Thyroid Levels and Their Impact on Altitude Sickness: Key Insights

Thyroid levels and altitude sickness issues?

Hello, I would like to ask about my condition.
I have been diagnosed with hyperthyroidism and have been on medication for over two years.
For the past year, both my TSH and FT4 levels have been within the normal range.
However, my most recent blood test showed a TSH level of 6.55, while FT4 remained normal at 1.29.
I have a few questions:
1.
Why did my TSH level suddenly spike while FT4 remains normal? Is there anything I should be concerned about?
2.
I will be traveling to South America in about a month, where I may reach altitudes of up to 5,000 meters.
Is there any relationship between thyroid disease and altitude sickness, or are these two issues unrelated?
3.
Are there any medications for preventing altitude sickness that I should avoid due to my thyroid condition? Thank you.

Lin, 20~29 year old female. Ask Date: 2019/08/26

Dr. Lin Jianliang reply Internal Medicine

1.
During the medication period for hyperthyroidism, this situation may occur.
You can discuss with your attending physician whether a medication adjustment is necessary.
2.
Being in a state of physical and mental stress, having irregular routines, or experiencing environmental changes may all be related to the occurrence of thyroid diseases.
3.
You can consult a physician at a travel clinic.

Reply Date: 2019/08/26

More Info

Hello! Thank you for your questions regarding your thyroid levels and their potential impact on altitude sickness. Let’s break down your concerns one by one.

1. Why is TSH suddenly elevated while FT4 remains normal?
The thyroid-stimulating hormone (TSH) is produced by the pituitary gland and regulates the production of thyroid hormones (T3 and T4) by the thyroid gland. An elevated TSH level, especially when FT4 is normal, can indicate a condition known as subclinical hypothyroidism. This means that while your thyroid is still producing adequate amounts of T4, the pituitary gland is signaling for more thyroid hormone production due to perceived low levels. This can happen for several reasons, including changes in your body’s metabolism, stress, illness, or even changes in medication adherence or absorption. It’s essential to monitor this trend closely, as persistent high TSH levels could indicate a need for medication adjustment.

2. Connection between thyroid disease and altitude sickness:
Altitude sickness, or acute mountain sickness (AMS), occurs when you ascend to high altitudes too quickly, leading to reduced oxygen availability. Individuals with thyroid disorders may have altered metabolic responses, which could theoretically affect how your body acclimatizes to high altitudes. However, there is limited direct evidence linking thyroid function to altitude sickness. Generally, if your thyroid levels are stable and within normal ranges, you should not have an increased risk of altitude sickness solely due to your thyroid condition. However, it’s crucial to listen to your body and be aware of symptoms such as headaches, nausea, dizziness, or fatigue, which are common signs of AMS.

3. Medications to avoid for altitude sickness:
When it comes to preventing altitude sickness, acetazolamide (Diamox) is a commonly prescribed medication. However, if you have a history of thyroid issues, it’s essential to consult your healthcare provider before taking any new medications, including those for altitude sickness. While acetazolamide is generally safe, it can have side effects, and its interaction with other medications you may be taking for your thyroid condition should be evaluated. Additionally, some people may be sensitive to changes in their electrolyte balance, which can be affected by altitude and certain medications.

Additional Considerations:
- Monitoring: Since you have a history of hyperthyroidism and are now experiencing fluctuations in TSH, regular monitoring of your thyroid levels is crucial. Discuss with your endocrinologist about the best course of action, especially before your trip.

- Acclimatization: When traveling to high altitudes, it’s advisable to ascend gradually if possible, allowing your body time to acclimatize. Stay hydrated, avoid alcohol, and consider taking it easy for the first few days at altitude.

- Diet and Lifestyle: Maintaining a balanced diet rich in nutrients can support overall thyroid health. Avoiding excessive iodine intake and managing stress levels can also be beneficial.

In conclusion, while your thyroid condition may not directly impact your risk of altitude sickness, it’s essential to remain vigilant about your thyroid levels and consult with your healthcare provider regarding any travel plans and medications. Safe travels, and I hope you have a wonderful trip to South America!

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