / L.

High levels:

High TSH levels in a baby usually point to congenital hypothyroidism, which can have dire consequences if not treated quickly.

Hypothyroidism is when the body does not produce enough thyroid hormone, indicated by a high TSH test of 40 mU / L.

Congenital hypothyroidism that is not treated during the first weeks of a baby’s life can cause mental retardation.

Other factors that can create higher-than-normal TSH readings in older babies who are not diagnosed with congenital thyroid disease are environmental toxins.

Environmental Health News reported in July 2010 that three different chemicals present in water, some foods, and tobacco smoke could inhibit the production of thyroid hormones, which causes TSH levels to rise.

Chemists, thiocyanate, perchlorate, and nitrate can contaminate drinking water and become an unwanted ingredient but are commonly seen in baby formula mixed with drinking water, in breast milk produced by mothers who drink water in babies who drink water on their own.

Is it possible to have a high TSH and normal levels of T3 and T4?

If, in some cases, the serum levels of T3 and T4 can be kept relatively within the range of normal, despite the elevation of TSH levels.

Some people assume that this is a reactive response, but you must realize that serum thyroid hormone levels do not necessarily reflect tissue levels of thyroid hormone.

The important thing is not the serum concentration but the amount of thyroid hormone entering the cells and activating the genetic transcription.

TSH reflects the tissue concentration of the pituitary gland but does not reflect the attention of, say, your liver.

We can use SHBG as an indirect marker to evaluate the concentration of thyroid function in the liver. This can be a somewhat sensitive marker for tissue levels in other body parts.


The metabolism of proteins and fats, respiration, heat production, heart function, and appetite are essential functions of the body to which thyroid hormone contributes.

The time when TSH levels rise is because the thyroid gland generates more thyroid hormone than it should, but it could also be because your thyroid is not active and does not respond to TSH.

When tests indicate that your TSH levels are high or fluctuate widely, it could indicate an endocrine problem that requires medical attention.

Similarly, there are particular lifestyle and dietary practices that, if followed, will help stabilize or suppress TSH levels in your body.

Paso 1:

If you think your TSH levels are above average, consult your doctor.

The symptoms that can occur when TSH levels rise include weakness, dry, rough, or pale skin, cramps, muscle aches, decreased libido, depressionconstipation, fatigue, and irritability.

The symptoms mentioned above occur when Graves disease or Hashimoto’s thyroiditis is when the immune system incapacitates or damages the thyroid gland causing it to become inflamed.

Paso 2:

It would help if you normalized your fiber intake.

A diet high in fiber provides many benefits, but fiber can also affect how the thyroid absorbs hormones and ultimately affect your TSH level.

Do not stop eating foods that are high in fiber.

If you have just started eating a high-fiber diet, give your body and thyroid gland time to adjust to the new regimen.

Avoid hesitation in fiber intake, as it may contribute to erratic TSH absorption and sporadic TSH increases.

Paso 3:

While taking thyroid medication, avoid taking iron and calcium supplements, vitamins, and iron tablets.

The mixture of iron and calcium can alter TSH absorption in the body.

However, if you must take an iron and calcium supplement, it is recommended to wait between 2 and 4 hours between one medication and another.

Paso 4:

TSH levels may increase due to excessive consumption of soy foods, so you should avoid them as much as possible.

The thyroid condition can be aggravated thanks to soy protein powder or other products with high concentrations of soy and over-the-counter menopause supplements.

Paso 5:

Avoid eating too many goitrogenic foods because they enlarge the thyroid and reduce its ability to respond to TSH.

Gobiogenic foods include turnips, Brussels sprouts, kohlrabi, radishes, cauliflower, kohlrabi, cabbage, and kale.

However, it can eliminate or minimize its negative effect on the thyroid if they are cooked very well.

Eating a moderate amount of these foods does not cause problems for most people.

Paso 6:

Control and restrict your use of certain herbal supplements.

Seaweed, iodine-containing products, vitamins, guggul, tyrosine, bladderwrack supplements, and some other supplements can affect thyroid function, causing changes in your TSH.

Paso 7:

Manage your diet, stress, and sleep.

Your entire endocrine system responds to lack of sleep and periods of extreme stress.

Patients with Graves disease and Hashimoto’s often experience a worsening of their symptoms when they are tired, stressed, or eat poorly.

If you feel that anxiety and stress are too much, it is best to find a way to address your problems and ease your mind, seek a professional’s help or talk to a trusted friend who can listen to you.

The best way to stabilize your TSH levels and improve your mood is by eating a healthy and balanced diet and improving your sleep habits.