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My TSH is low 0.01 T4 free is high 41, but I am cold, constipated and...
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My TSH is low 0.01 T4 free is high 41, but I am cold, constipated and gaining weight

I have just received news  that I may have hyperthyroidism, but I do not have any of the classic symptoms.  

Strangely,  I am cold, constipated and gaining  weight. I am also tired all the time. I have terrible joint pain especially, the wrists, shoulders and knees. I have terrible itch spells in the middle of the night.  For the past 6 months I have been under a great deal of stress.

Is it possible that I some other disease which is causing my TSH
(0.01) and T4 (41.0) levels to be abnormal.

I am not sure how long it will be until I see a specialist.  What type of questions should I ask?  Should I be requesting for a specific test to confirm the hyperthyroidism?

My WBC is a little on the low side.  My AST is 40 and Gamma GT is 80. My blood pressure is normal.  I am not on any medication.

Thank-you.  I am so grateful I found this site!
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173351 tn?1201217657
When you see the endo you should ask to have thyroid antibodies tested to see if the cause of your hyperthyroidism is Graves disease - an autoimmune disease.  Do other people in your family have thyroid disease - any type?  

Have you recently been pregnant?  Nearing menopause?  These are times when many thyroid problems rear their ugly heads.  Do you eat heaps and heaps of seafood or take supplements with iodine in them?  Excess iodine consumption can also trigger hyperthyroidism or autoimmune disease in the predisposed.  

You definately have hyperthyroidism - your TSH is clearly indicative of that.  Make sure they palpate (examine by touch) your thyroid gland, observing for signs of enlargement.  You may require a ultrasound of your thyroid.  

In future could you post the reference range for normal with your lab results for TSH and T4 (and indicate if it was a 'total' or 'free' T4).  It would just help to have a better understanding/picture of your biochemistry.  Regardless - a TSH of 0.01 is clearly hyper.    

It has been suggested (though not universally accepted as fact) that high stress levels may alter the immune response and trigger thyroid disease in some cases.  It is well known and accepted that when under prolonged high levels of stress that the immune system response to infection is flattened / inhibited - so that would explain your WBCs being a little on the low side.

I had some major life stresses when my thyroid problem came about - so I am inclined to believe that there is a link with high stress and thyroid disease.

I would not be concerned because you are not experiencing typical hyper symptoms.  What you describe is more consistent with typical hypo symptoms - BUT I have read that it is possible to have paradoxical (opposite) symptoms, after all we are all different and will be effected differently / have a different experience.  I'm pretty sure Dr Lupo who answers questions on the other side of the forum said the same thing in answer to an older question.  

Welcome to the club!!!  Browse the archives and read heaps of posts - follow information links that are given and educate yourself.  Knowledge is Power!!!
Keep us updated on how you go if you can...
Best wishes!
Avatar f tn
I have autonomous graves, I swing from diareah, to constipation, bloating, bad muscle/joint pain often cold to the point of shivers. My TSH 4.4, but other Graves symptoms, nervousness tremors, appetite  weight loss prevail. Have your antibodies tested....I didn't think I had graves , just Hashi's. Now i'm looking forward to treatment and feeling normal! ..
Avatar n tn

Thank-you so much for responding.  

I don't eat a lot of seafood or take supplements with iodine.  For the past 4 months I have been taking Glucosamine Sulfate (sodium free) for my joints.

Jen, you are so right on!    I am 48 years old, therefore, nearing menapause.  I have been under a lot of stress lately.  

I have a silly question, if my condition is triggered by stress and I do not have any of the hyperthyroidism symptons then if I got rid of the stress inside through meditation then would it be possible for the hyperthyroidism to resolve ... go away???  

My TSH         0.01  range .38--55
My T4 Free    41.3  range  10.5-20.0

I will ask for the thyroid antibodies test and ultrasound.  

Thanks again.

173351 tn?1201217657
If you are positive for antibodies and are diagnosed with Graves disease it would be unlikely that the hyperthyroidism would entirely go away if you got rid of the stress.  BUT it would improve your health and symptoms to get rid of or substantially lower your stress - of that I am absolutely sure.  

Think of what is happening for you as your body's way of saying "Hey - you need to take better care of me!"  - Our bodies weren't made to operate under prolonged high stress levels and it takes a hefty toll on our health.  

