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
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.
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
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.
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
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?
Can anyone help then on why both T4 and TSH could be high, currently don’t take anything and haven’t been diagnosed
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.
Thank you for replying. Ok so it’s normal for me to have high TSH and T4 then?
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.
Raised hormone levels 
TSH LEVEL IN 10 YEAR OLD, NO OTHER HORMONES TESTED! HELP!
Advice - Pituitary and Sex Hormone Levels
“Will be based on TSH and I would not use free hormone levels in primary hypothyroidism”
T3 levels and thyroid hormone signaling
