Elevated FT4, Subnormal TSH

[koolnmohan]

Hi. I had been diagnosed with hypothyroidism about an year ago, and was on 50 mcg Thyroxine.
After feeling normal for several months, i began to feel worse again. Got new tests done, here are the results.

Normal total T3, and FT3

Total T4 is beyond the normal range, and so is FT4.

TSH is ultra low at 0.03 (minimum aac to lab should be 0.3)

My throat is swollen to the extent that it looks like a double chin.

Also, I have a family history of Thyroid problems. My mom has been hypo for years, and my sister was tested for ATG and AMA and they came out positive, so i guess it's autoimmune.

[Mark Lupo, M.D.]

Talk to your doctor about his/her recommendations.  We would usually ask you to stop the thyroid medication and recheck levels in 4 weeks.  You likely have a temporary inflammation/swelling of the thyroid with release of thyroid hormone, if there is neck pain or symptoms from the hyperthyroidism you may need medication for these symptoms, but in most cases this will resolve on its own and you will be back to usualy hypothyroidism (and back on meds) within 6-12 weeks.

The other possibility is new onset graves' disease, but usually the T3 would be high as well.

[koolnmohan]

The test results are :

Test                        Value                      Normal  Range
---------------------------------------------------------------------------------------

Total T3 -               96 ng/dL                  (60-200)
Total T4 -               12.70 ug/dL             (4.5-12.0)
TSH      -                0.03 uIU/ml             (0.30 - 5.5)
FT3       -                3.99 pg/ml              (1.7-4.2)
FT4       -                2.04ng/dl                (0.70-1.80)