Thyroid Disorders Community
Advice? High TSH, Normal T3 & T4 Thyroidectomy
About This Community:

This patient support community is for discussions relating to thyroid issues, goiter, Graves disease, Hashimoto's Thyroiditis, Human Growth Hormone (HGH), hyperthyroid, hypothyroid, metabolism, parathyroid, pituitary gland, thyroiditis, and thyroid Stimulating Hormone (TSH).

Font Size:
A
A
A
Background:
Blank
Blank
Blank
Blank Blank

Advice? High TSH, Normal T3 & T4 Thyroidectomy

Hi,

Recently I received two high TSH scores (6.8 and 7.1) but seem to have "normal range" t3 and t4.  My thyroid was removed several years ago and only in the past 4 month have moved to the "not normal" range.  My MD doesn't seem to be worried.  I'm scheduled for an appointment soon.  Any thoughts or advice for me to mention to them?  Thanks.
Related Discussions
11 Comments Post a Comment
Blank
Avatar_f_tn
Please post the actual results of your T3 and T4 tests, indicate if they are free or total and post ranges as these vary lab to lab.

Whick meds are you on and what's your dose?

How do you feel?  Many hypo symptoms?
Blank
Avatar_m_tn
Thank you for your comment.  

I'm on Levothyroxine SODIUM 100mcg.  reduced from 125mcg six months ago .

Generally feeling fine with an occasional aches or stiffness.  

Just curious if others have high TSH and "normal" T3 & T4.  What are advice have they been given and what are they doing if anything?
Blank
Avatar_m_tn
Hello again and thank you for your interest.

The T3 & T4 labs were for "free".

The numbers:   T3 = 86,   Normal range is: 60 - 181
                       T4= 7.3,   Normal range is: 4.5 - 10.9

So it seems I'm smack in the middle of "normal"  
Blank
649848_tn?1357751184
While your FT4 is about mid range, your FT3 is quite low in its range.  Most of us find that we have to have FT4 about mid range and FT3 in the upper 1/3 of its range......... you have a long way to go on that.  

Why was your levo reduced 6 months ago? Were you hyper?

Your aches and stiffness are quite possibly signs of being hypo.  FT3 corresponds best with symptoms and with yours low in its range, this could be a cause.

That said, some people do run a higher TSH and are perfectly comfortable with it.
Blank
Avatar_f_tn
I have to say that those are very unusual FT3 and FT4 ranges.  Your T3 range looks more like an FT4 range, and your T4 range looks more like a total T4 range.  Would you check those again?  It's going to bug me!!!

Why was your thyroid removed?
Blank
Avatar_m_tn
Hello Goolarra,

Thanks (again) for your interest.  I did double check the results and the results are as follows:

Total T3 (ng/dL) Test Results = 86
T4 Test Results = 7.3

The Thyroid was removed due to Hashimoto's.  Felt great for 3+ years only recently have I gone off the rails....

Past few TSH test results: (most recent first)
6.15
7.67
.68

Yes the last one was .68    That's when they adjusted my meds Levothyroxine downward.   The number bounced back to "normal" range and then when I checked it recently the number jumped to 7.67 That's when we went back to check the TSH and T3 and T4 which are the most recent #'s that I've shared with you.



Blank
Avatar_f_tn
Total T3 and total T4 are not really very useful.  They tell the total hormone in the blood, but much of that is chemically bound by protein and thus unavailable to your cells.  Free numbers tell what's actually available.

So, interpretation of your tests is somewhat limited.  However, you can see that your TT4 is close to midrange, but it is below.  Midrange is the target for T4.  Your TT3, on the other hand is very low.  T3 often has be in the upper half to upper third of range before symptoms are relieved.  Yours is in the bottom quarter.  Again, I'd caution that total T3 and total T4 don't necessarily correlate with free T3 and free T4.

Furthermore, T4 should be lower in its range than T3 is in its.  Your T4 is at 44%, and T3 at 21%.  This profile is a little "updside down" (T4 higher than T3)and indicates that you convert slowly and might benefit from adding a direct source of T3 to your meds.

Your TSH would indicate that your pituitary would like levels higher.

However, you have indicated that you are symptom free.

TSH is the least important of the three tests.  It can be influenced by so many factors besides thyroid hormone levels.  Your doctor probably realizes that and that's why he's not concerned.  Most important is symptoms, followed by FT3 and FT4 and TSH.

I have to agree with him.  If you are symptom free, then don't sweat your TSH.  If, on the other hand, you think your aches may be thyroid related or you have other lingering, but tolerable, hypo symptoms, then there's plenty of room in your labs for an increase.

Next time around, ask for FT3 and FT4.

TSH causes no symptoms.  Mine hovers around 20.0 due to a pituitary issue.  My FT3 and FT4 are low in the ranges, but I'm symptom-free, so my endo and I just ignore TSH.      
Blank
Avatar_m_tn
Thank you so much for your help!  I visited my PCP and he ordered a "Free T4" test.  I'll post the results as soon as I hear back...should be a few days from now.
Blank
Avatar_m_tn
Whoops... just saw my T4 results (should have checked my email before posting last response).   The results are:

FT4  1.4     Range= 0.9 - 1.7   so it seems OK....  agree?
Blank
Avatar_f_tn
Yes, that's well up in the range...looks good.  Too bad he didn't test FT3.  Lots of doctors have a hard time with FT3.  I'm in no way justifying that, just saying that it's unfortunately not unusual.

Let your symptoms (or lack thereof) be your guide...
Blank
Avatar_m_tn
Thanks... will do.

You have been most helpful and are a very valuable addition to this website and the community of people with thyroid issues.  Keep up the good work and I hope your health remains excellent.  All the best.  "G"
Blank
Post a Comment
To
Blank
Weight Tracker
Weight Tracker
Start Tracking Now
Thyroid Disorders Community Resources
RSS Expert Activity
242532_tn?1269553979
Blank
The 3 Essentials to Ending Emotiona...
Sep 18 by Roger Gould, M.D.Blank
242532_tn?1269553979
Blank
Control Emotional Eating with this ...
Sep 04 by Roger Gould, M.D.Blank
242532_tn?1269553979
Blank
Emotional Eating Control: How to St...
Aug 28 by Roger Gould, M.D.Blank
Top Thyroid Answerers
Avatar_f_tn
Blank
goolarra
Sisters, OR
Avatar_m_tn
Blank
gimel
MI
168348_tn?1379360675
Blank
ChitChatNine
649848_tn?1357751184
Blank
Barb135
FL
1204245_tn?1356904325
Blank
898_1
Long Beach
Avatar_m_tn
Blank
flyingfool
WI