High TSH (which keeps rising over the years) and consistently high T4 for 7 years with no major symptoms.

[kev269]

Hi,

Over the last 7 years, my TSH has kept rising from around 5.88 and now it is at 11.9. My T4 has stayed consistently high at between 19 and 20 throughout this time. My antibodies test are normal with nearly non-existent antibodies and my T3 was normal in the middle of the range. All my other blood tests have always been fine, such as Vitamin D and B12, folate, ferritin.

I've never had any symptoms throughout the 7 years and I still don't. No gut issues or intolerance. However, I have had a couple of skin conditions like baldness on my lower legs that started more than 7 years ago which I still have today, but I don't know if that is 100% to do with the thyroid.

I am confused with my blood test results because high TSH is always talked about with a low or normal T4 level, but my T4 is always on the high side.

I did also check my iodine levels and it was very low. I started taking sea kelp about a year ago and raised my iodine level a good amount, but the TSH has still risen after my blood test last week.

Do you know what could be going on here? Could it be something to do with heavy metal toxicity because I spend my whole day in a dusty bedroom with a laptop on all day for the last 7 years working from home. I clean the room but it still gets easily dusty and I also sleep in this room... My brother also spends most of his time in the same room as me and he has also has seen exactly the same thing happen to him, but instead his TSH has risen more slowly compared to mine and is at 7.99 TSH with 19.4 T4. He also has no symptoms. This is why I'm suspecting an environmental cause in this. Both of us also have no other health condition and take no medications.

I also want to add that when we had our blood test 4 years ago, our FSH (Follicle stimulating hormone) was a little bit strange. Mine was on the very low side inside the range and his was slightly outside above the top of the range and so I wonder whether there is something going on with the pituitary gland communication with our hormones. Other hormones were fine.

Thanks for your help!

[FallingInReverse]

You will get more comprehensive answers, I will just share my experience and understanding.

First - increasing TSH and “normal” FT4 is the definition of subclinical hypothyroidism.

That term is often used incorrectly, so that can be confusing.

Also, typically subclinical does not present with symptoms early on (but not always). And it can be seen to stay the sane for a long time, or it progresses to low Free Ts and symptoms.

My experience, as with many here, only in retrospect do we connect the dots confidently between symptoms at stages like your (where most of us didn’t have the benefit of TSH results nor the discernment to understand them).

My earliest symptoms 8 years before diagnosis- rosacea, and a slight halo of short hairs on my head (early minor hair loss which was growing back.) I know these were caused/triggered by my low thyroid even though I have no relevant blood tests from so long ago because they cleared up as I started Levo 18 months ago.

[jimh111]

I'd be tempted to do nothing as long as you feel OK. It could be genetic or environmental. This recent paper by Carla Moran might be helpfuldoi.org/10.1210/clinem/dgad681 .

[greygoose]

If your FT4 is high/top of the range, and your FT3 middle of the range, that would suggest you have a problem converting T4 to T3.

I am confused with my blood test results because high TSH is always talked about with a low or normal T4 level, but my T4 is always on the high side.

But your FT3 isn't. And that affects the TSH too.

I did also check my iodine levels and it was very low. I started taking sea kelp about a year ago and raised my iodine level a good amount, but the TSH has still risen after my blood test last week.

If your thyroid is failing, no amount of iodine is going to make is work again. It doesn't work like that. Iodine is just one ingredient of thyroid hormone, it doesn't have any effect on how the thyroid works, and would therefore have no effect on the TSH.

And quite apart from that, self-treating with iodine is not a good idea. Excess iodine can make things worse because it is anti-thyroid. And there are protocols to be set up. You need an experienced practitioner for that.

[kev269 in reply to greygoose]

Hi, my T3 was 5.38 to be exact. As you probably know already, they won't test it on the NHS so I was unable to have it tested again last week.

At the time of my T3 test 4 years ago with Medichecks, I never focused on having selenium, but I have been in the last couple of years so it could be that my T3 has risen a bit more these days.

Or it could be that because of toxins, mercury, heavy metals, pesticides etc. that I'm not converting enough of my T4 to T3 while the TSH increases, which I explained in my original post why I believe it could be to do with heavy metals toxicity.

[greygoose in reply to kev269]

OK, so we can't really deduce anything much with any certitude from this latest test as FT3 wasn't tested. Perhaps it's time you did another Medichecks test?

[kev269 in reply to greygoose]

Yes I definitely will get the FT3 tested again, but assuming it came back with an average FT3 number again (or even a lower number) and I still have a high FT4 and a high TSH and I still have no symptoms, do you have any idea of what the treatment would be for this? My initial thought is that to prescribe levothyroxine to me wouldn't solve the issue?

In contrast, if my FT3 rises to the high end of the range and FT4 stays high also, should that make the TSH drop back to normal?

Thank you very much for your help,

[greygoose in reply to kev269]

assuming it came back with an average FT3 number again (or even a lower number) and I still have a high FT4 and a high TSH and I still have no symptoms, do you have any idea of what the treatment would be for this?

