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Old 02-10-2008, 05:50 PM   #1
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High TSH but Normal Free T4 and Free T3; What does it mean?

Just a quick background first. I was diagnosed with hypothyroidism 19 years ago when I was 16 (I had a goiter that prompted extensive tests). I have taken either Synthroid or generic Levothyroxine ever since. In 2005 I had a total hysterectomy and removal of both ovaries and was started on hrt. In 2006, at 35 yrs old, I was diagnosed with osteoporosis in my spine and osteopenia in my hips. I have since been taking lots of calcium and vitamin D. In 2007 I was diagnosed with fibromyalgia by a rheumatologist as well. I do have some idea that calcium supplements and hrt interact with thyroid hormone replacement but the complexity of it all boggles me.

Since my hysterectomy I have had a heck of a time with both hrt and thyroid levels and trying to figure out what symptoms are coming from what. Just recently I had my thyroid levels checked again due to extremely dry itchy skin all over, puffy itchy eyes, extreme fatigue, muscle and joint pain (especially deep aching in my upper arms and shoulders), crying uncontrollably and depressed. I had had my hrt lowered several months ago due to sore painful breasts and yeast infections so thought it was low estrogen again, but my TSH came back this time at 8.59! However, my free T4 was 1.1 and free T3 3.3, both smack in the middle of normal range. Why the high TSH when my other levels were normal? Is this still indicative of hypothyroidism? What does it mean exactly? You would think after 19 years I would get this but it still confuses me. Now with all my other problems thrown in I am even more confused.

My doctor increased my thyroid meds so hopefully that will help, but I have to wonder if being on thyroid meds for so long has also contributed to my osteoporosis. Also, I am and have always been underweight which I find unusual for being hypothyroid. Isnt it usually the opposite? I also get diarrhea and chills with a high TSH. Arent you supposed to become constipated?

Does anyone else find they have to have their thyroid meds adjusted several times a year? Even before my hysterectomy I had this problem.

Guess I asked more than my title called for. lol. I am just confused and discouraged with this. If anyone else has the high TSH and normal other lab values I would love to hear from you! Or if anyone understands what a high TSH but normal T4 and T3 means I would be grateful for any help! I keep going in circles with research. Argh!

 
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Old 02-11-2008, 10:06 AM   #2
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Re: High TSH but Normal Free T4 and Free T3; What does it mean?

Quote:
Originally Posted by Elaine444 View Post
Is this still indicative of hypothyroidism? What does it mean exactly? You would think after 19 years I would get this but it still confuses me. Also, I am and have always been underweight which I find unusual for being hypothyroid. Isnt it usually the opposite? I also get diarrhea and chills with a high TSH. Arent you supposed to become constipated?

Does anyone else find they have to have their thyroid meds adjusted several times a year?
Do you know if you have Hashimoto's? I do and a couple years back my TSH boosted from 0,2 to 8,4 in just 2 months - my Ft4 stayed in the normal range (but came down from 21.something to 15.something) and suddenly I felt absolutely s***ty. Then over the next few months I ended up doubling my dose (from 87,5 to 175) but finally felt absolutely c***py - my TSH stayed around 3 and FT4 around 19 (not enough for me). I went to see an endocrinologist and he gave me T3-supplement and I've been on it ever since. I think my thyroid was finally giving up. I think your TSH and symptoms also indicate hypo even though your freeT's show "normal". Good thing that your dosage was raised

I've had to change my dosage every 2 or 3 months but that has been the case ever since I started medication almost 3 years ago (after over a decade of "sub" state ) My TSH is now below normal but I go by symptoms (and FreeT's which need to stay at the highest end of the range or even slightly above it)

I've never had constipation (quite the opposite) and my BMI is at the low end of "normal" - never gained any weight.

Last edited by FinnMaid; 02-11-2008 at 12:01 PM. Reason: Some typos

 
Old 02-11-2008, 04:52 PM   #3
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Re: High TSH but Normal Free T4 and Free T3; What does it mean?

Thanks FinnMaid for sharing! It does help to know others are having the same types of problems. I don't recall ever being specifically diagnosed with Hashimotos. I had nuclear med scans and other tests in addition to blood tests to originally diagnose my hypothyroidism and the goiter I had. Is there a specific test for Hashimotos? What is the difference between that and general hypothyroidism?

Wow, that is an extreme change in TSH in a short time! About a year ago my TSH was .3 and now 8.59. Sometime in between I had it tested and it was between 3 and 4. All I know is that I feel horrible right now. I have absolutely no energy to speak of, muscle pain everywhere, and dry skin. I hope this increased dose kicks in fast!

Thanks again for posting!

 
Old 02-12-2008, 06:03 AM   #4
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Re: High TSH but Normal Free T4 and Free T3; What does it mean?

Get tested for your hashimoto antibodies. The tests are coded: TPOAb and TGAb. The TPOAb is a 90-95% indicator of hashimoto's. Hashimoto's has been known to cause all of your issues when untreated and antibodies are raging. Treatment is to shut down your thyroid with meds so that antibody production stops and your body can slowly purge the antibodies over time. I doubt if you have Hashi's the antibodies will ever totally go away, but if you medicate things will get better.

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Old 02-14-2008, 11:42 PM   #5
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Angry Re: High TSH

I came off my synthyroid .150 mcg on Dec 26 after having my Son Nov 1 of 2007 got a blood test Jan 10 levels weren’t where my Dr so I stayed off and finally got my whole body scan Jan 25 2008 and got back on 150 mcg of synthroid about going insaine at that point my moods where very erratic they were horrible I finally got so tired of driving everyone crazy I went to the ER I didn’t know if I was crazy or if it was my thyroid and that’s what they couldn’t figure out they took blood Jan 30 2008 and 2 days later when the results came back they called and said my levels were elevated not telling me what they were later to find out my TSH was 154.236 and no one helped me my general dr said see a psychiatrist a psych wouldn’t see me well I finally go back to the ER at in Birmingham and that was Feb 3 2008 my T4 was back to normal but TSH was 73.829 I am going crazy needless to say I'm seeing a new endo today because I can't handle these moods and I'm suprise I didn't go comatose my endo said that's the only way he'd give me a shot of synthroid...

 
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