Thyroid Cancer / Nodules & Hyperthyroidism Expert Forum
High TSH, Normal Free T4, Lots of symptoms
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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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High TSH, Normal Free T4, Lots of symptoms

Today I am feeling a little frustrated.  I have been feeling ill for quite some time by the last two weeks have been progressively worse.  When I check the hypothyroid symptom lists I can put a check to almost all of them.  I have had a positive ANA a few times and because of that for a long time I thought perhaps it was auto-immune related.  Last week I had a TSH test which was 8.45 (normal .3 - 3).  The doctor said she thought for sure I was hypo and ordered the Free T4 test and another TSH.  I got the results back today and the TSH went up to 12.24 but the Free T4 was 15 (9-23 is normal).  Doctor examined my thyroid and said it was enlarged on the right side.  He then proceeded to tell me that he didn't think it was hypo and that he thought my symptoms pointed to auto-immune but did not feel as though Hashimotos was a possibility and refused to test for it.  He said the fact that my Free T4 was normal indicated it was not Hypo or Hashimotos.  I've been referred to a Endocrinologist but that could take months.  Every day I've been feeling worse and worse.  I'm not sure what to do.  Also 3 years ago my TSH was 4.45 and that was thought to be normal at the time.  Are there other reasons for an elevated TSH that don't have to do with hypo?
97953_tn?1193367871
This sounds like Hashimoto's thyroiditis with early subclinical hypothyroidism which may be causing symptoms.  In these cases usually we confirm with thyroid antibodies and offer a trial of levothyroxine.
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