What does high thyroid stimulating hormone mean

Alternative names for thyroid stimulating hormone

TSH; thyrotropin, thyrotrophin

What is thyroid stimulating hormone?  

Thyroid stimulating hormone is produced and released into the bloodstream by the pituitary gland. It controls production of the thyroid hormones, thyroxine and triiodothyronine, by the thyroid gland by binding to receptors located on cells in the thyroid gland. Thyroxine and triiodothyronine are essential to maintaining the body’s metabolic rate, heart and digestive functions, muscle control, brain development and maintenance of bones. 

How is thyroid stimulating hormone controlled?  

When thyroid stimulating hormone binds to the receptor on the thyroid cells, this causes these cells to produce thyroxine and triiodothyronine and release them into the bloodstream. These hormones have a negative effect on the pituitary gland and stop the production of thyroid stimulating hormone if the levels of thyroxine and triiodothyronine are too high. They also switch off production of a hormone called thyrotropin-releasing hormone. This hormone is produced by the hypothalamus and it also stimulates the pituitary gland to make thyroid stimulating hormone. 

What happens if I have too much thyroid stimulating hormone?

A simple blood test can measure thyroid stimulating hormone in the circulation. If a person has too much, this may indicate that their thyroid gland is not making enough thyroid hormone, that is, they have an underactive thyroid gland or hypothyroidism. People with an underactive thyroid often feel lethargic, experience weight gain and feel the cold. Their thyroid gland may enlarge to produce a goitre. Treatment is medication in the form of tablets to bring the level of thyroid hormones back to normal. This also reduces the amount of thyroid stimulating hormone in circulation. It is particularly important for pregnant women to have the correct amounts of thyroid stimulating hormone and thyroid hormones to ensure the healthy development of their babies. Thyroid stimulating hormone is one of the hormones measured in newborns. Rarely, problems from the pitutiary gland or rare genetic conditions can result in inappropriately high thyroid stimulating hormones, and high free thyroid hormone levels.

What happens if I have too little thyroid stimulating hormone?

If a person has too little thyroid stimulating hormone, it is most likely that their thyroid gland is making too much thyroid hormone, that is, they have an overactive thyroid or hyperthyroidism, which is suppressing the thyroid stimulating hormone. People with an overactive thyroid have the opposite symptoms to those with hypothyroidism, i.e. they lose weight (despite increasing the amount they eat), feel too hot and can experience palpitations or anxiety. They may also have a slightly enlarged thyroid gland. Treatment is medication in the form of tablets, which reduce the activity of the thyroid gland and return all thyroid hormone levels to normal. Rarely, problems in the pituitary gland can also result in a low thyroid stimulating hormone, and low free thyroid hormone levels. 


Last reviewed: Mar 2018


A TSH test is done to find out if your thyroid gland is working the way it should. It can tell you if it’s overactive (hyperthyroidism) or underactive (hypothyroidism). The test can also detect a thyroid disorder before you have any symptoms. If untreated, a thyroid disorder can cause health problems.

TSH stands for “thyroid stimulating hormone” and the test measures how much of this hormone is in your blood. TSH is produced by the pituitary gland in your brain. This gland tells your thyroid to make and release the thyroid hormones into your blood.

The Test

The TSH test involves simply drawing some blood from your body. The blood will then be analyzed in a lab. This test can be performed at any time during the day. No preparation is needed (such as overnight fasting). You shouldn’t feel any pain beyond a small prick from the needle in your arm. You may have some slight bruising.

In general, there is no need to stop taking your medicine(s) before having your TSH level checked. However, it is important to let the doctor know what medications you are taking as some drugs can affect thyroid function. For example, thyroid function must be monitored if you are taking lithium. While taking lithium, there is a high chance that your thyroid might stop functioning correctly. It's recommended that you have a TSH level test before starting this medicine. If your levels are normal, then you can have your levels checked every 6 to 12 months, as recommended by your doctor. If your thyroid function becomes abnormal, you should be treated.

High Levels of TSH

TSH levels typically fall between 0.4 and 4.0 milliunits per liter (mU/L), according to the American Thyroid Association. Ranges between laboratories will vary with the upper limit generally being between 4 to 5. If your level is higher than this, chances are you have an underactive thyroid.

In general, T3 and T4 levels increase in pregnancy and TSH levels decrease.

Low Levels of TSH

It's also possible that the test reading comes back showing lower than normal levels of TSH and an overactive thyroid. This could be caused by:

  • Graves’ disease (your body’s immune system attacks the thyroid)
  • Too much iodine in your body
  • Too much thyroid hormone medication
  • Too much of a natural supplement that contains the thyroid hormone

If you're on medications like steroids, dopamine, or opioid painkillers (like morphine), you could get a lower-than-normal reading. Taking biotin (B vitamin supplements) also can falsely give lower TSH levels.

The TSH test usually isn’t the only one used to diagnose thyroid disorders. Other tests, like the free T3, the free T4, the reverse T3, and the anti-TPO antibody, are often used too when determining whether you need thyroid treatment or not.

Treatment

Treatment for an underactive thyroid usually involves taking a synthetic thyroid hormone by pill daily. This medication will get your hormone levels back to normal, and you may begin to feel less tired and lose weight.

To make sure you're getting the right dosage of medication, your doctor will check your TSH levels after 2 or 3 months. Once they are sure you are on the correct dosage, they will continue to check your TSH level each year to see whether it is normal.

If your thyroid is overactive, there are several options:

  • Radioactive iodine to slow down your thyroid
  • Anti-thyroid medications to prevent it from overproducing hormones
  • Beta blockers to reduce a rapid heart rate caused by high thyroid levels
  • Surgery to remove the thyroid (this is less common)

Your doctor may also regularly check your TSH levels if you have an overactive thyroid.

What would cause high TSH levels?

High TSH is often linked to an underactive thyroid or hypothyroidism..
1) Hypothyroidism (Underactive Thyroid).
2) Iodine Deficiency or Excess..
3) Obesity..
4) Radiation Therapy..
5) Pituitary Tumors..
6) Some Toxins, Drugs, and Supplements..
7) Rare Genetic Disorders..
8) Aging..

What are symptoms of TSH being too high?

High TSH levels indicate hypothyroidism. fatigue. weight gain. swelling of the face and neck. increased sensitivity to cold temperatures.

Should I worry about high TSH?

If your TSH level is higher than 10 mIU/L, you should start treatment, because you will very likely develop symptoms of an underactive thyroid, even if you don't have them now.