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High TSH, normal T3 and T$
I have been on Synthroid for 1 1/2 years for hypothyroidism.  Recently, my test results were normal, or slightly below normal, for T4 (.9) and T3 (229).  But my TSH was 43.9.  Six months ago my TSH was 1.35, and T4 was 1.44.  But, at that time I reduced by dosage of Synthroid because I was suffering from extreme insomnia, and was always highly alert and full of energy, all hyperthroid symptoms.  I was sure that Synthroid was causing this.

Could this TSH problem be a problem with my pituitary or hypothalamus, rather than my thyroid?  My doctor found no problems on Thyroid ultrasound and TPO antibodies test showed positive (high).
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Avatar universal
I don't think there would be a problem with the pituitary as you are more likely to get really low T4 with a really low TSH for this to be the case = secondary hypothyroidism. Although i'm not entirely sure. The TSH of 43.9 is your body saying that although the T4 is just low normal, it is not enough T4 for your body at this time. I live in UK and we use different units of measurement for T4 and T3, but i have had the equivalent of 0.7 for T4 with a TSH of 30 for one of my results which is fairly similar to your recent result. The high TSH is your bodies way of saying it needs more  
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your probably right that the synthyroid was causing your hyperthyroid symptoms. How are you feeling now?
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393685 tn?1425816122
I really feel that the Hypo is causing a problem. Your TSH - if this is recent? - is very high as you now and your T4 can not catch up as the post said above. I see your concern of your Hyper symptoms. Have you been on the same dose of meds all this time?   If I may ask - are you pretty faithful taking your meds everyday and around the same time?  I don't think you require a T3 addition to your Synthroid as of right now - due to the hyper symptoms you experience.

Post back later  with answer on these questions if you can.
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393685 tn?1425816122
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question if I have a high tsh but noraml t3 and t4  am I hypo or hyper
can't figure it out... and does anyone know if you start on medicine do you have take it for the rest of your life ???  ty
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393685 tn?1425816122
High TSH levels will indicate Hypothyroidism. The higher the TSH - the more hypo

and vise versa with Hyperthyroidism.

Low tests indicate an over functioning gland called hyperthyroidism
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393685 tn?1425816122
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my tsh is 6.45 and my t3 is normal and t4 is 1.10 (free) and reg t4 is 7.6.  Dr doesn't want to start meds for life but I feel sore, fatique, hair loss, and temperature problems.  Am I hypo or not?  Do I need more tests?
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my tsh is 6.45 and my t3 is normal and t4 is 1.10 (free) and reg t4 is 7.6.  Dr doesn't want to start meds for life but I feel sore, fatique, hair loss, and temperature problems.  Am I hypo or not?  Do I need more tests?
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1569091 tn?1295812151
Doctors do not know everything. Because, labs read normal, does not mean that you feel good. I call them TSH immaculatas. Actually, FT3, and FT4 tells waaay more than T4, T3. TSH tells you how well your pituitary gland is interacting with your thyroid.  With a TSH of 43, I would not be able to operate at all.
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1569091 tn?1295812151
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1569091 tn?1295812151
JAZZGIRL;

It certainly sounds as if you are hypo. Hair loss, and fatigue is a SURE sign that you are hypo. T3, and T4 do not tell the whole story. Free T3, and Free T4 gives a better picture of what is going on with your thyroid. And, the soreness aces it. Who is your doctor? Run.
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1569091 tn?1295812151
One caveat that I forgot to mention, T4 is a storage hormone. T3 is the active hormone that gives you energy. The only way that you can find out where you are with this is if you have a FT3, and FT4. That way you can tell where your numbers are in relation to lab values. FT3 is suppose to be at the top of your lab value. FT4 is supposed to be midway to your lab values.
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if t3 & t4 is normal & tsh is 24 then tsh can be control through medicine or it is a symptom is thyroid .
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TSH cannot be controlled directly.  It is only controlled by manipulating T3 and T4.  However, if your FT3 and FT4 are normal AND you are symptom-free, there's no reason to control TSH (unless you've had thyroid cancer).  TSH doesn't cause any symptoms.  If it's not accurately reflecting your FT3 and FT4 levels, it can simply be ignored.  Many factors can influence TSH.  Doctors should be treating us until we are symptom-free.  
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