Hormone levels

[JoshRH]

Can someone help me? I don’t get why both my TSH and T4 are both quite high, my most recent tests were

TSH 4.52 range 0.2/4.2

T4 19.4 range 12/22

I know my T4 is still in range but I thought T4 had to be low and TSH high in order to have hypothyroidism, could someone help me with this thanks

[dang]

Are you on Levo only, what’s your dose? I had this issue with Levo, with tsh around 3.5 my ft4 would be 24 or higher (always over range). I didn’t convert well. If you’re not converting T4 to T3 then it pools in the blood leaving you with higher ft4.

How do you feel in general? I can tell you from experience even with ft4 over range I still felt rather hypo. FT3 will dictate much more how euthyroid you are rather than FT4.

The addition of T3 should help bring down your FT4 and TSH.

[JoshRH in reply to dang]

Thanks for replying, I’m currently not on any medication and haven’t being diagnosed yet, but they said there monitoring it, so that’s why I’m confused cos TSH is over range most the time and T4 is within range but still high, could this just be stress

[dang in reply to JoshRH]

Ah ok, sorry I had assumed you were on medication. In that case you can completely disregard my previous reply.

T4 doesn’t necessarily have to be low for you to be diagnosed hypo, it’s TSH that first goes up, in the meantime your thyroid will just struggle harder while being able to keep up your hormone levels for some time. Have you been tested for antibodies too?

Here are my results from diagnosis (for reference) tsh 19.32 (0.27 - 4.20) ft3 3.24 (2.0 - 4.4) ft4 1.11 (0.93 - 1.7). So as you can see even tho my tsh was quite high, my ft3 and ft4 results were rather “good”. However clinically speaking I had a lot of symptoms and my thyroid was really on its last push to keep up.

[JoshRH in reply to dang]

Ahh okay thank you, so you don’t think my kind of higher levels of T4 will be affecting me? My TSH is far lower than yours, could mine just be stress do you think, cos that’s what the doctors think, but they said they are monitoring my hormone levels

[dang in reply to JoshRH]

It’s really hard to say. I could only speculate. The one thing I would definitely recommend is getting doctors to test for antibodies to rule out auto-immune thyroiditis. Doctors sometimes don’t do that test but it’s one of the most common causes of hypothyroidism.

Do you have symptoms otherwise?

[greygoose in reply to dang]

It doesn't just 'pool in the blood', it's either excreted or converted to rT3.

[dang in reply to greygoose]

Very true!

[JoshRH]

Can anyone help then on why both T4 and TSH could be high, currently don’t take anything and haven’t been diagnosed

[helvella in reply to JoshRH]

JoshRH,

High TSH could cause high FT4. For example, if your pituitary is pumping out too much TSH that then stimulates your thyroid into pumping out too much T4. This could be due to a tiny tumour in the pituitary or "pituitary resistance to thyroid hormone".

The tests could be suffering from interference. There are several reasons tests can display anomalous results including: antibodies to TSH and consuming high dose biotin.

Hypothyroidism has several definitions but the overall issue is that your cells are not receiving sufficient thyroid hormone. Your blood test results are just indicators.

[JoshRH in reply to helvella]

Thank you for replying. Ok so it’s normal for me to have high TSH and T4 then?

[helvella in reply to JoshRH]

JoshRH,

Giving a definite answer is impossible on the limited information. It would be unusual for someone to have an out-of-range high TSH and regard that as "normal".

(Even allowing that your "normal" could be significantly different to the "normal" of most other people.)

I was trying to let you know that there are reasons for high TSH and high FT4 at the same time. Not that your FT4 is that high, it is still in range.

[JoshRH in reply to helvella]

Yeah I’ve still not been diagnosed yet they said there monitoring it, obviously waiting until my TSH reaches 6 I think