# High TSH but normal FT3/FT4



## Mike007 (Jul 26, 2017)

Hi all,

Previously hyperthyroid so had RAI treatment back in 2006 and I have been on a stable dose of 150mcg since then. TSH has always been less than 0.5 whilst FT3 and FT4 have been in normal/upper part of the range (Cant remember exact numbers now).

However six months ago I had strange headaches and eye focus issues so went to see the Ophthalmologist and he said all was good.

Went to the GP to get Thyroid tests done and numbers came (December 2016)

TSH 4.0 uIU/mL (Range by lab 0.55-4.78)

FT4 1.36 ng/dL (Range by lab 0.89-1.76)

FT3 3.97 pg/mL (Range by lab 2.30-4.20)

I was quite surprised that TSH came that high. Got a bit worried but kept my dose as 150mcg. Had some symptoms of muscle spasm, acid reflux, hand/feeling numbness etc and I was thinking this could all be due to high TSH. Decided to back to the doctor and results are (July 2017)

TSH 4.64 uIU/mL (Range by lab 0.55-4.78)

FT4 1.42 ng/dL (Range by lab 0.89-1.76)

FT3 3.54 pg/mL (Range by lab 2.30-4.20)

Could anyone give a feedback why TSH is elevated and not going down? Shall I try raising the dose a bit to see if that helps? I do feel hypo symptoms sometimes like difficult concentrating and forgetfulness which was not there before. In ten years of taking T4, this has never happened. Body is converting T3 fine as my energy levels are good but a few symptoms do exist.

Went through a great deal of stress last year, could this be related as well? GP was okay with the results as "These are within the range"

Planning to see an Endo now but want to understand what I am looking for here.

Thanks


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## Lovlkn (Dec 20, 2009)

You likely have antibody involvement. I run little to no TSH since my thyroid was removed. I tested my TBII antibodies to "prove" to a doc that I had stimulating antibodies which worked for awhile. Then that doc got paranoid about me not having TSH so I found a doc who only doses by FT-4 and FT-3.

You likely had stimulating antibodies before suppressing your TSH and now your blocking antibodies are causing your TSH to rise.

Focus on your FT-4 and fT-3 and try to keep those somewhere in the 1/2-3/4 of range.

For fatigue, test Vit D levels, Ferritin levels and B-12 levels.


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## Mike007 (Jul 26, 2017)

Lovlkn said:


> You likely have antibody involvement. I run little to no TSH since my thyroid was removed. I tested my TBII antibodies to "prove" to a doc that I had stimulating antibodies which worked for awhile. Then that doc got paranoid about me not having TSH so I found a doc who only doses by FT-4 and FT-3.
> 
> You likely had stimulating antibodies before suppressing your TSH and now your blocking antibodies are causing your TSH to rise.
> 
> ...


Thank you. I have no thyroid either as I had an RAI treatment.

I had antibodies hence Hashimoto/Grave's diasease leading to thyroid removal. I understand nothing can be done with these antibodies and hope for the best over time. No issues with FT4/FT3 and I can adjust dose as well but could elevated TSH cause any other issue in my case (No thyroid).


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## Lovlkn (Dec 20, 2009)

Not that I'm aware of. Similar to my issue of completely normal FT-4 and FT-3 with little TSH


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## my3gr8girls (Mar 18, 2016)

That's very odd and interesting! My endocrinologist told me the reason they don't pay too much attention to FT4 and FT3 is because they are highly variable and go up and down all day long. He said the TSH shows the overall picture of levels because it indicates how much thyroid hormones are being demanded by the pituitary gland (I know most here won't agree with this, but I thought it was an interesting explanation). I wonder if you are just getting your labs drawn at a time of day when your frees are high. I don't really know, but it does seem like thyroid labs are confusing.

I have the opposite situation. My TSH is almost non-existent and my frees are low. My latest labs from less than a month ago showed TSH is 0.17 (0.5-4.5), FT4 is 1.1 (0.7-1.5), and my FT3 is 2.2 (2.3-4.2). I currently take 88 mcg of Synthroid daily plus 3/4 grain of Naturethroid. My labs have consistently shown me to have lower FT3 when I'm taking a med with T3 in it. It's so weird. Adding T3 to my regimen lowers my FT3 labs. Makes no sense. I do feel great though so I don't care really, but it confounds me.


