How to Reduce TSH Levels

Co-authored by Damaris Vega, MD and Dan Hickey

Last Updated: May 2, 2024 Fact Checked

Having high thyroid-stimulating hormone (TSH) is an indication of an underactive thyroid, a condition known as hypothyroidism. Hypothyroidism occurs when your thyroid does not produce enough of certain hormones your body uses to control important metabolic, or chemical, processes throughout your body. Hypothyroidism can cause fatigue, depression, weight gain, and a lack of appetite. If untreated, it can lead to obesity, infertility, heart disease, and joint pain.^{[1]
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Go to source} If you have hypothyroidism, you may want to lower your TSH levels so you can lessen the symptoms of your condition. You can take thyroid medication to treat high TSH levels. You can also make dietary and lifestyle changes to address your hypothyroidism.

Method 1

Method 1 of 2:

Adjusting Your Diet and Lifestyle

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1
Maintain a diet rich in Vitamin B and iodine.^{[2]
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Go to source} Have a diet rich in healthy sources of protein like tofu, chicken, and beans as well as Vitamin B rich foods like whole grains, nuts, and seeds. Add a good balance of fruits and vegetables to your diet, specifically sea vegetables, as they are rich in iodine. Foods high in natural iodine are good for your thyroid.^{[3]
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- You could try having sea vegetables like kelp, nori, and kombu at least once a day. Sprinkle kelp over your salads or soups for added iodine. Add kombu to your beans or meat. Wrap foods in nori.
- Add nuts and seeds to stir fries, quinoa, and salads.
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Exercise regularly.^{[4]
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Damaris Vega, MD
Board Certified Endocrinologist

Expert Interview. 11 November 2020.} Daily physical activity is associated with lower thyroid hormone levels as well as reduced inflammation and a stronger immune system.^{[5]
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PubMed Central
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Go to source} Exercise can also help boost your metabolism and counteract some of the side effects of an underactive thyroid, such as fatigue, depression and weight gain. Go for regular runs or bike rides, or join a gym and take workout classes. Make it a habit to be active for at least 30 minutes a day.
- You can also try taking a yoga class to help you stay active and to reduce your stress levels. Look for yoga classes at your local gym or yoga studio.
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Get enough Vitamin D every day. Aim to get at least 20 to 30 minutes of sun exposure in the early morning or the evening. Expose your arms, legs, and face to the sun. Low vitamin D levels have been found to be associated with hypothyroidism. Bringing those levels up may improve your symptoms of hypothyroidism.^{[6]
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- If you live in an area that gets very little direct sunlight, especially during the winter months, speak to your doctor about taking Vitamin D supplements.
- Most people typically receive enough vitamin D from sunlight from April through September, with levels dropping from October through March.
- Dietary sources of vitamin D include oily fish (like salmon or herring), red meat, liver, egg yolks, and fortified foods (like some cereals).^{[7]
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Reduce stress and anxiety. Keep your stress and anxiety levels low to avoid agitating your thyroid. Do relaxing activities like painting, drawing, and knitting. Try doing a hobby you enjoy to release stress and anxiety. Working out can also be a good way to reduce your stress levels.^{[8]
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- You can also do deep breathing exercises to help reduce your stress levels or take a weekly yoga class.
- While reduced stress may help lower your TSH levels and improve thyroid function, most research on this correlation has been conducted on rats.^{[9]
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  Go to source} More human testing is needed to confirm the efficacy of reduced stress on TSH levels.

Method 2

Method 2 of 2:

Taking Thyroid Medication

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If you are exhibiting some of the effects of hypothyroidism, such as constipation, hoarseness, and fatigue, go to the doctor to discover for sure whether or not you have hypothyroidism. At the appointment, your doctor will do a blood test to find out if your thyroid is underactive.^{[10]
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Ask your doctor for a prescription for thyroid medication. The most reliable way to lower your TSH levels due to hypothyroidism is to take a synthetic thyroid hormone called levothyroxine.^{[11]
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Damaris Vega, MD
Board Certified Endocrinologist

