Normal TSH but low T4


Hope someone can give me some advice after receiving some blood results back today of TSH 1.01 (normal range 0.27 - 4.2) and T4 free 12.3 (normal range 12.0 - 22.0)

To give you some background - 2 years ago I went to the G.P with symptoms of hypothyroidism. She did blood tests, said they were normal and put me on anti depressants even though I wasn't sure I needed them.

My symptoms, (constipation, fatigue, dry skin, feeling cold etc ) continued so I visited a naturopath who asked to look at the blood results. He told me that only the TSH had been done. In the meantime I had been back to the GP with the same symptoms as originally and she told me to eat more fibre!

After seeing the naturopath I asked the GP to do a T4 test and she refused. So last week I paid for one and the results were as above.

Does this indicate secondary/tertiary hypothyroidism? I should add the symptoms haven't gone anywhere.

I have a 3 year old and a 5 year old and I am wondering if a problem could have been triggered by the birth of my second child. I didn't notice the tiredness straight away after having her obviously because after having a baby you are tired for several months anyway!

I have an appointment to see the doctor (a different one) next week. Any advice?

Thanks in advance,


5 Replies

Did you lose a lot of blood with the birth of either child? Blood loss can cause pituitary dysfunction. If your pituitary isn't working well, your TSH will be lower than it should be therefore producing a lower level of T4.

The bottom line is that your T4 is much lower than it should be. It's barely within the reference range which does suggest something is wrong. You would expect your TSH to be higher with such a low T4 which leads me to suspect secondary hypothyroidism. This is even more likely if you have experienced heavy blood loss.

I'm afraid I can't really advise what to ask your doctor but you might want to ask for a referral given that your blood results, although normal, are not exactly typical.

I hope you get somewhere with this.

Carolyn x

Hi Carolyn,

Thank you very much for your reply. As far as I am aware I didn't lose a lot of blood during either birth, at least no one told me I did. I did seem to lose quite a lot of blood in the days following the birth of my eldest but I'm not sure what is a 'normal' amount so its hard to say.

I went to the GP this morning with my blood results indicating the normal TSH but low T4. Initially he was dismissive and said the T4 was normal (12.3 with normal range of 12-22). I had to push and say that they were only just normal and asked about secondary hypothyroidism.

Once I had mentioned this he agreed to do further blood tests and test for FSH too. (I mentioned my cycles were getting lengthier and I hadn't been able to conceive after trying for a year - but had put both these things down to age - I'm 39)

It seems I will have to be a little pushy to get to the bottom of this! My blood tests are next week so will let you know!

Again, I appreciate your time in responding.


Hi Claire just wondered if you got anywhere with this? I have very similar results and also experienced problems with my periods, but Drs telling me can't be my thyroid as results are all within range.

No I didn't! But I've had more tests since (through an online company) and now my T4 is even lower, at 11. I also have low B12, a count of 234 but again the GP says I don't need treatment as I'm within the reference range (just) . This is despite my hair falling out quite badly and having dizzy spells that are bad enough to leave me unable to drive/work at times. I've given up with docs to be honest and ordered some B12 jabs to do myself. Drastic but it seems from looking on here several people do it and I feel I've been left no choice. Good luck!

Hi my tsh is 1.01 and t4free is 1.1 I have been having symptoms of thyroid problems too but my doc said my levels are normal.

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