Top of range T4

[Tabitha6]

A male friend of mine has a very high T4 result of 25 but no symptoms of hyperthyroidism such as palpitations, increased heart rate etc. He has no energy and is not showing any signs of being over medicated. He has a heart pacemaker following a heart attack several years ago when he was diagnosed with hypothyroidism. I have suggested he gets full blood tests done and he will be joining thyroid UK and this forum soon but in the meantime would be grateful for any thoughts? Thank you!

[Lalatoot]

Free T3 is the more important result. Too much or too little of it gives us our symptoms with ft4 taken into consideration. Maybe he needs ft4 at this level to give him enough ft3.

[Tabitha6 in reply to Lalatoot]

Thanks for your reply. He hopes to get blood results including T3 soon.

[SeasideSusie Remembering]

Tabitha6

If he has been diagnosed with hypothyroidism and is on Levothyroxine, then he can't possibly have hyperthyroidism, which you possibly already know. His high FT4 suggests either overmedication or the fact that he has autoimmune thyroid disease aka Hashimoto's which is where the immune system attacks and gradually destroys the thyroid. If this is the case then he could be going through a temporary"hyper" phase of Hashi's.

Best thing to do is get a full thyroid/vitamin panel:

TSH

FT4

FT3

Thyroid antibodies

Vit D

B12

Folate

Ferritin

I used to have way over range FT4 with a suppressed TSH but no signs of overmedication. Turns out I had poor conversion of T4 to T3, GP kept increasing my dose of Levo but not testing FT3, so I was having more and more Levo but still having symptoms of hypothyroidism.

[Tabitha6 in reply to SeasideSusie]

Thanks for your reply. Hopefully he will get blood results soon, including T3.

[Gilbo72]

My T4 has gone up to 36 (306%through range) and I feel great on it! My GPS hate it and always reduce my meds. On further investigations I have no sign of tremor, my heat beat is a steady 70bpm, and my T3 is only 40% through range. When they bring it down (about 106%) through range, my T3 drops to 0% through range (ie bottom of range) and I feel like pants. This is ongoing. I’m building up to insisting on a trial of T3....

[Tabitha6]

Thanks for your reply. Interesting that such a high T4 produces no tremor etc. I hope you are successful in getting a T3 trial. I have been unsuccessful unfortunately.

[Hoxo]

Read the paper Diogenes has mentioned recently. Explains about thyroid ranges while on Levothyroxine.

[Tabitha6]

Will do, thank you.