# 20y/o skinny male, elevated TSH, normal FT3/4



## Lamoen (Jan 18, 2016)

Hey,

I went to the doctor because I noticed hair loss and general fatigue and slightly reduced libido, got a blood test and it looks there's some hypo thingy going on:


TSH: 6.16 mU/L (0.27 - 4.20)
FT4: 21.3 pmol/L (12.0 - 22.0)
FT3: 5.08 pmol/L (3.10 - 6.80)
25-OH-Vitamine D 14.6 ng/mL (30.0 - 100.0), if relevant

From what I've read - correct me if I'm wrong - this looks like *subclinical hypothyroidism.*

I do feel better and my hair loss seems to have slowed down. I'm kind of surprised being a 20 year old male to have my thyroid disfunctioning so I have a couple of questions:


Could this be subclinical hypo?
If so, could it be temporary? Or will I eventually get clinical hypo somewhere in my lifetime? (I know that it's POSSIBLE, I just want to know whether it's likely or not)
If I do get clinical hypo (and catch / treat it early), what will the effects be on my daily life except for taking a pill a day? Will I gain weight even if I start treatment early? I'm pretty skinny so I can't really imagine myself gaining much weight. Also, will you get your hair back if you start treatment (if caused by thyroid)?

If someone could give their opinion on (some of these), I'd be really happy. I also made an appointment with my endocrinologist, but that's in a month and I'd like to get some answers now.

Thanks!


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## Lovlkn (Dec 20, 2009)

Welcome to the board!



> TSH: 6.16 mU/L (0.27 - 4.20)
> FT4: 21.3 pmol/L (12.0 - 22.0)
> FT3: 5.08 pmol/L (3.10 - 6.80)
> 25-OH-Vitamine D 14.6 ng/mL (30.0 - 100.0), if relevant


Thank you for your detail and posting of these labs.

Free T-4 and Free T-3 are the most accurate way to test for free thyroid hormone in your blood. Your Free's are on the side of hyper. Just below range is higher than normal, especially with an elevated TSH of 6.16.

Many doctors only treat or dose med's by TSH so be aware.

You will need to have antibodies tests, I would suggest asking for TSI, TPO and thyroglobulin antibodies and an ultrasound of your thyroid.

Hormone movement can escalate hairloss.

What prescriptions or supplements or drugs do you regularly take?


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## Lamoen (Jan 18, 2016)

Hey, thanks a lot for your reply!

What could it mean that my free's are hyper-ish? Is that good or bad? I'm totally new to this. Will ask for the tests you mentioned.

Hormone movement can escalate hair loss - sure, but could it grow back when I get treated?

I don't take anything at the moment

E: Seems to be relevant, I also got a raised sex-hormone binding globulin (69.4 nmol/L) (18.3 - 54.1)


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## Lamoen (Jan 18, 2016)

Lovlkn - thanks. I really appreciate people like you spending their free time helping other people out.

From that list, I think I can rule everything out except Hyperthyroidism (is that even possible with TSH being too high). So basically some factors are pointing to hyper (high T4, high SHBG and me being pretty skinny (no anorexia at all)) and others are pointing to hypo (raised TSH).

From what I've read it can also be caused by a tumor on my thyroid. I'll make sure to get that checked as well - I guess the ultrasound test would detect this?


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## jenny v (May 6, 2012)

Definitely ask for an ultrasound. With weird results like yours, antibody testing and an ultrasound should be at the top of the list.

And hair does grow back after thyroid issues are worked out. I lost about half of my hair at one point, but it came back (although it did take a while).


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## Lamoen (Jan 18, 2016)

Thanks Jenny. Will do. Also noticed all my bilirubin levels are too high. AFAIK this indicates there's too much thyroid hormone, but no clue whether that would make me hypo or hyper.


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## Lamoen (Jan 18, 2016)

@Lovlkn, @Jenny v or @others:

In case it helps, my TPOab turned out to be 10 U/mL (< 34) so that looks pretty normal. Does that mean I can rule out Hashimoto and Graves as well? They didn't test my TSI antibodies though.

