High TSH but normal T4?
Hi,
My husband had thyroid test done by his GP
TSH 5.9 (0.27-4.2)
T4 17.9 (12-22)
T3 wasn't done. The GP said they will keep an eye on it but didn't give him any medication. He is very tired all the time. I want him to go back and ask for medication as I'm sure he is hypo. Just want to ask why is T4 in a healthy range while TSH so high? Any thoughts?
Thank you
He needs to get both thyroid antibodies checked so he can exclude autoimmune thyroiditis, companies like Medichecks and Blue Horizon offer postal finger-prick tests which are reliable. The antibody tests should include Free T3 as well.
I have the same results as your husband but my antibodies are normal. A private endocrinologist told me it was likely to be subacute/transient thyroiditis which is thought to be caused by a temporary viral or bacterial illness. He said the thyroid results will sometimes return to normal after the body fights off the illness. He said some people do remain hypothyroid permanently and they are welcome to try levothyroxine medication to see if they feel better.
My NHS GP was confused as my TSH was 6.3 but Free T4 appeared normal. He has referred me to an NHS endocrinologist who I have yet to see. When I finally see the NHS endocrinologist, I am going to ask to trial levothyroxine.
If I can give you some further advice, only have the thyroid bloods tested in the morning around 8 or 9 am, that is when the TSH is highest. In the afternoon, TSH drops quite a bit and your husband's results would probably be within range at that point.
Unfortunately for me, I had a private doctor pressured me to have blood taken after a consultation at 7:30 PM, my TSH had dropped to 3.1 and he recommended against treatment based on that result.
EDIT:
Regarding your husband's situation, you need to ask the GP how long he intends to monitor the thyroid for before accepting that your husband is hypothyroid. I've heard that GP's like to see an elevated TSH over a 6 month period before they'll treat it. Their concern is the TSH may be the result of a temporary illness.
She did the test back in March this year. He goes to see her regularly to check up on his blood pressure but she hasn't repeated the test since March. I'm going to get medichecks thyroid test and see if anything comes up with T3 or antibodies and if it does will send him back to her with the results. Thank you for your reply. I didn't know TSH can get high temporarily - interesting.
Get him to ask for regular NHS thyroid tests, say every three months. Booked well in advance, it should be easy to get an appointment at the same time (earlyish in the morning), each time.
Remember the blood tests has to be at the very earliest possible, fasting (he can drink water) and if he was on levo he'd allow a gap of 24 hours between last dose and test.
TSH is highest earliest a.m. and drops throughout the day which could mean the difference between being diagnosed or not.
Raised blood pressure can be a Hypo symptom. Also test B12 - folate - Ferritin - VitD - all are often low when hypo and can make you feel rotten.
In other countries we would be diagnosed if TSH was over 3 but in the UK, the criteria is that the TSH has to reach 10. I think whoever thought up this number must have been suffering with hypo as it just doesn't make sense, especially when your husband's TSH is above the top range.
good dr bec he is right.....
Tsh normal high t3 and t4
normal TSH high Free T4
Low TSH High T3 Normal T4 Total Thyroidectomy
High tsh and high t4 - help!
Could be a conversion problem - low T3. Were his antibodies tested?
No antibodies test. Just the t4. I'm going to buy Medichecks test and get him tested and see what comes up. Thank you.
Yes, that's best.