You can improve your body's ability to handle stress too - just by looking after yourself, you know what I mean...  Go back to the simple things... eating un-processed foods (eg. lots of fruit and vegetables), getting enough good quality sleep, drinking enough water every day, getting moderate daily exercise!  *** Exercise is proven to help the body's ability to balance hormones and reduce stress levels too!!!  Just what you need!!!!  When we are busy and stressed these things are often the first things that get overlooked... don't feel bad... we all do it (me too!) and it's not too late to make changes *IF* you want.

B vitamins are great for someone under stress.  They are commonly touted as 'Stress formula's" - you would have heard of banana's being called 'brain food', they are also high in B vitamins.  They are not a vitamin that our bodies store so it is important to get a good daily intake especially in times of stress.  (I used to work at a pharmacy years ago - now I'm a nurse)

Wishing you wellness!
Avatar n tn
Hi, I recently began having irregular heartbeats after being on cytomel 50mcg for 2 weeks.  My doctor took me off of it on Monday.  I have an appt with a cardiologist for an echo.  My question is, if the cytomel was indeed not needed and my current TSH is 0.01, FreeT3 2.9 and FT4 is 0.8, will this normalize without more meds?  I can't remember the initial TSH but was being treated for "clinical hypothyroidism" due to fatigue, dry skin, etc.  How long does it take cytomel to clear you system and the thyroid to adjust, or will it?  I have an appt with an endo now because my PCP is now concerned???

Avatar n tn
  i have irregular periods problem.. for that doctor advice me to take thyroid test (t3,t4.tsh)
the results are
t3- 222
t4- 11.5
tsh-0.01 (remark <than 0.01)
I want to know wht exactly the problemwas..
Now i have give sample for the test
   free t3
free t4
and tsh (again)
and prolatin

please help me to know about my body condition...
Thanks in advance
914071 tn?1243100568
My test results are TSH 0.01 standard range is 0.4-4.00 UIu/ml

FREE T-4 is 0.73

can anyone tell me what this means exactly? I am scheduled for surgery to remove my gallbladder on the 28th and its freaking me out because I can't get an answer from a doctor that actually read my file prior to having their nurse call me.

Avatar f tn
Your results are a bit of a contradiction.  Your TSH would indicate that you are becomming hyperthyroid.  However, your FT4 is quite low, which indicates hypothyroid.  Do you have the reference range on this?  Did they do FT3?  Are you on any thyroid meds?  Have you been diagnosed with a thyroid disorder?
914071 tn?1243100568
No I am not on any medication for my thyroid at all and the numbers that I have listed are the exact numbers that I was given, I double checked them.

I was told about 15 years ago that I had thyroiditis and it would just go away. Never knew I had anything I always felt fine. The only reason I even went to the doctor was that I was dieting and exercising allot daily and not losing anything and that’s when they took blood and that’s what they told me.

I also was given that test that they give you the radiation I guess it was pills and you go back a few times through out the day and they put you under a machine to be tested.

Again I was told it would go away never given medication.

I am just concerned because I am having surgery on the 28th and I have Kaiser and this is the second time that a doctor has given me an answer with out first reasoning my chart.

When asked about the test results and wanting them to be clarified to me I was left a message from the nurse who told me that the doctor said that the results are "normal" for some one that is taking thyroid medication of which I am NOT.

So I called back and got upset with the nurse because she seemed just as ditzy as the surgeon.

I am so confused because I gain weight so easy and it’s even harder to lose it and if it truly is a "hyper" thyroid, why am I not thin???

Believe me I wish I didn't have to have this surgery but I have been suffering for 8 years with this paid and was told it was an ulcer and have been treating an ulcer and I was finally told after having an ultra sound that I have gall stones and there is a mass and the symptoms are progressively getting worse so again I have no choice.

Do you know anything about what I might be going through and if so, what do you suggest?

I welcome any suggestions......
914071 tn?1243100568
Oh I did the FREE T4 test     T4 FREE 0.73 0.70-1.48 ng/dL

TSH      MINE  0.01       STANDARD IS 0.4-4.00 uIU/mL

I was just looking at my tests and apparently I had this test is march and this is what it says.

Name Standard Range            3/20/09                             5/20/09
TSH                                        1.21                                   0.01

Starnge enough the dermotologist that I saw that day did this test, I wonder why? I don't have acne or anything.

These are the results of a liver panel that I had about a month ago. Maybe it means something to you as well its just Chinese to me.

