Thyroid results - very high TSH, slightly high T4

[Uknmy]

Has anyone had this?

 

[pattismith]

when T4 is high, TSH is supposed to be low, so there is something wrong with these results.
What does your endocrinologist says about it?
Do you have hyperthyroidism symptoms (hot feeling, sweating, palpitations…), or do you have hypothyroidism sign?

 

[pattismith]

the first syndrome it make me think about is "impaired sensitivity to thyroid hormons",
it can result from defect in thyroid hormon transporters, thyroid hormon receptors...
The second syndrome that I think about is auto antibodies against thyroid hormones (anti thyroxine antibodies).

These anti thyroid hormone antibodies are well known to interfer with thyroid testing and produce discrepancy in the lab test results:
"The six main types of interference known to affect measurements of thyroid stimulating hormone (TSH), free thyroxine (T4) and free triiodothyronine (T3):
-macro-TSH,
-biotin,
-antistreptavidin antibodies,
-anti-ruthenium antibodies,
-thyroid hormone autoantibodies,
-and heterophilic antibodies.

https://academic.oup.com/edrv/article-abstract/39/5/830/5048350?redirectedFrom=fulltext
https://www.uptodate.com/contents/impaired-sensitivity-to-thyroid-hormone

 

[Pyrrhus]

This is commonly found in the case of pituitary adenomas. Basically, your thyroid is fine, but the pituitary gland has a abnormal growth of the cells that produce TSH, and the result is too much TSH.

There are other explanations as well, such as the ones that @pattismith mentioned.

 

[Uknmy]

I should note, that I have had a thyroidectomy.

My endocrinologist thinks that heterophile antibodies are interfering with the TSH test. I have wondered about pituitary gland tumours, but this has not been investigated.