If you have no symptoms, why would you want treatment? What you would need is further investigation.

There are several possible explanations for these results:

- TSH and/or FT4 are high due to laboratory error. It happens.

- TSH could be high due to anti-TSH antibodies. To find that out you would need to be retested in a different lab that uses different testing methods.

- or it could be due to a pituitary problem - in which case, your FT3 could be on the high-side because the thyroid is getting too much stimulation. You would need to have your pituitary checked out with a scan and testing other pituitary hormones.

- TSH is high due to low FT3 - the question then would be why is your FT4 so high? You would need TPO and Tg antibodies, TRAB and TSI tested to see if it's an autoimmune problem - which is a possiblity.

But, in any case, TSH does not cause symptoms whether it's high or low.

[jimh111 in reply to greygoose]

When fT4 goes higher type-2 deiodinase (T4 - > T3) is reduced. This is to protect against hyperthyroidism.

[greygoose in reply to jimh111]

You're telling me that?

[SlowDragon Ambassador]

Look at testing cholesterol

High cholesterol linked to being hypothyroid

Also testing kidney function

Low GFR linked to low thyroid hormone

And testing testosterone too

All my other blood tests have always been fine, such as Vitamin D and B12, folate, ferritin.

please add actual results

consider getting outside more

Try working in the garden or at a cafe or somewhere else for a change of scene

And some exercise, especially out in the sunshine

[kev269 in reply to SlowDragon]

Cholesterol - 4.7

Vitamin D - 91

Vitamin B12 - 550

Folate - 6.9

Ferritin - 250

Testosterone was an average number.

I also had my liver and kidney checked and the doctor said they were normal, but I don't have the actual results yet.

[SlowDragon Ambassador in reply to kev269]

Do you supplement any vitamins or are these on no supplements?

Folate could be better

[kev269 in reply to SlowDragon]

Hi,

I take iGennus Super B-Complex, but only 1 tablet per week just to keep my levels topped up.

[SlowDragon Ambassador in reply to kev269]

Perhaps look at increasing to 3-5 days per week

IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before ALL BLOOD TESTS , as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

In week before blood test, when you stop vitamin B complex, you might want to consider taking a separate folate supplement (eg Jarrow methyl folate 400mcg)

Post discussing how biotin can affect test results

healthunlocked.com/thyroidu...

helvella.blogspot.com/p/hel...

[kev269 in reply to SlowDragon]

Thanks, I had stopped taking the vitamin b complex 2 weeks before I had my blood test. I don't think it has anything to do with my latest results because when I had my previous blood tests, I was never taking any supplements.

[SlowDragon Ambassador in reply to kev269]

Suggest you get bloods retested via different lab and testing kit to rule out anti mouse antibodies

pubmed.ncbi.nlm.nih.gov/232...

academic.oup.com/clinchem/a...

ncbi.nlm.nih.gov/pmc/articl....

[janeroar in reply to SlowDragon]

What a coincidence. A friend told me yesterday this had happened to them; they had been infected by rodent antibodies which affected their thyroid test. Never heard of that before!

[jimh111]

It's possible you have a genetic mutation of thyroid hormone receptors causing a resistance to thyroid hormone (RTH) or some form of endocrine disruption. If this is the case your body is self correcting by secreting more TSH. It could also be that the TSH assay is giving incorrect results.Whatever it is you are currently clinically euthyroid so there's no need to do anything. The Moran paper although very technical covers all known possibilities other than endocrine disruption. If you are seeing an endocrinologist you could give them a copy of the paper.

[Den_And]

Having high TSH and high T4 levels may indicate that you have an issue with your pituitary gland that’s causing it to release too much TSH, and thus triggering your thyroid to make excess T4. Extremely rare result combination but ……….

[kiefer]

From what this article below mentions, if you increase your iodine intake sufficiently, the result will be an increase in the TSH and FT4 levels. This might explain the rather unusual results you're seeing.

"After improved iodine intake, TSH levels, as well as fT4 values and TPO-Ab, were found to be increased."

"Better iodine nutrition obviously requires higher normal TSH levels to maintain a certain thyroid hormone secretion—because of the smaller thyroid volume and the decreased sensitivity of the gland to TSH."

The fact that a higher iodine intake (measured by urinary iodine excretion) is associated with a shift in TSH toward higher levels has already been observed in several epidemiological studies in adults."

ncbi.nlm.nih.gov/pmc/articl...

[kev269]

Just wanted to give an update on this post...

I decided to do a heavy metals test and there is one metal which came back high and that was Arsenic. I was 39ug, but I should be <15ug. All other metals were quite low, for example, my lead was 0.5ug, and I should be <10ug.

I did mention in my original post about me and my brother being exposed to the laptops all day long in a small room without much ventilation and it seems to me like this could be the cause of our issues. Gallium arsenide is highly used along with silicon in semiconductor in laptops (and is actually overtaking the use of silicon) and arsenic is a known endocrine disruptor.