Thyroid Cancer Canada
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Thyroid Stimulating Hormone

TSH with Hormone Replacement


Treatments – Thyroid StimulatING Hormone

Thyroid Stimulating Hormone (TSH)

In patients with papillary or follicular thyroid cancer, surgery is the usual form of treatment. In addition, Thyroid Stimulating Hormone (TSH) treatment is given. TSH helps regulate the levels of thyroid hormones in the body.

  • In healthy people (with normally functioning thyroid glands), TSH should be to be about 0.4 to 5.0 µIU/mL.
  • In people with thyroid cancer, TSH drops to 0.01 to 3.0 µIU/mL. This is because thyroid hormone replacement pills suppress the production of TSH. Low TSH helps prevent cancer recurrence, but a careful balance of hormone levels is important.

TSH (Synthroid or Eltroxin)

When a person’s thyroid gland is removed, they can no longer produce thyroid hormone (T4), which is important for the body to function normally. For this reason, they take a man-made form of thyroid. In Canada, thyroid pills go by the names Synthroid® and Eltroxin®.


A balance between TSH and thyroid hormone is needed so that you can feel at your best. While a low TSH helps reduce recurrence risk, too much or too little thyroid hormone can result in bothersome side effects.

Symptoms of hypothyroidism (low thyroid levels)

  • Fatigue, weakness
  • Trouble sleeping, nightmares or excess sleep
  • Puffiness especially in the face, bloating
  • Poor concentration, memory loss
  • Weight gain
  • Anxiety, panic attacks, irritability, mood swings
  • Depression
  • Dry eyes, skin and hair; hair loss
  • Change in menstrual cycle
  • Joint pains and stiffness, muscle cramps
  • Intolerance to cold
  • Constipation and/or nausea
  • Tingling or numbness in fingers or toes
  • Itchiness
  • Ringing in ears
  • Slight changes in eyesight

Symptoms of hyperthyroidism (high thyroid levels)

  • Fatigue
  • Trouble sleeping, nightmares
  • Shakiness, nervousness, restlessness
  • Weight loss, increased hunger
  • Anxiety, panic attacks, irritability, mood swings
  • Increased sweating, warm/moist hands
  • Hair loss, brittle nails
  • Change in menstrual cycle
  • Increased thirst
  • Itching, hives
  • Joint pains and stiffness, muscle cramps
  • Diarrhea
  • Increased heart rate, palpitations, shortness of breath

Your doctor will determine the right dose of thyroid pills to help achieve the right hormonal balance, and regularly monitor your thyroid levels. It may take a few dose adjustments along the way. It’s important to talk to your doctor about the optimal hormone level he/she has set for you, and how often you need to be tested.

Taking your pills correctly is a key part of your treatment. Here are a few tips:

DO take your pills

  • At the same time each day
  • With a glass of water. Do not take them with hot drinks, especially coffee.
  • On an empty stomach (1 hour before eating or drinking anything other than water, or 3 hours after)

DO NOT take your pills

  • With vitamins or minerals, especially calcium and iron (if you do, wait 5 hours)
  • With laxatives or high-fibre foods

DO NOT allow your pills to become heated

  • In the summer, take precautions to not expose your pills to the sun/heat
  • Avoid storing pills in places that can overheat (e.g., a cupboard over the oven or stove, a hot car). If your pills are exposed to heat, dispose of them and get a fresh supply from the pharmacy.