Expert Interview. 11 November 2020.} This drug is available by prescription from your doctor. It is an oral medication that restores your hormone levels and reverses the symptoms of hypothyroidism. You will need to take it once a day, typically 30–60 minutes before breakfast on an empty stomach.^{[12]
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- Once you begin taking medication, your symptoms should start to improve within 3–5 days. The medication should be fully effective in 4–6 weeks.^{[13]
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- Always follow your doctor's instructions on dosage. Never take more than the recommended dose of the medication.
- Thyroid medication must be taken for life to maintain lower TSH levels, but luckily, it is relatively inexpensive. Your doctor will break down the exact costs for the medication.
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Learn the side effects of the medication. If you have a dose that is too high and you get an excessive amount of the thyroid hormone, you can experience side effects. Your doctor may need to adjust your dosage to fit your body's needs. You may also be prescribed a specific medication that your body doesn't respond well to. Get emergency medical help if you have signs of an allergic reaction to levothyroxine including hives, difficulty breathing, and/or swelling of your face, lips, tongue, or throat.^{[14]
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Research source} Contact your doctor immediately if you experience any of the following symptoms:^{[15]
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- Fast or irregular heart rate
- Chest pain and/or difficulty breathing
- Fever, hot flashes, and/or excessive sweating
- Feeling unusually cold
- Weakness, tiredness, and/or sleep problems
- Memory problems, feeling depressed, or feeling irritable
- Muscle aches
- Dryness of skin, dryness of hair, or hair loss
- Changes in your menstrual periods
- Vomiting, diarrhea, appetite changes, and/or weight changes^{[16]
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Do not take certain supplements at the same time as the medication. Iron, calcium, and fiber supplements can affect your body's ability to absorb the medication, as well as proton pump inhibitors (like Prilosec or Prevacid), soy products, and multivitamins containing minerals. Wait 3–4 hours after taking your medication to have these supplements.^{[17]
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Research source} You should also avoid having medications that contain cholestyramine and aluminum hydroxide.^{[18]
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- Speak to your doctor if you are on other medications or supplements before you take thyroid medication.^{[19]
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  Damaris Vega, MD
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  Expert Interview. 11 November 2020.}
- Generally, thyroid medication is most effective when taken on an empty stomach about 30 minutes before eating.
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Try “natural” thyroid medications with caution. “Natural” thyroid replacement medication comes from animal thyroids, usually pigs. You can buy it online as a food supplement. However, the medication is not purified and not regulated by the Food and Drug Administration (FDA). Avoid buying or taking any “natural” thyroid medication that is not prescribed or recommended by your doctor.^{[20]
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- You can be prescribed these “natural” alternative medication options in either extract or desiccated form.
- If you're interested in learning more, ask your doctor about Armour Thyroid, a natural thyroid extract that is available by prescription.^{[21]
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Monitor your progress on the medication. Have regular check ins with your doctor to confirm your TSH levels are going down with the help of the medication. In some cases, your doctor may adjust your dosage after two to three months to ensure your body is getting enough of the hormone.^{[22]
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- After one to two months on the medication at the correct dose, your symptoms should improve and you should feel less tired. Your eating habits and weight should also improve.
- Typically, your doctor will retest your TSH levels after 6–8 weeks of using levothyroxine or another medication and adjust your dosage if needed.
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Get your TSH levels tested every 6–12 months.^{[23]
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Damaris Vega, MD
Board Certified Endocrinologist

Expert Interview. 11 November 2020.} Arrange for an annual test with your doctor to ensure your TSH levels are where they should be. Your doctor should test your levels at least once a year to confirm the medication is working. Generally, you’ll get tested every 4–6 months when first starting the medication before transitioning to annual testing.^{[24]
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- You may need to get your levels tested more frequently if you're on a new dose of levothyroxine, you’re pregnant, or you show symptoms of incorrect dosage.^{[25]
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- Taking thyroid hormone replacement medication is a lifelong requirement for people with hypothyroidism. Do not stop taking your medication if you start to feel better, as your symptoms will likely return.

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How do I keep TSH levels consistent?

Damaris Vega, MD
Board Certified Endocrinologist
Dr. Damaris Vega is a board certified Endocrinologist. She graduated Magna Cum Laude from the Pontifical Catholic University of Puerto Rico with a BS in General Science and subsequently earned an MD from the Ponce School of Medicine, Ponce, PR. During medical school, Dr. Vega served as president of the Alpha Omega Alpha Medical Honor Society and was selected as her school's representative for the American Association of Medical Colleges. She then completed a residency in Internal Medicine and a fellowship in Endocrinology, Diabetes, Mineral, and Metabolism at The University of Texas Southwestern Medical School. Dr. Vega has been recognized for excellent patient care multiple times by the National Committee for Quality Assurance and received the Patients' Choice Award in 2008, 2009, and 2015. She is a fellow of the American College of Clinical Endocrinologists and is an active member of the American Association of Clinical Endocrinologists, the American Diabetes Association, and the Endocrine Society. Dr. Vega is also the founder and CEO of Houston Endocrinology Center as well as a principal investigator for multiple clinical trials at Juno Research, LLC.

Damaris Vega, MD

Board Certified Endocrinologist

Expert Answer

I recommend you talk to your doctor about medication. If you have hypothyroidism, they'll likely have you take thyroid medication daily to regulate your levels.

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