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Old 10-15-2004, 01:05 PM   #1
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Question Normal TSH, elevated T4 and Thyroxine?

Hi, I'm hoping someone here can clear up my confusion. I've been sick for about 7 months. All the typical hyper symptoms. Thirthy six pounds just kind of fell off of me, hair falling out, dry skin, moodiness, fatigue and restlessness all at the same time, feeling agitated plus several other symptoms. All bloodwork is normal except thyroid.

T3 uptake 34.38 normal range 24.4-39.1
T4, total 13.6 normal range 6.5-10.5
Free Thyroxine 14.7 normal range 6.0-11.4
TSH 1.2 normal range .35-5.50

The TSH is normal but the free thyroxine and T4 are elevated. My internist sent me to an endo. The PA at the endo's office agreed with the internist that there might be reason to be concerned. The endo thought all was normal and sent me away. She said those were normal levels for a woman my age...post-menopausal.

My confusion is this...the TSH levels mean the thyroid is working properly but couldn't the elevated T4 and free thyroxine mean there is a secondary problem that is causing the elevation and symptoms I am having?

Life has become such a struggle. I go from not feeling like I can get out of bed for days at a time to feeling like I have energy but my body still feels very fatigued. Does anyone have any suggests, comments or ideas as for as what might be going on in my body?
Thanks!

 
Old 10-15-2004, 02:52 PM   #2
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Meep HB UserMeep HB UserMeep HB User
Re: Normal TSH, elevated T4 and Thyroxine?

Quote:
Originally Posted by cathy52
T3 uptake 34.38 normal range 24.4-39.1
T4, total 13.6 normal range 6.5-10.5
Free Thyroxine 14.7 normal range 6.0-11.4
TSH 1.2 normal range .35-5.50

The TSH is normal but the free thyroxine and T4 are elevated. My internist sent me to an endo. The PA at the endo's office agreed with the internist that there might be reason to be concerned. The endo thought all was normal and sent me away. She said those were normal levels for a woman my age...post-menopausal.

My confusion is this...the TSH levels mean the thyroid is working properly but couldn't the elevated T4 and free thyroxine mean there is a secondary problem that is causing the elevation and symptoms I am having?

Life has become such a struggle. I go from not feeling like I can get out of bed for days at a time to feeling like I have energy but my body still feels very fatigued. Does anyone have any suggests, comments or ideas as for as what might be going on in my body?
Thanks!
Your endo needs a good kick in the seat of the pants. Elevated Total T4 and Free Thyroxine (Calculated Free T4 - not very accurate, but somewhat useful) indicate a problem REGARDLESS of TSH.

TSH tells us nothing about the thyroid gland itself, but about what your hypothalamus and pituitary THINK your thyroid gland should be doing. Your TSH looks normal.

Your thyroid gland, on the other hand, appears to be doing something else. With your T4 that high, your pituitary and hypothalamus should see that there is too much T4, and your TSH should drop--telling your thyroid gland to put on the brakes until the dust and some of the T4 settles out of your system.

My guess is that your doctor should next check for Graves antibodies (especially) and TPO and Thyroglobulin antibodies, as well as taking real Free T4, Free T3 and TSH readings. Those labs woudl tell us what your thyroid levels look like, what your body THINKS thyroid levels should be, and whether antibodies are attacking your thyroid gland, making it misbehave, which is my guess at this point.

My advice? Get another opinion, and another and another, until you find a doctor that knows their elbow from a hole in the ground when it comes to interpreting these labs. Your health and life are too important to trust them to some bozo who has learned nothing aobut how thyroid health should be evaluated and cared for.
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Old 10-15-2004, 07:02 PM   #3
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dea4 HB Userdea4 HB User
Re: Normal TSH, elevated T4 and Thyroxine?

Well said MEEP as always. I fully agree, get another dr and another opinion, fast!

Keep us posted


By the way, Welcome to the boards.

Last edited by dea4; 10-15-2004 at 07:03 PM.