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## creepingdeath (Apr 6, 2014)

How accurate can a missing or "moth eaten" thyroid be?

A sick or missing thyroid needs to communicate with the thymus gland then the thymus to the pituitary.

Seems to me there would be miss-communication between these organs that make testing using TSH invalid anymore .

A sick thyroid means the biofeedback system which controls the thyroid process is damaged and not accurate anymore.

My doctor and I treat my thyroid issues more by the way I feel than any tests or ranges.

:to my3gr8girls:

Your doctor is referring to a healthy thyroid that works correctly.

When taking thyroid replacement our thyroid doesn't need to work anymore because of damage or disease .

The replacement hormone takes it's place and needs to be measured by the active hormone in our blood not by what a diseased and damaged thyroid is producing.

TSH is irrelevant anymore after hormone replacement begins.................


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## Lovlkn (Dec 20, 2009)

> My endocrinologist told me the reason they don't pay too much attention to FT4 and FT3 is because they are highly variable and go up and down all day long.


 That's funny because mine are always close to the same at ever lab draw and TSH results can lag up to 6 weeks


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## Mike007 (Jul 26, 2017)

my3gr8girls said:


> That's very odd and interesting! My endocrinologist told me the reason they don't pay too much attention to FT4 and FT3 is because they are highly variable and go up and down all day long. He said the TSH shows the overall picture of levels because it indicates how much thyroid hormones are being demanded by the pituitary gland (I know most here won't agree with this, but I thought it was an interesting explanation). I wonder if you are just getting your labs drawn at a time of day when your frees are high. I don't really know, but it does seem like thyroid labs are confusing.
> 
> I have the opposite situation. My TSH is almost non-existent and my frees are low. My latest labs from less than a month ago showed TSH is 0.17 (0.5-4.5), FT4 is 1.1 (0.7-1.5), and my FT3 is 2.2 (2.3-4.2). I currently take 88 mcg of Synthroid daily plus 3/4 grain of Naturethroid. My labs have consistently shown me to have lower FT3 when I'm taking a med with T3 in it. It's so weird. Adding T3 to my regimen lowers my FT3 labs. Makes no sense. I do feel great though so I don't care really, but it confounds me.


I have been seeing Dr Barry Peatfield (Barry Durrant-Peatfield) during early days and to be honest I usually don't care about labs as long as I am feeling good.

Trouble is that blood tests have always been consistent. This time, I had strange feelings, headache and other symptoms hence I went to the Dr for blood tests and results were quite odd. So something did happen or changed otherwise it should have been consistent.

Whatever it was, the body seems to be returning to normal now and slowly and gradually I am feeling better. I have upped my dose by 25mcg and feel a lot better. Will see how it goes in the next few months and will adjust accordingly. I don't trust any doctors, Barry was very good in understanding but it was quite a long ago (2006/07).

My take is if numbers are consistent with the previous results (No big change) and one feels great then it doesn't matter, where the results sit in the range. But if suddenly there is a big change in numbers and feeling is not good then obviously further investigation is needed. I wouldn't ignore test results in that case.


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## creepingdeath (Apr 6, 2014)

:A few reasons why this might happen:

1-This ain't 2006/2007 anymore and you are ten more years older.

2-TSH can change if you have the common cold or other health issues.
3-Part of your thyroid might still be alive and is trying to come back to life once and awhile by sending the signal to the thymus/pituitary glands.

4-You still have thyroid disease even though you are being treated and always will.

5-No treatment is perfect because of too many variables.

I am sure this won't be the last time this will happen to you.
I still get really weird symptoms from time to time and probably always will.
Most of the symptoms are gone or are still disappearing and I have been on hormone for 5 years now.
Some symptoms were and still can be so strange I dare not tell any doctors on fear they would label me crazy.

HORMONES ARE SOME STRANGE S**T............


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