# High TSH, High FT3, what does this mean?



## PharmD (Oct 9, 2012)

Hi guys. Here are my lab results:

Free T3: 4.95(2.0-4.4) HIGH
TSH-Ultrasensitive: 4.060(0.270-4.200)
T4: 7.1(4.5-11.7)
T3 Total: 1.53(0.80-2.00)
Anti-ThyroGlobulin AB: under 20(0-40)

Symptoms: Basically google low testosterone symptoms: I have every single one, Google hypothyroid symptoms: I have every single one.

I am just confused because I have read that high TSH usually indicates hypothyroidism while high FT-3 would be hyperthyroidism. I have a combination of both and have no idea what this means and neither does my doctor.

If you want to read more about my case/lab results, here are two posts I made on two different websites, both are basically the same information.

Referenced contained within the links...

ey guys, just got back from my doctor: <name removed>
Basically, I've had a very low libido my whole life. This past summer I finally went to a urologist who tested my testosterone: 268, put me on cpyionate shots for 6 weeks. I came off because I noticed absolutely no improvements whatsoever. Fast forward a few months, saw <name removed>, had a slew of labs done, now just got them back today. Here is the important stuff: (I have been off everything for a few months, not taking any medications) Also BP taken today was 140/80 and I weigh 220lbs, 5'9, although I am not fat, just have absolutely no muscle, skinny frame, but a belly I guess.

FSH: 1.0(1-11)
LH: 1.2(1-8)
Cholesterol: 208(under 170)
HDL: 41(over 40)
LDL: 150(under 130)
Alkaline Phosphatase: 54(60-270)
Testosterone: 119(160-726)
Free Testo w/ Total and SHGB: 4.19(2.03-13.48)
SHGB: 5.7(10-57)
%Free Testosterone: 3.5 High(1.50-3.2)
Estradiol: 41: (0-56) How can zero be an acceptable value???????
Progesterone: 0.4(0.0-.09)
Cortisal: 14.9(AM: 5-25)(PM: 5-14) Blood drawn at 12:30PM
T3 Total: 1.53(0.80-2.00)
T4: 7.1(4.5-11.7)
TSH-Ultrasensitive: 4.060(0.270-4.200)
Free T3: 4.95(2.0-4.4) HIGH
Vitamin D: 33(30-100) This does not make sense to me, I've been supplementing with 10,000 iu D-3 everyday for the past year, why isn't it higher?
DHEA Sulfate: 389(108-441)
Anti-ThyroGlobulin AB: under 20(0-40)
Estriol Serum: 0.02(00.00-0.16) What is this and how does it differ from Estradiol?

All in all I am satisfied with this doctor, at least compared to the vast majority of others. IGF-1 is not listed here but I believe they ordered it, it is just taking longer than expected. He did not test free T-4 which confuses me. He could not explain why my SHGB is so low. He said it is good to have low SHGB as it frees more testosterone but I believe mine is way too low, thus not allowing testosterone to circulate and be delivered to receptors. This is my theory as to why I did not feel better on the shots. My research told me that low SHGB is a symptom of Hypothyroid, which is what I assumed I had, with my TSH being so high, but now my FT-3 contradicts that. It is over the range, which would suggest hyperthyroid. So I have no idea what is going on here.

He has prescribed a regimen of HCG and Nolvadex to be taken for the next 6 weeks. I will take the HCG for the first 2, then discontinue and start Nolva. He wants a blood test 1 week after cessation but I will wait at least 3, maybe 4 to get a true value. If this does not work, then I will go on hormone replacement therapy with a lose dose HCG and possibly anti-estrogen. My concern though, is that my libido will not improve on this without something else in the equation because of my low SHGB. Any thoughts?

Edit: also, why is my alkaline phosphatise low on a consistent basis? I've had a number of blood test and this number always hovers around 54. And how can I have such low total testosterone while having high free%testosterone?

Also symptoms: Basically google low testosterone symptoms: I have every single one, Google hypothyroid symptoms: I have every single one.

Thanks and also I am 19 male.


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## Lovlkn (Dec 20, 2009)

> (I have been off everything for a few months, not taking any medications)


What were you taking?


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## PharmD (Oct 9, 2012)

I was on testosterone cypionate 300mg every other week for 6 weeks. I have been off that for a few months now. I was also taking creatine, protein, vitamins, but have stopped that all as well, not that stopping those would have any positive impact, I just wanted to have a completely clean slate when I had my bloods done. Also, I continued to take 10,000 vitamin d3 everyday, although a week or two prior to getting bloods done, I abstained from this as well.


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## PharmD (Oct 9, 2012)

Just read this article: "Reverse T3 dominance, also known as Wilson's Syndrome, is a condition that exhibits most hypothyroid symptoms although circulating levels of T3 and T4 are within normal test limits. The metabolism of T4 into rT3 is in excess when compared to T3 therefore it is a T4 metabolism malfunction rather than a straight forward thyroid deficiency. Periods of prolonged stress may cause an increase in cortisol levels as the adrenal glands respond to the stress. The high cortisol levels inhibit the 5-deiodinase enzyme and thus the conversion of T4 into T3 thus reducing active T3 levels. The conversion of T4 is then shunted towards the production of the inactive rT3 via the 5′-deiodinase enzyme. This rT3 dominance may persist even after the stress passes and cortisol levels have returned to normal as the rT3:T3 imbalance itself may also inhibit the 5-deiodinase enzyme thus perpetuating the production of the inactive rT3 isomer. There is some argument to this last point with some research indicating that the elevated rT3 is only temporary and not a permanent condition and in most healthy people this may well be the case. We have however found that in many patients suffering from a range of hypothyroid symptoms do indeed have prolonged elevated rT3 levels which respond favorably to this treatment. Many medical practitioners do not accept rT3 dominance theory and thus many doctors will refuse to treat this condition despite the fact many suffers have been successfully treated. See below for the evidence in the references."

Here: http://www.custommedicine.com.au/health-articles/reverse-t3-dominance/

Do you think it is possible I could have reverse t-3 dominance. It makes sense as to why my ft-3 is so high while I have all the hypothyroid symptoms. I am seeing an endocrinologist tomorrow and will ask about this. I don't know why my previously doctor didn't test rt3, would have made this a lot easier.


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