High tsh normal t4 and t3

[blossom5]

I was diagnosed hyper in September

Ft4 was 2.16 (0.7-1.85)

Ft3 was 4.95 (2.28-5.27)

tsh was 0.775 (0.490-4.670)

I recently did a blood test Saturday the results were:

Ft4 1.78 (0.71-1.85)

Ft3 3.26 (2.28-5.27)

Tsh 6.460 (0.490-4.670)

As you can see my latest results my tsh is very high while t3 and t4 is normal. Can anyone shed come light on this situation?

I'm seeing my endo next week but I'm curious if anyone has any idea why my tsh is so high

[greygoose]

Were the two tests both done at the same time of day? Had you eaten before either of them?

You weren't hyper in that first test. Your TSH wasn't suppressed, and your FT3 wasn't over-range. Your FT4 was over-range, but that's because you don't convert very well, not because you were hyper.

Anyway, you are now very much hypo. Your TSH is well over range, and your FT3 isn't even mid-range. But, your doctor will probably want to wait another three months and do another test. For the next test, make you your appointment is early in the morning - as near to 8 am as possible - and fast over-night. That will give you your TSH at it's highest.

[blossom5 in reply to greygoose]

First test was done in the evening, the one I did Saturday was done in the morning. I did not eat anything in the morning.

Doctor said my t4 was a little high in september and I did have symptoms such as weight loss, hair loss, heart palpitations, weakness, hand tremors and I did have some mood swings. I was put on carbimazole and since that the symptoms went away except for the hair loss and heart palpitations.

So this means I'll need to be on another set of meds? Thanks for replying

[greygoose in reply to blossom5]

It's not high T4 that makes you hyper - I explained why it was high, because you weren't converting it to T3. It's high FT3 that makes you hyper, along with a suppressed TSH. You had neither, so you were not hyper, and taking carbimazole was completely the wrong thing to do. It has made you hypo!

However, once you stop the carbimazole, your levels will probably go back to 'normal'. But, you will still have your conversion problem. So, taking the normal thyroid hormone replacement (NOT meds), called levothyroxine, probably won't work for you. But it's very doubtful that your endo will understand that. They don't usually know much about thyroid. If he had, he would never have put you on carbimazole!

As to your symptoms, they don't prove much because they could also be hypo symptoms. Even the weight loss. Some hypos do lose weight.

[humanbean in reply to greygoose]

I agree that greygoose's interpretation of your results is the most likely - you were never hyper and your results look a bit strange because they were done under very different conditions.

However, I just wanted to mention another possibility which may be related, which is that you may have high antibodies of the TPOAb type and/or the TgAb type. See the table on this page :

labtestsonline.org.uk/under...

Antibodies destroy your thyroid, one cell at a time. As the cells are killed off they dump their hormone load into the body and bloodstream. This release of thyroid hormone can change thyroid function test results, and could make Free T4 and Free T3 higher than expected, and this makes the TSH lower.

People with autoimmune hypothyroidism (i.e. have loads of antibodies) - otherwise known as Hashimoto's Thyroiditis - can have major swings from hypo to hyper and back again particularly in the early days, but inevitably they become permanently hypothyroid eventually as the thyroid is slowly destroyed. (It could take many years.)

If you have an antibody attack it can make you appear to be hyper or almost hyper in both symptoms and tests for a while. But you may go back to being hypo very quickly. Your doctor putting you on carbimazole may have just speeded up the process.

Your best best would be to find out if you have high thyroid antibodies. If you do then you would be best to try and reduce them. There are various things people can do to help themselves with this, but I'm not an expert - I don't have autoimmune hypothyroidism. You should ask for help on this if you know you have Hashi's.

[blossom5 in reply to humanbean]

I did a thyroid ultrasound saturday and everything looked normal. I did thyroid receptor antibodies which came back 1.60 (>1.8 TO <2.0 IU/L Borderline >2.0 IU/L: Positive)

I guess I'll just see what my endo says next week, confused about all this. Thanks for your help.

[humanbean in reply to blossom5]

Thyroid receptor antibodies are tested when Graves' Disease is suspected (hyperthyroidism). You aren't positive for this particular type of antibodies. You really need the other types of antibody tested as well.

Do you live in the UK? Based on the reference ranges you've quoted I think you must live elsewhere. But if I'm wrong you can get a full thyroid function test and basic minerals and vitamins tested privately here in the UK without the involvement of a doctor.

[blossom5 in reply to humanbean]

I live in the Caribbean. But I shall speak with my endo about all of this next week when I see him. As for now I'll stop the carbimazole