High T4 normal TSH: Hi I do not have results to... - Thyroid UK

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High T4 normal TSH

Orangepie1 profile image
8 Replies

Hi

I do not have results to hand but will request next week. What does it mean when T4 is high/elevated and TSH is normal within range . This is what the GP told me will discuss next week with her. But in meantime please ease my worried mind. I am on levothyroxine originally with hypothyroidism and celiac.

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Orangepie1
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8 Replies
m7-cola profile image
m7-cola

Yes, get the figures and post them here. The main question to ask yourself is ‘how do you feel?’ Are you taking Levothyroxine? If so what dose?

Orangepie1 profile image
Orangepie1 in reply tom7-cola

I feel well only thing is my hair is falling out. Also I'm

More worried about what it will do to the pregnancy as I'm only 6-7 weeks . Obviously will discuss next week with gp. I'm on 75 mg Levo.

SeasideSusie profile image
SeasideSusieRemembering

Orangepie1

There's nothing really we can add to Shaw's reply to you in this post from 4 days ago

healthunlocked.com/thyroidu...

If I were you I'd pop along to the surgery and pick up a printed copy of your results from the reception desk. This way you can post on the forum and get comments before seeing your GP and you may well be in a position to discuss what you GP might want to do (as in maybe lower your dose of Levo, etc).

Orangepie1 profile image
Orangepie1 in reply toSeasideSusie

The thing is I'll be doing that tomorrow anyway , but thought it mean hyperthyroidism or something but okay if there's nothing to add I'll wait until tomorrow .

SeasideSusie profile image
SeasideSusieRemembering in reply toOrangepie1

If you have a diagnosis of hypothyroidism and are on Levo, you can't then be hyperthyroid, it's a physical impossibility. You can, of course, be overmedicated, but your TSH would be suppressed with an over range FT4, but to be absolutely sure you'd need FT3 testing at the same time as FT4 and TSH, it's FT3 over range that tells us we're overmedicated.

Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine (the magazine for doctors):

"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l. In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l. Most patients will feel well in that circumstance. But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l. This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l).*"

*He recently confirmed, during a public meeting, that this applies to Free T3 as well as Total T3.

If you would like a copy of the article you can email Dionne at ThyroidUK, it's question 6 that deals with this

tukadmin@thyroiduk.org

Orangepie1 profile image
Orangepie1 in reply toSeasideSusie

Perfect thanks this is what I'm looking for ! I'll post results tomorrow !

greygoose profile image
greygoose

Very often when that happens, it means that you aren't converting very well. Do you know if they tested your FT3? Because if they don't test the FT4 and FT3 at the same time, it's impossible to tell how well you convert. :)

Orangepie1 profile image
Orangepie1

They didn't test t3 :( just got my results will post

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