# TSH and free T4 results - concerning?



## John_Finan (Feb 2, 2015)

I had a couple of TSH tests previously which came back normal, but my most recent came in way above.

Results:

TSH 8.2 ulU/mL - at a parenthesis of 0.35 - 4.94

free T4 - 12.7 pmol/L - with a parenthesis of 9 - 19

I'm awaiting my free T3 results.

My prolactin levels came back high also at 29.4 ng/ml, normal being 3.46 - 19.4

Are they indicators of anything?

What kind of prescriptions should I be considering or getting from a doctor if they are?

I hear a lot about Natural Pig Thyroid being much better than Eltroxin or synthetic thyroid...?


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## John_Finan (Feb 2, 2015)

Progesterone also came back high at 0.9, with the parenthesis being <0.64


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## joplin1975 (Jul 21, 2011)

A high TSH and low free t4 is indicative or hypothyroid. You should have your antibodies tested (TPO, TSI, Tg, and TgAB) and you should also have an ultrasound of your thyroid.

There is no one thyroid medication that is categorically better than another. What matters is what's best for you and determining that should be based on labs and a little trial and error. You will likely be put on synthroid or the generic equivalent as a starting point, with adjustments made as necessary.


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## John_Finan (Feb 2, 2015)

Are them free T4 results, would they be considered as being low??

My main issue is the fatigue, inability to function etc.

I think that's a thyroid symptom, right?

Considering the previous tests with a normal TSH - is hypothyroidism still a possibility given the normal results?


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## joplin1975 (Jul 21, 2011)

Yes -- speaking generally, anything below the mid point of the range (14, in this case) is considered low.

And, yes, those are hypo thyroid symptoms. Hypothyroidism can kind of sneak up on you slowly. Previous normal TSH tests don't always give the whole picture. Also, just because TSH falls within the "normal" range, it doesn't always mean normal. Do you happen to know what the results and ranges of those previous tests were?


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## John_Finan (Feb 2, 2015)

I had one TSH taken in December gone by, that was

4.54 ulU/ml, parenthesis being 0.35 - 4.94

Then one taken in September, which was

4.17 ulU/ml, same parenthesis

The free T4 was at 13.2 and 12.8 respectively, on each occasion, again being between 9 - 19 pmol/L


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## joplin1975 (Jul 21, 2011)

While falling within the "normal" ranges, those are considered elevated TSH results. Most doctors now consider anything above 3.0 to be high. And, each of those free t4 results are on the low side. So, you've been hypo for at least a couple of months.


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## John_Finan (Feb 2, 2015)

So, my doc wants to prescribe eltroxin, basically synthetic thyroid.

Would that be the best way to go?

They say they won't prescribe Armour thyroid or NDT cause it's unlicensed.

I haven't got the results back yet but, in terms of free T3, should be be corrected with Thyroxine?

Or would I be looking at getting a supplement for that too?


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## joplin1975 (Jul 21, 2011)

I'm on synthroid which is considered "synthetic" (I use quotes b/c desiccated such as Armour is highly processes and just as synthetic) and I am thriving. So, for me it works.

The issue is finding out whether or not your body converts t4 (the active medication in synthroid) to t3, which is the "active" hormone that your body needs for metabolism. This process takes place in the liver. Some people's body is very effective at converting the medication. I'm one of those people and therefore Armour would not be a good mix for me. Free t3 can be corrected with a t4 medication if your body can convert the molecule.

So how to you figure things out? You start on eltroxin, wait six weeks, and then have labs re-run. Once your fee t4 is at about 3/4ths of the range, take a look at your free t3. If that stays low/unchanged, then you can consider switching to desiccated medication and/or you can add cytomel (a t3-only med) to the mix.


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## John_Finan (Feb 2, 2015)

Okay got it.

When you say 3/4 the range, my range being 9 - 19, do you me 75% of 19, that being about 15 or just below, or 75% of the range difference, that being about 16.5?

I appreciate this insight BTW


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## jrohrigj (Aug 30, 2012)

3/4 of the range differene. 16.5


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## John_Finan (Feb 2, 2015)

Went to my doc today.

He wouldn't prescribe anything.

Have to wait a few more weeks for appointment with an endocrinologist.

Said I should have thyroid antibody tests and the ultrasound done before prescribing eltroxin etc.

Does it normally work that way?

I didn't think Eltroxin was so potent as to require a consultant prescription.


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## joplin1975 (Jul 21, 2011)

Eh...plenty of primary/general practitioners prescribe thyroid meds. I don't know if I'd say it requires a consult. I mean, second opinions are, I think, always good, but I don't think its necessary. And, I don't think you *have* to have antobodies tested or have an ultrasound before started the med. Your TSH is clearly high enough. You just want those things done sooner rather than later.


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## John_Finan (Feb 2, 2015)

Got Total T3 results today.

They came in at 1.37 nmol/L, at a parenthesis of 1.28 - 2.33 nmol/L

Don't know is that good or what?

My GP sent me on my way cause it was within range, but still waiting on an appointment with an endo to figure this all out.


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