# High TSH, normal FT3 and FT4



## laff66 (Mar 9, 2012)

Great, they just added TSH as a standard test to our fire department annual physical and it caught a hypothyroid condition in a good friend of mine. TPO was negative, but after being on 25 of levothyroxine for a few months, heres the latest labs:

FT3: 3.0 (2.0-4.4)
FT4: 1.16 (.82-1.77)
TSH: 9.13
TPOab: 15

Hes got lots of foot and leg pain, plus low energy and feels terrible. 
They just upped his levo to 50, and I told him the standard line about getting numbers up to upper third of range, but is it unusual for the TSH to still be so high? It didn't come down hardly at all with the 25mcg of levo.

Hes worried about pituitary problems, but I thought I'd ask if the high TSH/normal FT's was unusual or not.


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## Andros (Aug 26, 2009)

laff66 said:


> Great, they just added TSH as a standard test to our fire department annual physical and it caught a hypothyroid condition in a good friend of mine. TPO was negative, but after being on 25 of levothyroxine for a few months, heres the latest labs:
> 
> FT3: 3.0 (2.0-4.4)
> FT4: 1.16 (.82-1.77)
> ...


Your friend is undermedicated at this time. FT4 is below the mid-range and so is the FT3. FT3 should be at about 75% of the range given by the lab used.

Doc should re-test your friend at exactly the 8 week mark for further titration upward until goals are met.

Most of us feel best w/TSH @ 1.0 or less and FT3 @ about 3/4 of the way up in the range furnished by the lab.

Let us know. Better yet; send your friend on over!

Normal titration schedule would be 50 mcg. for 8 weeks, 75 mcg. for 8 weeks, 100 mcg. for 8 weeks and so on.


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## laff66 (Mar 9, 2012)

Wow, that was quick! Yes, I'm working on getting him registered. Is it unusual for the TSH to be that high? I've only got experience with my own that was BARELY elevated with lower FTs than his.


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## Andros (Aug 26, 2009)

laff66 said:


> Wow, that was quick! Yes, I'm working on getting him registered. Is it unusual for the TSH to be that high? I've only got experience with my own that was BARELY elevated with lower FTs than his.


We have seen TSH in the hundreds. But, high is high when you don't feel well. There is no place like the "right" place.


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