Asymptomatic 48 yo male caucasion. Routine H&P. TSH results .003. Other labs WNL. Retest five days later TSH .01, Free T-4 0.81 (low normal) and Free Triiodothyronine 3.1 (normal). What are your thoughts? What are my concerns? What should I do next? Am I looking at Pituitary or Thyroid?
Likely subclinical hyperthyroidism (ie mild hyperthyroidism) but need to consider unlikely pituitary source -- so would look at other pituitary labs like prolactin. Would repeat labs in 6 weeks and re-evaluate esp if you have no symptoms of hyperthyroidism at this point. The lexapro is not known to decrease TSH like this.
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