# Normal TSH + normal ft3 + high ft4.



## Sztoto (Oct 27, 2017)

Hello since my next visit to endocrinologist is scheduled for july I thought I'll ask here to get some opinion since the results are strange (according to the doctor that did my thyroid ultrasound.). I'll start with saying that I am 25 yo male.

First TSH + ft4 blood test:

11-08-2016

TSH 3.46 (0.27-4.2 for adults)

FT4 21.6 (12-22)

after results above my GP told me that the TSH is higher than it should be even though it is technically in range (it should be closer to 2 according to her) and because of the family background (my mom and sister both have Hypothyroidism + my mom had Hashimoto's thyroiditis*) *I got directed to endocrinologist.

I took the blood tests before the visit + made thyroid ultrasound. In the ultrasound the thyroid looked fine according to the lady that wrote the image description (well there was one small lump but she said that's common and nothing to worry about).

Here are the blood results:

27-07-2017

TSH 5.17 (0.27-4.2 for adults)

FT4 19.43 (12-22)

So TSH got higher and ft4 slightly decreased but still in the high end of what is considered normal.

My endocrinologist prescribed me euthyrox 37.5 mg (1.5 * 25mg tablet) and to do the blood test after 2-3 months of taking it.

So today I got the results after taking euthyrox for 3 months:

27-10-2017

TSH 2.79 (0.27-4.2 for adults)

FT4 24.85 (12-22)

FT3 5.01 (3.13-6.76)

So at first I went from high TSH + high ft4 (but both in normal range) to higher TSH (out of range) and still high ft4 and got prescribed euthyrox. Now my TSH looks decent, ft3 is alright but ft4 is out of range.

Any idea what these "strange" results might mean? Doesn't look like problem with transforming ft4-->ft3.

edit: changed USG to ultrasound


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## joplin1975 (Jul 21, 2011)

How do you feel?

I'm not totally sure, but my knee jerk reaction wouldn't have been to put you on any thyroid medication right away. Your free t4 was already high enough...adding more t4 medication seems a little misguided.

Does USG mean a thyroid ultrasound? I'd love to hear more about the nodule they found -- size and other characteristics.

Above all, I think it would be really important for you to have your thyroid antibodies tested: TPO, TSI, and Tg/TgAB.


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## Sztoto (Oct 27, 2017)

Thank you for the answer. And yes USG is the ultrasound - for some reason I thought it is English abbreviation and not the Polish one.

Well I feel like I have felt for the last 5-7 years - that means somewhat sleepy, with "heavy head" and that might sound weird: I feel like I have big yawn in me that I can't get out. That's not something that would disturb significantly my daily life as I got used to it over time but it is an inconvenience for sure (not sure if that is somehow correlated to my thyroid problems though).

About the prescribed euthyrox: endocrinologist told me that the 37.5 mg is almost a homeopathic dose and it will get my TSH to normal range and it might help with the lump/nodule (that it can dissolve it somehow). Also she said that it is mainly because Hypothyroidism seems to run in my family. For some reason I think she haven't even noticed the ft4 being in the high range, unfortunately I didn't know anything about the thyroid at that time to point it out.

Translating the thyroid ultrasound description written by the doc from my native language to English might be tricky but I'll give it a try:

Thyroid size: normal

Right thyroid lobe volume: 8.64 ml

Left thyroid lobe volume: 6.35 ml

Thyroid isthmus width: 2.7 mm

Echogenicity of the thyroid parenchyma: normal/correct

In the upper part of the left lobe 5.6 mm isoechogenic (or isoechoic?) nodule

Parenchymal flow (doppler) normal/correct.

Haven't found enlarged lymph nodes.

About doing the antibodies tests - my endocrinologist told me to do the anty-TPO shortly before the next visit (that is in july). I'll read about the antibodies though and I'll consider doing the tests then.

Thanks once again.

edit: typos


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## jenny v (May 6, 2012)

I would maybe ask for a reverse T3 test, along with the thyroid antibody tests Joplin mentioned. Your TSH is a bit high but your FT3 and FT4 are actually good, but you're reporting hypo symptoms. A full panel might help uncover any other oddities.


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## Lovlkn (Dec 20, 2009)

> Above all, I think it would be really important for you to have your thyroid antibodies tested: TPO, TSI, and Tg/TgAB.


I totally agree with the suggestion to have these antibodies tested.


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## creepingdeath (Apr 6, 2014)

The American Thyroid Associations Guidelines state that..............
The treatment is the same whether you have any high antibodies or not if you're Hypo.......
Synthetic t4 only..............


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