High TSH Normal T4

[arkano]

T4 Level 1.16 ng/dL  TPO Ab Level 24 IU/ML   TSH Level 5.17 ulu/ML.  Should I be concerned about a thyroid disorder with these lab results?

[regutierr]

Arkano, what did you end up doing? I am was was tested with nearly identical TSH (5.32 with a reference range of .4 - 4.5) and Free T4 (1.1 with a reference range of .8 - 1.8). I never had any symptoms of hyperthyroidism but was prescribed 50MCG of levothyroxine by my primary care physician, which I just started taking yesterday. Since I never had symptoms and hear many conflicting things I am debating on stoping the meds until I see a endocrinologist. I just feel with zero symptoms it may not be completely necessary now. Thought from arkano or anyone else??

[arkano]

T4 Free Direct,serum is 1.16 ng/dL  Normal range according to lab is .82-1.77

TPO Ab is 24 IU/mL  Normal range according to lab is 0-34

T3 was not measured.

[flyingfool]

I would also wonder about what your free T3 level is.  It is possible arkano has a conversion problem. (converting T4 to T3)  So even with "normal" T4 if there is not enough T3 in the bloodstream, the pituitary may sense this and put out TSH call for more and this might explain the "normal" T4 with a high TSH.

Also I believe the latest recommended range for  TSH is 0.3 to 3.0.  Older ranges used to go up toward 5 on the upper end. Unfortunately most labs still use the old range recommendations.

[Barb135]

What is the exact T4 level and its reference range?  Is that FREE T4 or total?  

Even though your T4 level is "normal", it might not be right for you......particularly, if its low in its range.

[arkano]

Yes, I have a copy of the lab report.  TSH level is 5.17 ulU/mL.  Lab report says normal range is is .45-4.5.  T4 levels were normal.  Diagnosis is subclinical hypothyroidism.

[Barb135]

"Gray" area?  I guess that means "borderline"?

Do you have a copy of the lab report? I can't believe that if you've already been dx'd with hypothyroidism, your doctor isn't going to treat you.  Untreated hypothyroidism is dangerous.

[arkano]

HCP said I was in the "gray" area.  I do have hypothyroidism but since T4 is normal and I really have no true symptoms, she is not going to treat with meds now.  Just monitor over time.

[Barb135]

All lab tests have a reference range used by your particular lab; it's often printed in parentheses beside the result or sometimes in a column by itself, labeled "reference ranges).  It will be  (XX - XX).

Each lab uses different reference ranges, therefore, those must come from your report.  There will be a range for the FT4 and one for the TPOab.  

[arkano]

No Symptoms.  T4 is Free.  Lab did not perform a T3.  What do you mean by reference ranges for the TPOab?

[Barb135]

Your TSH is high, but that doesn't necessarily mean you have a thyroid disorder, since TSH is a pituitary hormone and merely an indicator of thyroid malfunction.  

What are the reference ranges for the T4 (is that Free or Total?) and the TPOab?  Higher than normal TPOab would mean you have Hashimoto's Thyroiditis and you may need to start on thyroid replacement hormones.  

You also need to have a Free T3 test....... Free T3 is the active thyroid hormone and correlates best with symptoms.  You should also get a thyroid ultrsound and TGab test.

What, if any symptoms do you have?