# Low free t4, normal TSH



## SammyBear

Hi everyone,

I'm brand new here, and this is my first post. I am looking for some opinions on my lab results. Some general info about me: I am 30 yo, female, and I seem to have both hyper/hypo symptoms (e.g. weight gain, palpitations).

I have been seeing dr's for years trying to figure out what in the world is wrong. Thus far, pretty much everything has come back normal. So, here is my thyroid info:

Aug 2005: TSH 4.17
December 2007: TSH 3.26 free T4 0.78 
November 2009: TSH 1.84
March 2011: TSH 2.12 free T4 0.67

I spoke with my PCP and he says although my free t4 is slightly below range (bottom of range is 0.71), that because my TSH is normal, it means nothing is wrong. However, I have read that a low free t4 with a normal TSH could mean a problem with the pituitary. Does anyone have any experience with this? Do you think my results are normal, or should I get another opinion?

I am seeing my ob/gyn on Monday for an unrelated issue, I may bring it up with her. She has checked my prolactin level in the past for irregular menstruation, and it was 11 (normal).

Thanks in advance for your help!


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## lainey

Free T4 below the range is a red flag for hypothyroidism.

You need a better doctor and better tests. Stat.

You should have the thyroid antibodies done--TPO, TSI and thyoglobulins. The free T3 should be run also (in otherwords, the thyroid panel again, with detail). A sonogram of your thyroid is in order to check for structural defects and possibly and uptake scan to see how your thyroid is working.

Yes, the normal TSH with low free T4 can signal a pituitary problem, and that should be considered. I would discuss your results with your OB and see if they can suggest a good endocrinologist that will fully examine you.


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## Andros

SammyBear said:


> Hi everyone,
> 
> I'm brand new here, and this is my first post. I am looking for some opinions on my lab results. Some general info about me: I am 30 yo, female, and I seem to have both hyper/hypo symptoms (e.g. weight gain, palpitations).
> 
> I have been seeing dr's for years trying to figure out what in the world is wrong. Thus far, pretty much everything has come back normal. So, here is my thyroid info:
> 
> Aug 2005: TSH 4.17
> December 2007: TSH 3.26 free T4 0.78
> November 2009: TSH 1.84
> March 2011: TSH 2.12 free T4 0.67
> 
> I spoke with my PCP and he says although my free t4 is slightly below range (bottom of range is 0.71), that because my TSH is normal, it means nothing is wrong. However, I have read that a low free t4 with a normal TSH could mean a problem with the pituitary. Does anyone have any experience with this? Do you think my results are normal, or should I get another opinion?
> 
> I am seeing my ob/gyn on Monday for an unrelated issue, I may bring it up with her. She has checked my prolactin level in the past for irregular menstruation, and it was 11 (normal).
> 
> Thanks in advance for your help!


High there, SammyBear!









I do beg to differ as there are binding, blocking and stimulating antibodies that can make the labs look like this; meanwhile, the patient is quite unwell.

I suggest these tests.

TSI (thyroid stimulating immunoglobulin),TPO (antimicrosomal antibodies) TBII (thyrotropin-binding inhibitory immunoglobulin), Thyroglobulin Ab, ANA (antinuclear antibodies), (thyroid hormone panel) TSH, Free T3, Free T4.

You can look this stuff up here and more.........
http://www.labtestsonline.org/

There have been times as evidenced by your labs that you have been going through major swings.

I believe that the low T4 means that you probably need T4 replacement therapy.

Next time when you post your most recent labs, please also post the ranges as different labs use different ranges.

Sadly your PCP is confused and you will see why when you read this matrix and I might add, this is not at all reassuring. This is "basic" stuff. (i.e. pituitary)

http://www.drrind.com/therapies/thyroid-scale-matrix

Please get the antibodies' tests.


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