Component                                    Your Value                               Standard Range
BILIRUBIN, TOTAL                            0.40                                          0.1-1.0 mg/dL
ALKALINE PHOSPHATASE               79                                           20-125 units/L
ALT                                                  185                                           14-54 units/L

All this is very scary to me. I have always been in good health, I thought just normal aches and pains of getting old right now but for the most part I am very healthy, or is it just being masked?

Or am i just used to feeling a certain way that I have accepted that this si how I am and this is normal for me to feel  this way?? I am starting to question my health now.

You have medical insurance for a reason and you go to doctors with the thought that they know more than you do and they will take care of you.

i am starting to question the surgery that I need and I am concerned and need to get my personal things in order, just in case. You never know do you??

I appreciate anything thing that you can tell me.


Avatar f tn
No, I wasn't questioning your numbers, just wanted to see the range that you gave me in your second post (0.7-1.48 for FT4).

Unfortunately, weight gain is one of the symptoms that people report when both hyper and hypo.  It seems to be a symptom of "thyroid not right".  Hypers are often skinny, but not necessarily.

I wouldn't even say the results of your tests were "normal" for someone taking thyroid meds.  The drop in TSH can happen if your meds level is off, but dropping as far as 0.01 is a cause for caution if not concern (when taking meds).  Since you are not on meds, I think it would warrant further thyroid testing, if nothing else.  FT4 is more important than TSH, and yours is very low in the range, indicating hypo.

I'm afraid I don't know anything about gall stones (and hope I don't have to learn about them!!!).  Also don't know much about liver, except the first two liver values are in normal range and the thrid is considerably elevated, 185 in a normal range of 14-54.  Sorry, but I have no interpretation of those.

With thyroid problems, your first clue is usually that you feel two ways about it.  Yes, symptoms can be subtle and creep up slowly, so you're not aware of them for a while, but they do eventually make themselves very apparent.  If you feel well, relative to thyroid, then you probably are well.

To set your mind at ease, once your surgery is behind you, have further thyroid testing done.  The most important tests are free T3 (FT3), free T4 (FT4) and TSH.  If you want to know if you have one of the autoimmune thyroid conditions (most thyroid diseases are autoimmune), also have your thyroid antibodies checked,  These are TPOab, TGab and TRab.

If you have a chance, google hypothyroid symptoms and see if you have others besides weight gain.
914071 tn?1243100568
Thank you so much for the information.I am going to email my doctor and discuss this Before Thursday which is my surgery day.

Are you in the medical field is that how you know so much about it and why do you think they would do the T4 before the T3, that seems strange to me but than again, it is Kaiser.

Again, I appreciate all the information that you have given me, believe me its more than what my doctors have given me in almost 15 years of dealing with them telling me different things regarding my thyroid.

Have a Blessed weekend!

Avatar f tn
No. I'm not in the medical field.  I was a systems analyst all my life...basically a diagnostician, only my "patients" were computers!  I know what I know because I suffered under a very inept doctor for almost a year.  I just had to do my own research and be my own advocate, even learned to pretty much adjust my own meds.  Lots of wonderful people on this forum helped me tremendously and taught me a lot.  I have them to thank for a lot of what I know.

It's actually very common for doctors to order only T4 and not T3, which I, personally, feel is a big mistake.  The last time I had labs, my doctor hadn't ordered T3 (he always had before).  I whipped my arm back from the resident vampire until she added it.  I don't care if he didn't want to see it, I did.  I actually see this as a rather disturbing trend.  I think because so many of us are on T4 only replacement, they don't think T3 is important...wrong!
Avatar f tn
I was diagnosed with thyroid cancer in 2006 had a total thyroidectomy I-131 therapy recurrent thyroid ca and another round of I-131 this past week my labs are all crazy again T4 out of range, TSH 40 why have I gone so hyper again but no other symptoms but the labs heartrate is always around 60-70, I am always hot however I sweat all of the time but this has been going on for years way before the labs started going crazy. I have had enlarged lymphnodes in the past but no more testing scheduled until December. I have difficulties swallowing at times and even choke over water at times. Is any of this something to be worried over the only other change that is going on is major headaches I have seen a neuologist for them and has me on 200 of topimax a day which helps some but no side effects from it which they say is amazing with such a high dose and I have lost 40 lbs but that can be related to the topamax and diabetic meds they have me on now not just the thyroid labs any input would be great I am really worried that the cancer may be back again.
Avatar m tn
my mom thyroid stimulating hormone is 4.4UIu/ml  so the she want totake tablet? kindly sugest me my dear sir / mam.thanq u so much.
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