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Extremely High TSH, Normal T4
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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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Extremely High TSH, Normal T4

Hi, I have been having some issues with kidney stones for a while.  My Urologist performed various procedures removing the stones and they would come back almost immediately.  Rather than keep removing them, we decided on trying to figure out why I was forming so many so often.  He did a PTH test along with a 24 hour urine collection.  Both came back normal, but my calcium level was a bit high.  He had me make an appointment with an Endocrinologist.  The Endocrinologist I'd like to see is booked for months, but I made an appointment anyway.

I visited my GP after having more pain in my kidneys along with blood in the urine.  When I told him I was scheduled for the Endocrinologist visit, he went ahead and ordered TSH, T4, and PTH tests on me to see if we could get my appointment moved up if anything was off.

My TSH came back abnormally high and he had me retested immediately.  The test again came back abnormally high.  My levels for my T4 (and PTH) are very normal.  He said with my TSH being so high, the T4 should be low and it simply didn't make sense.  I also have the opposite symptoms for someone with such a high TSH level, he said.  He is trying to schedule me for another Endocrinologist at the moment and seeing if there are any other tests he can run in the meantime.

My PTH is 31, my T4 came back as 7.1 and 6.8.  My TSH ... 160.

I also had an ER visit where my GFR levels came back low at 68 and I'm not sure if this has any connection to thyroid issues.

The kidney stones are still giving me problems and it seems that issue is now being overlooked because of how strange things going on with my thyroid are.  I'm hoping that whatever is done resolves the kidney stone problem, but I feel that I'm moving in the opposite direction of getting that fixed now.

What I'm hoping to find out is if there are any conditions that would cause such a high TSH and a normal T4 and is there any relation to kidney stones?

Thank you!
97953_tn?1193367871
Would retest TSH along with Free T4 as the Total T4 is oddly normal w/ TSH of 160. The PTH is normal, but this should always be measured along w/ Calcium (esp with history of stones).  Hypothyroidism may decrease GFR but is not likely to cause kidney stones.
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Thanks for the reply. I had more blood work done through my GP, who is relaying it back to the Endocrinologist.

I was tested for Human Anti-Mouse Antibody, which my doctor was told could cause the high TSH reading. The test showed >600 with the range being 0-188. I assume this means I have it, but we're waiting to hear back from the Endocrinologist on that. Another TSH test came back as 160 again.

Other tests that came back were Alpha Subunit (Free) and it tested high at 0.73. My LH was 0.2, FSH was 0.5, and Beta HCG (QN) was <1.

I think these were all being checked for possible connection to a pituitary problem, as the list of things the Endocrinologist suggested had MRI of the head as the next thing after blood work. However, we are waiting to hear back before that is done.

As much as I don't like the idea of something being wrong with something so close to the brain, it would be a relief to hear that one thing is causing things like my fatigue and headaches, possibly even the kidney stones.
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