Thyroid Cancer / Nodules & Hyperthyroidism Expert Forum
Can you have hyperthyroidism with normal TSH and T4(Free) results?
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Questions in the Thyroid forum are answered by Mark Lupo, MD. Topics covered include Goiter, Graves Disease, Hyperthyroid, Parathyroid/Calcium Problems, Thyroid Cancer, Thyroid Nodules/Cysts, Thyroiditis, Thyroid & Pregnancy, Thyroid Stimulating Hormone (TSH), Thyroid Tests, and Thyroid Surgery.

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Can you have hyperthyroidism with normal TSH and T4(Free) results?

Hello, for the past year and a half I have been experiencing numerous symptoms of hyperthyroidism that came out of nowhere.  I had anxiety issues 10 years ago and it felt like they all came back 10-fold, but I have not been anxious about a thing.  I saw a therapist for a while and she said she was certain there is something physically wrong with me, as my symptoms don't seem to be triggered by anything. Since July of 2012, I have been so hot, to the point that just taking out the trash or doing very light housework makes me feel like I'm going to be sick.  I have also had tremors since this time, as well as anxiety, insomnia, sweaty hands, and recently heart palpitations.  The heart palpitations and tremors have been really bad lately. Today I was so shaky and my heart was pounding so hard that I went to urgent care and was tested for hyperthyroidism.  I have had so much blood work done in the past several months, all of which has been normal.  (I don't have diabetes or hypoglycemia.)  I had my gallbladder removed last month and as I have still been having a lot of nausea and pain, my surgeon did a liver function test.  My ALK PHOS was slightly elevated (though I am obese), as well as my MPV.  I've read that one cause of both of those levels being elevated is hyperthyroidism.  I'm wondering if it is possible to still have an overactive thyroid with normal test results.  Here are my historical values:  

TSH:           4/27/2013 = 1.45     10/25//2012 = 2.16                               5/16/2012 = 1.10       9/7/2010 = 2.14

T4-FREE:   4/27/2013 = 1.1       10/25/2012  = No Test Performed        5/16/2012 = 1.1        9/7/2010 = 1.01
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I should add that while I do have anxiety issues, the way I have been feeling the past several months is not how I feel when I have anxiety.  I don't feel anxious or nervous at all.
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are we related. I have dealt with anxiety and pow out of nowhere in August of last year, I went Hyper, after seven years of being Hypo. I am now being treated for hashis and the anxiety had subsided but the last three days my endo put me back on synthroid which they took me off of in September. Now after three days I am back to Anxiety at a 10
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