Thyroid Disorders Community
Which thyroid situation is more ideal?
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Which thyroid situation is more ideal?

(A) A person with a high TSH (above 5) and a Free T4 in the upper half of its range.

OR

(B) A person with a low TSH (around 2.25) and a Free T4 in twenty percent of its range.

Why?

(NOTE: This would be a person who is not on any thyroid medication to begin with)
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Avatar_f_tn
The one huge factor you're leaving out is FT3, which is the test that best correlates with symptoms.  

Person A, if having hypo symptoms, would have a major conversion problem.

Person B could very well be hypo...depends on symptoms.

In my opinion, FT4 ALWAYS supercedes TSH.  However, one person can be very comfortable as person A and another as person B.  
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Avatar_f_tn
I should also have added that FT3 almost always trumps FT4.  FT3, FT4, TSH in order of importance.
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Avatar_m_tn
My answer is none of the above.

As pointed out both of them are relatively useless information. Your body ONLY uses FT3.

Measuring FT4 is like determining how well your car runs by looking at the gas level in the fuel tank.  Certainly you need gas in the tank in order to run well.  But that doesn't mean the engine is operating well even if the tank is full.

Measuring TSH is like measuring the response of the Throttle of the car.

To determine if your engine is running well you need to measure at the very least the fuel flow at the engine and if it is getting enough among other things.  That is what FT3 does.
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