Normal TSH High T4 Free?

tdog333

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I just got a few tests back, first ever thyroid test done, here are the results:
Thyroid
TSH Result: 2.200 Reference range: 0.450-4.500 uIU/mL

T4,Free(Direct) Result: 1.88 Reference Range: 0.82-1.77 ng/dl

Liver
Ast(sgot) Result:41 Reference Range 0-40
Alt(sgpt) result:78 Reference Range 0-44

Everything else seems pretty okay.

My Calcium Serum was 10.5 which is apparently a bit high as well, I've heard this correlated with hyperthyroid.

I've done some googling but it seems that normal TSH and high T4 is a bit more rare. I'm getting more testing done this tuesday, probably t3 I'm guessing.

I think for graves or hashimoto's TSH is very low, which is not the case for me.

I have all the symptoms of hyperthyroid except hair falling out, I have random adrenaline rushes, anxiety, high temperature(normally around 99.0F), I'm always either really hot or really cold, never quite right. Rapid heart beat, random irritability, unstable bowl habits, low weight, inability to gain weight, fatigue, muscle weakness. My voice also gets raspy fast and it hurts to talk after a few minutes of conversation. My throat feels a bit sore to the touch where my thyroid is located.

Does anyone have any input? I'm not very knowledgeable about thyroid ranges. Any help is great!
 

vamah

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I think most people who know a lot about this (not me, I'm just borrowing from others) consider a tsh above 2 to be high, even though up to 4 or 5 is usually given as a reference range. There is a site called stopthethyroidmadness that explains well what it means to have some of your thyroid results normal and others not. I have used them to try to figure my own test results out (tsh 1.45 - very normal, but t3 and t4 low). They also have views on what constitutes "normal" results that are different than your doctor may tell you.
 

Ema

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Panel 7 and the section
"Normal or raised TSH, raised free T4 or T3"
in this paper may be of some help...

http://www.iccidd.org/cm_data/2001_Dayan_Interpretation_of_thyroid_function_tests_Lancet.pdf

Basically, I would want to know my FT3 as well to know if it is also high.

I would also want to have my thyroid antibodies (particularly anti-TPO) measured, sex hormone binding globulin and an MRI scan of the pituitary to rule out a TSH secreting tumor. The latter, while almost 100% benign, seems unlikely though because your TSH is not particularly elevated (though higher than optimal).

If I had to guess, I would probably go for antibody interference but it's best checked out by a specialist.
 

barbc56

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I just had my TSH tested and the normal range was 0.358 - 3.740 mcIU/mL.

Don't know if this would make a difference or not when you look at the TSH combined with the T4 results.

Barb

Also had the following tests:

AST 15 - 37 U/L

ALT 12 - 78 U/L

Do different labs have different ranges?
 
Last edited:

tdog333

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I think most people who know a lot about this (not me, I'm just borrowing from others) consider a tsh above 2 to be high, even though up to 4 or 5 is usually given as a reference range. There is a site called stopthethyroidmadness that explains well what it means to have some of your thyroid results normal and others not. I have used them to try to figure my own test results out (tsh 1.45 - very normal, but t3 and t4 low). They also have views on what constitutes "normal" results that are different than your doctor may tell you.
@vamah Thanks, I am looking at that site now, it has some great info! I figured the ranges were a bit off, labs are constantly updating optimal ranges and still don't get it right most of the time.


Panel 7 and the section
"Normal or raised TSH, raised free T4 or T3"
in this paper may be of some help...

http://www.iccidd.org/cm_data/2001_Dayan_Interpretation_of_thyroid_function_tests_Lancet.pdf

Basically, I would want to know my FT3 as well to know if it is also high.

I would also want to have my thyroid antibodies (particularly anti-TPO) measured, sex hormone binding globulin and an MRI scan of the pituitary to rule out a TSH secreting tumor. The latter, while almost 100% benign, seems unlikely though because your TSH is not particularly elevated (though higher than optimal).

If I had to guess, I would probably go for antibody interference but it's best checked out by a specialist.
@Ema Thanks! Yeah I'm gonna make sure I get more tests for it. Do you think I would receive any benefit from taking some sort of thyroid blocker? There are a few herbs I want to try before any prescription stuff that do the same thing with less side effects. I'm really just hoping I can get some energy back, gain weight, and cut back on some anxiety.

I just had my TSH tested and the normal range was 0.358 - 3.740 mcIU/mL.

Don't know if this would make a difference or not when you look at the TSH combined with the T4 results.

Barb

Also had the following tests:

AST 15 - 37 U/L

ALT 12 - 78 U/L

Do different labs have different ranges?
@barbc56 My AST and ALT were measured in IU/L which is the international measurement, I'm not sure how the reference ranges compare to U/L since U simply means "units" and varies nationally.
 

xks201

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Possible t4- t3 conversion problem. You should always also get free t3 as well. No idea why this doc just ordered free T4, lmao.
 

tdog333

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@xks201 I asked him for a T3 free my next appt. and got the results back- They were a 3.0.

Triiodothyronine,Free,Serum3.0 Range:2.0-4.4

I got a ultrasound on my thyroid a couple days ago too, no results yet
 

Ema

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@xks201 I asked him for a T3 free my next appt. and got the results back- They were a 3.0.

Triiodothyronine,Free,Serum3.0 Range:2.0-4.4

I got a ultrasound on my thyroid a couple days ago too, no results yet
I'd be hesitant to take thyroid blockers since your FT3 is on the lower side of optimal. It does look more like a conversion issue, which also makes sense considering your liver enzymes are high. I might look into that more...
 

xks201

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Your TSH is normal at 2.2......why would you need a thyroid blocker? What am i missing here? Lol
 

tdog333

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My T4 is highish, I have lots of hyperthyroid symptoms. My voice gets raspy and hurts to talk. I got my ultrasound results back, it said this:

Thyroid dimensions are within normal limits. The right lobe measures 4.9
x 1.1 x 1.7 cm. The left lobe measures 4.6 x 1.3 x 1.6 cm. There are too
numerous to count small colloid cysts throughout both thyroid measuring
2-4 mm in diameter.
IMPRESSION: Too numerous to count small colloid cysts throughout both
thyroid without discrete solid nodules
Not really sure what to think...