Also, I actually lost weight. I'm now 51.6 kg (114 pounds) and I'm about 175 cm (5,75 ft). BMI is around 16,7 which is undoubtedly underweight (even though I love eating).

Perhaps I'm experiencing gluten intolerance (damn I love my spaghetti  )? But I have no idea how that would be liked to my strange TSH behavior.


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## creepingdeath (Apr 6, 2014)

By personal experience I can tell you, you can be hypothyroid and be under weight.

I have been extremely hypo with TSH in the 100's and never gained much weight.

So the elusive thyroid disease does not always follow the signs and symptoms printed in medical books.


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## jenny v (May 6, 2012)

You know, you might ask to re-do the first set of tests (TSH, FT3 and FT4). Sometimes the lab techs accidentally drop or mishandle the vials of blood and that can affect results. Yours are just so random, I might have them done again to double check.


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## Lamoen (Jan 18, 2016)

So I went to another doc today but it didn't quite turn out as expected. He indeed confirmed my thyroid was too slow looking at my TSH levels, said my FT3/FT4 levels were 'still' alright but will get affected by time and he didn't really have anything to say about the elevated SHBG. He just minimized my symptoms (hair loss equals male pattern baldness without even looking at my hair), and said my symptoms are likely to have another cause and that a second blood test is not needed. So frustrating! I know and feel something is happening but they just don't want to listen.


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## Lovlkn (Dec 20, 2009)

> TSH: 6.16 mU/L (0.27 - 4.20)
> FT4: 21.3 pmol/L (12.0 - 22.0)
> FT3: 5.08 pmol/L (3.10 - 6.80)
> 25-OH-Vitamine D 14.6 ng/mL (30.0 - 100.0), if relevant


Your labs are not normal at all - if your doctor is refusing to test further you have 2 choices. Find a different doctor or order and pay for repeat labs yourself. Do you still have the appointment with an endo?

Your Vitamin D is below range - have they prescribed D for you to take? 50K IU weekly for 12 weeks is what I was given then retested. I now take 5K IU daily to maintain 1/2-3/4 levels.

What's interesting about your labs is TSH reflects you being hypo while your Free T-4 is top range and almost hyper, Free T-3 is almost perfect. Repeat TSH, FT-4 and FT-3 as well as Antibodies testing to include a repeat TPO, TSI and Thyroglobulin and an ultrasound of your thyroid is what I would be asking for if it were me.

The link below may help you understand the tests.

http://www.thyroid.org/wp-content/uploads/patients/brochures/FunctionTests_brochure.pdf


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## Lamoen (Jan 18, 2016)

Luckily for me paying for labs is not an issue, long live European health care.

Yes, my doctor prescribed me Vitamin D and also said I need more sun, which is kind of hard in January at freezing degrees. I will take the supplements but that won't do anything about my thyroid problems correct?

I will ask to redo all the tests including TSI, Thyroglobulin and an ultrasound just to make sure. But I read that, with subclinical hypothyroidism which would be the early stages of clinical hypothyroidism, it is actually normal to not have your TS levels affected by the elevated TSH. Also I'm beginning to suspect *subacute thyroidism *to be a possible cause as well. I've experienced both hyper- and hypo symptoms and my results could be somewhere in between now.

Thanks everyone for answering my questions. Just maybe one last question regarding weight gain in case it turns out to be hypothyroidism: I just bought a new wardrobe and it would quite suck to gain lots of weight due to this disease. If the endo confirms this is subclinical hypo, would it be a good idea to start treatment in order to prevent weight gain (would it even work?). I do need some extra weight but I don't want to get obese either.


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## creepingdeath (Apr 6, 2014)

I wouldn't worry too much about gaining weight.

What you don't want are the other horrible symptoms of hypothyroidism .

Joint and muscle pain to the point of not being able to climb stairs.

Constipation that feels as if someone punched you in the stomach and knocked the wind out of you.

The wonderful pins and needles in your extremities.

Dizzy light headed feeling of passing out.

These are only a few nasty symptoms you may get from long term untreated thyroid disease.

You may be one of the lucky people who get no symptoms at all.

Find another doctor, stand your ground and do not give up.

You know your own body.

Everyone is different.


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