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Old 10-13-2002, 12:37 AM   #1
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Post what causes an elevated TSH but normal T3 and T4?

Over the years I have been told by 3 different doctors that I have an elevated TSH level. The first time was about 8 years ago. I'm not sure what the number was, but the doctor said it wasn't that high and didn't warrant treatment. Then just last year, my doctor included a TSH test in with another blood test he was running and the result came back at around 10. He then decided to do a T3 and T4 test which aparently came back normal. So again, he didn't think I needed to be treated. Well, I recently switched doctors, so as part of a new patient physical he did a a TSH test which came back at 14. I'm not sure if he did a T3 or T4 test as well, but based on the TSH test alone he has started me on Levoxyl. It's been about 3 weeks and I am feeling a lot better actually - I'm not tired as much, and my mood has brightened.

My question though, is how can my TSH be elevated but my T3 and T4 be normal? Why is my body producing extra TSH if it doesn't need to? It sort of seems like my thyroid is working fine, but the rest of my body doesn't think it is! And why am I feeling better on Levoxyl if my T3 and T4 levels are normal?

 
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Old 10-13-2002, 09:09 PM   #2
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Hi pdb123. An elevated TSH suggests Hypothyroidism. But certain things can make the TSH fluctuate, so it's more accurate to test the TSH along with Free T3 and Free T4 (the free amounts of hormone available for the body to use) to get a better picture of what's going on. These blood tests, in addition to the patient's symptoms, usually help suggest if treatment is necessary.

I'm glad to hear that the Levoxyl seems to be helping you. It is possible that you have thyroid antibodies (additional blood tests) and therefore had symptoms before your levels dropped below the lab's reference ranges.

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Old 10-14-2002, 07:54 AM   #3
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Quote:
Originally posted by pdb123:
My question though, is how can my TSH be elevated but my T3 and T4 be normal? Why is my body producing extra TSH if it doesn't need to? It sort of seems like my thyroid is working fine, but the rest of my body doesn't think it is! And why am I feeling better on Levoxyl if my T3 and T4 levels are normal?
Well, your thyroid gland usually ISN'T healthy if your TSH is elevated. This is a littel simplified, but what happens is that the thyroid gland starts to fail and is not producing enough thyroid hormones so your pituitary releases more TSH to tell it to work harder.

Your poor thyroid gland is already failing and overworked, and starts to fail some more, an d then even more TSH is produced to keep it working. Some people can go on for years like this feeling "normal" and having "normal" T3 and T4 results, but others start to feel steadily worse over time even with all labs being in range.

I don't think ANY of your doctors took the right approach to treating you. The first two ran the right tests and just didn't interpret them properly--you should have been treated long ago. The most recent doctor is treating you, but should have backed up his findings with more tests, in my opinion, just to cover his posterior (it is possible to have an elevated TSH and be hypER in rare cases, adn this should have been ruled out by doing Free T3 and Free T4 tests). In your case, his approach is OK, but going by TSH alone is not the most effective way to diagnose and treat a thyroid problem.



[This message has been edited by Meep (edited 10-14-2002).]
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