Low T4, normal TSH

[ROJAS123]

My TSH levels are normal but my T4's are low.  Not sure what this means since if my pituitary glands are producing enough TSH what is happening to make my T4's low?
Doctor wants we to take a THS 3rd generation and a CBC and basic Metab panel.

I have all the symptoms of hypothyroid, depression, fatigue weight gain, joint pain, have cold hands and feet and got grey hair at a very early age as well as suffered infertility but she has not mentioned that and just told me to take these additional tests, so I am confused.
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[Tete13]

I like to ask u a question my tsh is normal range but my free t4 is 7.0. Do u know what this means

[Gibbon1]

Usually better to start a new thread. But whatever.

Mandy.  In your case your thyroid hormones are kinda low and TSH is 'normal' and you have a bunch of symptoms.  Normally when thyroid hormones are low, TSH is 'high', often spectacularly high, like 100.

TSH stands for thyroid stimulating hormone and is produced by your pituitary.  I think your endocrinologist wants to test your pituitary function to rule or detect any other insufficiency.  You really want that.

Also I totally understand the I'm losing a paycheck problem. I've been there. In my book inability to work is a symptomo el grande  that doesn't get paid enough attention by doctors.

[hypochallenge1975]

I have one  ya. .....

TSH  9.04
Free T4~ 0.64
Free T3~ 3.8
I am having a hard time getiing these levels in the close together. Doc's are stumped.  

[Mandy206]

I am also searching for answers. It is hard for me to say when my symptolims began because I have been through so much, I always choked my feelings up to stress and life. I became pregnant with my 3rd child in 11/2010 and by January was on bedrest for placenta previa issues. I became deprssed and gained lots of weight! My baby was born 7/2011 via my first c-section due to failure to progress. I became hypertensive after she was born and was put on Lasix for swelling. Since then everything has been difficult. I am depressed (the worst ever in my life) and have anxiety/panic attacks, I have gained more weight even after watching my diet (which I have never had to do), I am irritable/moody, I have dry skin, coarse hair, and my cholesterol levels are climbing. I have being see my primary who started me on celexa, then paxil, now lamictal with no relief. I have decreased libido, I am tired 24/7, no interest in anything. Most recently I hit "rock bottom" felt like a mental breakdown, have taken a medical leave from work and insisted my doc help me. Thyroid levels tested : Tsh 0.61, free T4 0.8, and T3 total 112. So my free T4 is low by 0.1, my tsh is at the low end of normal and my total T3 is smack in the middle of normal. She sent me for a thyroid scan which showed a goiter and small nodules. I went for my referral appt to an endo today and she says she thinks the T4 level was a lab mistake and is going to have it rechecked as well as having me do a steroid test for cortisol to rule out Cushings. So over the next 3 weeks I will be having these labs drawn and then I go back to her. Even if cortisol shows signs of Cushings she says that will just indicate need for more tests. Should she have not diagnosed me as hypo today and started some type of treatment in the meantime? I am miserable and losing a paycheck. I need answers!!! Please help

[flyingfool]

many people seem to find symptom relief when their Free 4 is MID RANGE AND meaning in addition, their FT3 is in the UPPER 1/3 of the range.

You are far from being close to mid range in Free T4 which is 1.3 from the latest test range,  In fat you are BELOW normal range.  Furthermore your FT3 which is the only thing your body uses is well below the upper 1/3.  You would have to test at about 3.6 to get to the upper 1/3.

It is no surprise that you are feeling Hypo with those results.  Since your FT4 is so low it would make sense to start on a T4 med such as synthroid or Levothyroxine (ie levvo).  Starting dosages are usually 15 to 25 mcg.  And shouldn't be above 50 mcg. Many people can't start right out at 50 without side effects.

T4 meds take 6 to even 8 weeks to stabilize in the blood.  So if you do start medication, don't expet instant results.  Another blood test will have to be done again after 6 to 8 weeks. In which case a modification of dosage may be required until you start to feel good.

It is important to make sure that you continue to get BOTH the Free T4 AND the Free T3.  many Dr's don't want to medicate because they only use TSH which is almost useless unless you are REALLY Hypo or Hyper.  Beyond that TSH is just about worthless.  Even so the Dr's who believe in TSH only, commonly will want the TSH to be between 1.0 and 2.0.   With yours being a bit over 2.0,  you may have some luck asking your Dr. to prescribe a starter dosage of synthyroid.

[shstace]

Hi everyone--

I need some advice! I've never been on here before, but just stumbled upon this site as I was trying to do some thyroid research. For a few years now I have been dealing with depression and extreme fatigue, among other things. My doc has checked my thyroid a couple times and here is my latest result:
TSH is 1.57 (range is .34- 4.82)
and FT4 is .5 (range is .7- 1.7) flagged as Low

Last year this was essentially the same and my dr. wanted to put me on Synthroid. I didn't want to jump into this because I didn't know much about it.... So I went for a couple other opinions. Went to an endo in March 2010... my results:
TSH was 2.310 (range: .350- 5.5)
FT3 was 3.13 (range 2.30- 4.20)
FT4 was .81 (range .89-1.76) this was flagged as Low.

They weren't convinced anything was wrong w/thyroid. Went to Boston for another opinion. Said nothing was wrong.

But...symptoms haven't gone away. Depressed and seeing counselor for that plus have taken zoloft for a year. Still extrrememly tired all the time. I have the HARDEST time losing any weight, even when eating healthy. Plus, this summer I gained about 15 pounds and didn't eat a ton.

Was just diagnosed with celiac disease and haven't eaten gluten in 3 weeks. Eating mostly healthy meats (chicken, fish) and veggies, fruits, etc. Not eating a lot of fatty/processed/starchy foods and haven't lost a single pound.

So now I want to go back to my PCP or something and figure out this thyroid thing and get another blood test. Have one scheduled for November, but don't really want to wait that long.

Does anyone have any thoughts/advice/suggestions???? Thanks!!