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Elevated TSH Levels-Normal T4
I went for my annual checkup and I mentioned I was having irregular or no periods (even on birth control).  She ran some blood tests and called me to let me know that my TSH levels were 5.64 and the range was within .45-4.5. She called in a prescription for Synthroid, asked me to start taking it.  She stated that my T4 results were 1.38, within a range of .82-1.77, which is normal.  I'm trying to understand if I have a real problem, if it's normal to have T4 results come back normal even though TSH levels are elevated.  I have been tired lately and experiencing hair loss over the past couple of years.  (I had tests ran when it initially began, but all my results came back normal).
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231441 tn?1333896366
Yes, early in hypothyroid T4 levels can apparently be normal, even with TSH elevated.

A low dose of thyroid meds would be recommended.  Optimal TSH for most people is usually between 1 and 2.  FT3 and FT4 would optimally be in the upper half of the reference range, when medicated.

Next time, please ask your Doctor to test TSH, FT3 and FT4.  The Free t3 and Free t4 as these are the available hormone (T3 and T4 can also reflect protein-bound or unavailable hormone).

You may find you feel better with the support of thyroid meds.

Hope this helps.
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