 
Old 10-15-2004, 07:52 PM   #4
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cathy52 HB User
Smile Re: Normal TSH, elevated T4 and Thyroxine?

Thank you Meep, I was kinda hoping I would hear from you. Been reading these forums for a couple of days and have seen some of your posts.

I agree, the endo needs a kick in the butt and with my mood lately I wish I could be the one to give it to her. The funny thing is, the internist, the PA at the internist's office and the endo's PA all saw the lab results and said there was a problem. The endo spent maybe 10 minutes with me, didn't look me in the eyes once and dismissed me. My thyroid was painful when she manipulated it but she seems unconcerned. I showed her the lumpy red spots on the front of my legs and she seemed unconcerned. I knew when I waked out of her VERY state of the art office that I had just paid a lot of money for nothing. VERY frustrating.

I stay in a confused state of mind lately. Can't seem to concentrate or hold an intelligent thought. I've been reading and researching regardless but not trusting that I am interpretting things properly. My thinking was alsot that the TSH had nothing to do with what my thyroid gland was actually doing and that the high T4 and thyroxine levels were a better indication that there was a problem. What do I know though, I'm just the person suffering the horrendous symptoms?!?!

Thank you so much for your input. My mind kept coming back to Grave's Disease based on what I have been reading. I have another consult next week with another endo and won't stop until I find one willing to listen to me. You have given great advice as far as what to ask for and discuss with the next endo. I'm making notes and going in a little better prepared this time.

I have to admit to being terribly afraid at this point. I had a very bad day today. I was able to do things around the house that I haven't been able to do in nearly a week but the energy I had was not your normal type energy. By mid-afternoon I was close to collapsing. I was so weak and fatigued I was afraid to lay down, afraid I would not wake up if I slept. When I did fall asleep it was like death and I didn't wake up for 3 hours. I should feel rested but I don't.

Normally I'm an energetic, positive, independent person. Feeling, slowed down, negative and dependent on others is getting the best of me emotionally. I have to keep going until I find answers, that is just my personality....tenacious as hell!

Thank you again, you have helped calm some uncertainties I was having.
Cathy

 
Old 10-15-2004, 07:59 PM   #5
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cathy52 HB User
Re: Normal TSH, elevated T4 and Thyroxine?

Thanks for the welcome dea. What I think I might do is take a trip to the emergency room over the weekend if I don't start to feel better. When all this first started several months ago I would have maybe one day a week that I would feel the fatigue and shakiness. I'm to the point now that I have maybe one day a week where I'm functional. The rest of the time I'm on the couch in front of the TV. There is NOTHING on TV during the day....hell, if the thyroid thing doesn't kill me trying to find a decent show at 12 noon will!!

I WANT MY LIFE BACK!!
This used to be me
these are indicative of what I feel lately
I'm not ready to become one of these!

 
Old 10-15-2004, 08:25 PM   #6
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cathy52 HB User
Re: Normal TSH, elevated T4 and Thyroxine?

One more question...TPO is not something I'm familiar with, could you explain that to me meep?

 
Old 10-16-2004, 07:59 AM   #7
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Re: Normal TSH, elevated T4 and Thyroxine?

Quote:
Originally Posted by cathy52
One more question...TPO is not something I'm familiar with, could you explain that to me meep?
TPO is an abbreviation for Thyroid PerOxydase. Thyroid Peroxydase antibodies attack the mechanism and process responsible for the production of thyroid hormones in the thyroid gland.
__________________
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I am not a doctor, nor have I ever played one on TV...

 
Old 10-17-2004, 01:02 PM   #8
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dea4 HB Userdea4 HB User
Re: Normal TSH, elevated T4 and Thyroxine?

Quote:
Originally Posted by cathy52
I'm to the point now that I have maybe one day a week where I'm functional. The rest of the time I'm on the couch in front of the TV.

I know the feeling, been there, felt like that.
Hang in there, it can and will get better with proper treatment.

Keep us posted on how things are going in your search for a decent dr.

 
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