High free t4 but normal TSH

[anna836]

Hello all
I'm new comer to this forum. Just don't understand my test results.
I was suffering from Hyperthyroidism 3 years ago but it went to remission. And I don’t take medicine from that time. Yesterday I received my lab test result by email and it shows:
tsh:  0.8          normal range (0.2-6)
free t4:  38      normal range (10-26)   high
free t3:  6      normal range (3.1-6.8)
Can you please help me what does it mean?
My free t4 is too high while TSH is in normal range!!!!
Does it mean I’m hyperthyroid again?
Thanks for helping

[gimel]

Sorry, but I'm not aware of those being used as primary tests for Graves' Disease.  So, I would request to be tested for TSI, Free T3 and Free T4.  Along with your hyper type symptoms, that should provide enough information to confirm that you have become hyper again.  

[anna836]

actually i had down thyroid peroxidase IgG and anti TPO antibody 3 years ago and they were in normal range.i should say that my doc tested them after thyroid treatment.
I did thyroid scan and it showed nothing too.
would you please list tests That i should do?

Thanks for your big help

[anna836]

actually i had down thyroid peroxidase IgG and anti TPO antibody 3 years ago and they were in normal range.i should say that my doc tested them after thyroid treatment.
I did thyroid scan and it showed nothing too.
would you please list tests That i should do?

Thanks for your big help

[gimel]

First, TSH is a pituitary hormone that is supposed to reflect accurately levels of the actual thyroid hormones; however, TSH is affected by so many things that it cannot be shown to correlate well with either Free T3 or Free T4, which are the biologically active thyroid hormones, much less correlate with symptoms.  So TSH is only an indicator, to be considered along with more important indicators such as symptoms and also Free T3 and Free T4.  

Free T3 and Free T4 are very different tests from Total T3 and Total T4.  The totals represent the total amount in your blood.  Most of that is bound up with protein molecules and thereby inactive.  Only the small portion that is not bound to protein (thus designated as free) is biologically active.  Free T3 and Free T4 are much more important to know than the Totals.

If you wanted to run another test, I think the doctor would do the TSI test used for Grave's.

[anna836]

i,m really confused.
why TSH , t4 and t3 are normal?
Is it natural or i need to do another test?

Thanking you in advance

[gimel]

Yes, from those symptoms and your Free T4 above range, and your Free T3 high in the range, I'd say you are back into being hyper again.   Time to see your doctor again.

[anna836]

yes .I have been taking medicine for 6 month 3 years ago.
does it shows thyroid is getting hyper again?

[gimel]

Were you previously diagnosed with Grave"s and treated with anti-thyroid meds?

[anna836]

Really Thanks for your answer
Actually I feel Nervousness, anxiety and muscle weakness.
But I’m not sure it’s because of my thyroid.
This is complete test result:
TSH:  0.8                         normal range (0.2 - 6)
Free t4:  38                    normal range (10 - 26)     high
Free t3:  6                      normal range (3.1 - 6.8)
T4: 12.8                           normal range (5.1 – 14.1)
T3: 1.3                            normal range (0.7 - 2)
Free t4 index: 19.7       normal range (4.8 – 12.7)    high
T-uptake: 0.8                 normal range (0.8 – 1.3)
Would you please advise me about it?

[anna836]

Really Thanks for your answer
Actually I feel Nervousness, anxiety and muscle weakness.
But I’m not sure it’s because of my thyroid.
This is complete test result:
TSH:  0.8                         normal range (0.2 - 6)
Free t4:  38                    normal range (10 - 26)     high
Free t3:  6                      normal range (3.1 - 6.8)
T4: 12.8                           normal range (5.1 – 14.1)
T3: 1.3                            normal range (0.7 - 2)
Free t4 index: 19.7       normal range (4.8 – 12.7)    high
T-uptake: 0.8                 normal range (0.8 – 1.3)
Would you please advise me about it?

[gimel]

I'd say yes.  Your Free T4 is way over the range and Free T3 near the high end of the range.  TSH is a pituitary hormone that is supposed to reflect levels of the actual thyroid hormones, but is affected by so many things that it doesn't correlate well with either FT4 or FT3, much less with symptoms.  Symptoms and thyroid hormone levels are  much better indicators of thyroid status.  What symptoms are you having, if any?