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I have high tsh and normal t4 level I’m 31 years old

I’m 31 years old and I have high tsh around 6 and normal t4.whats the reason for this?what can cause high tsh? I have just high blood pressure problem before.what can be related to high tsh numbers?
15 Responses
Avatar universal
Please post your thyroid related test results and reference ranges shown on the lab report.  Even more important, please tell us about any symptoms you have.
Avatar universal
My tsh level is 5.140 and t4 is 1.12
Avatar universal
I feel weak a little and tired always , and usually when I eat or drink coffee my heart beats faster it’s like palpitations
Avatar universal
Reference range shown on the lab report for the T4 test please.
1 Comments
T4 is 1.12 range
Avatar universal
T4 is 1.12
Avatar universal
Along with the T4 result, does the lab report list something like (.8 - 1.8), which is the reference range I need to know to help assess your status.
Avatar universal
So my levels are bad?
Avatar universal
In trying to assess thyroid status, symptoms are the most important consideration, followed by Free T4 and Free T3.   TSH is a pituitary hormone, not a thyroid hormone.  TSH is affected by so many things that, at best, it is only an indicator, to be considered along with other more important indicators previously mentioned above. That said, your TSH is higher than would be expected normally.
So you should be tested further to check for the possibility of Hashimoto's Thyroiditis.  Two tests are required, Thyroid Peroxidase antibodies (TPO ab) and Thyroglobulin antibodies (TG ab).

You mentioned fatigue, which is one of the symptoms typical of hypothyroidism.  Your TSH is high enough to warrant further tests.  I cannot assess your Free T4 unless you provide the reference range shown on the lab report for what you show at T4.  You need to make sure they always test for both Free T4 and Free T3 every time you are tested.  You also need to be tested for Vitamin D, B12 and ferritin.  

From the limited info you have provided I suspect that you are hypothyroid, but really need to know the reference range for the T4 test, and also would like to know Free T3 level.  

As you proceed with this, make sure to keep in mind that a good thyroid doctor will treat a potential hypothyroid  patient clinically (for symptoms), by testing and adjusting Free T4 and Free T3 levels as needed to relieve symptoms, without being influenced by resultant TSH levels.  Symptom relief should be all important, not just test results.  If your doctor is unwilling to treat clinically as described then you will need to find a good thyroid doctor that will do so.
1 Comments
Doctor just made a test and no antibodies were found .but t4 is 8.2 and t3 up is 46.2 and ultra high is 4.555. He put on medicine levothyroxine 25 mcg. What do you think about my values? I wanted to get a second opinion
Avatar universal
Is that Total T4 or Free T3?  They are quite different.  Also, what is the reference range shown for the T4 test?  Also is the T3 test called T3 Uptake?   If so, that doesn't tell us much.  I can't answer your question about the 25 mcg of Levo without answers to my questions.
Avatar universal
I also meant to ask, what test was done for antibodies?
Avatar universal
T3 uptake yes is 46.2 and it’s range 32-45 so he told me it’s high.and t4 is 8.2 and range is 4.5-12.5 so that’s normal.and ultra high is 4.555 and range is 0.5-4.2 and he told me that’s high also.and he did anti-tpo ab and anti-tg Ab. And it’s 0.. vitamin d is normal.
Avatar universal
"T3 Uptake

This is a measure of the unbound throxine binding globulins in the blood (unsaturated with thyroid hormone). The less thyroid hormone that is present, the more unsaturated TBG is present.

This is an indirect measure of thyroid hormone levels. It has nothing to do with T3, despite the name."  With the development of tests for the biologically active thyroid hormones, Free T4 and Free T3, Tests for Total T4 and T3 Uptake are outdated.  Far better to test for Free T4 and Free T3.  You should make sure they always test for Free T4 and Free T3  in the future.  

Using the Total T4 and F3 Uptake test results to calculate what is called T7 (which is an estimate of Free T4) indicates that you might be low in thyroid hormone.  This needs to be confirmed by testing Free T4 and Free T3.  If those are low in their range, along with your TSH being on the high end of the range, that might indicate that your thyroid gland is not producing enough hormone.  Usually those conditions would be related to the autoimmune disorder called Hashimoto's Thyroiditis, yet your antibodies tests you said were negative for Hashi's.  This makes me wonder if there could be another reason your thyroid gland is not producing adequate hormone.  For that reason I also suggest that you should test for iodine.  Having adequate iodine is vital to thyroid hormone production.  

Taking the 25 mcg of T4 is going to do nothing for you since it will reduce your TSH level and also the output of thyroid hormone.  Since serum thyroid levels are the sum of both natural thyroid and thyroid med, only when TSH becomes suppressed enough to no longer stimulate natural thyroid hormone production, will serum thyroid levels reflect further increases in thyroid medication.  At the usual rate of testing and dosage increases, that would be a long time.  So unless you are experiencing severe symptoms, I would hold off on the med until getting tested for Free T4, Free T3, B12, ferritin, and iodine.  I included B12 because it affects energy and it is best in the upper end of its range.  Ferritin is important in the conversion of T4 to T3.  You mentioned testing Vitamin D.  For info Vitamin D should be at least 50 ng/mL.  

Can you get these tests done?  
1 Comments
Yes I will ask my doctor to do these test.i have another question.do you think herpes or any other std is the reason of thyroid disorders and hashimoto?
Avatar universal
I know of no reason to consider that as a possible cause for thyroid disorders and Hashimoto's Thyroiditis.
1 Comments
Ok thank you my doctor told me free ts4 is normal and free ts3 also
Avatar universal
Can you get the test results and references shown on the lab report?  I will be surprised if it is really Free T4 and Free T3.  I expect it is really Total T4 and Total T3, which is not nearly as revealing as the Frees.   Free T4 and Free T3 are the biologically active thyroid hormones that you need to know about.
1 Comments
I made an ultrasound  and they saw a nodule on left lobe measured 4.4•1.1•1.8 cm ad lower pole 0.8x0.4x0.6
Avatar universal
Just because your Free T4 and Free T3 are within the "normal" range does not mean they are adequate for you.  The ranges are far too broad to be functional across their entire breadth.  In order to try and assess your status we need to know the actual test results and reference ranges for the Free T4 and Free T3 tests.    Also what was your Vitamin D result and reference range?  Since one of your main symptoms seems to be fatigue, you also need to test for Vitamin B12.  Also, as previously recommended you need to test for iodine.  Can you provide the requested test results and reference ranges and also get those tests done?
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