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Old 05-18-2012, 04:51 AM   #1
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Question High TSH, normal (low-end) free T4

I had a test last October and my TSH was 4.71 and my free T4 was 16.8pmol/L, lab ranges are 0.4-5.0 and 10.0-23.0. So I managed to get a retest two weeks ago and it came in at 27.97 and 12.9 then a further retest last week was 21.9 and 11.8. Still awaiting the antibody test. Prolactin is normal.

As I have various symptoms my doctor wants me to start on thyroxine and retest in a month. I feel a little confused and wonder if this is the correct course and whether any further testing needs to be done. She did seem to suggest it is rather unusual in 31 year old men though my cousin (male) has an underactive thyroid.

As for symptoms. For the last year I am tired and lost all motivation which for me is a major change. Skin has been very dry and my heart rate rests around 50 (Back in my fit youth it was more around 60). And in the last few months I have developed random pains in legs and recently arms; as well as a ringing in my ear. My physio also thinks my reoccurring tendinitis may be related to thyroid - hence the initial test.

Last edited by MoleBob; 05-18-2012 at 04:54 AM. Reason: Adding Symptoms

 
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Old 05-18-2012, 05:00 AM   #2
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Re: High TSH, normal (low-end) free T4

I know many men that are hypothyroid---even my endocrinologist who is male so that's an odd statement---I wonder what your free t3 is? Has it been tested?

 
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Old 05-18-2012, 05:13 AM   #3
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Re: High TSH, normal (low-end) free T4

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Originally Posted by Reece View Post
I know many men that are hypothyroid---even my endocrinologist who is male so that's an odd statement---I wonder what your free t3 is? Has it been tested?
Well this is just my GP (I am in the UK). She didn't seem that interested in testing other things at the moment beyond antibodies and was more interested if the drug changed my symptoms. I am not sure if I should be referred to an endocrinologist or not.

 
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Old 05-18-2012, 06:11 AM   #4
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Re: High TSH, normal (low-end) free T4

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I am not sure if I should be referred to an endocrinologist or not.
At this point not necessarily, the main thing is to get you some treatment ie. thyroid replacement.

 
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Old 05-18-2012, 06:17 AM   #5
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Re: High TSH, normal (low-end) free T4

Your symptoms indicate hypothyroidism and your labs confirm it.

TSH > 2 is a sign that thyroid hormone levels are too low for the body's needs.

Your FreeT4 thyroid hormone levels is definitely lower than a healthy person would have. Healthy people have FreeT4 levels towards the high end of the range.

You are very, very fortunate that your GP wants to start you on treatment - many doctors miss what is obvious to us.

I wouldn't necessarily be in a rush to see an endo - many of them are horrible at treating thyroid disease.

Starting on thyroxine will get you on the path to wellness. It will take some time for your meds dose to be titrated to a point that will eliminate symptoms but, it will happen if your dose is appropriate.
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Old 05-18-2012, 06:57 AM   #6
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Re: High TSH, normal (low-end) free T4

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Originally Posted by sammy64 View Post
I wouldn't necessarily be in a rush to see an endo - many of them are horrible at treating thyroid disease.

Starting on thyroxine will get you on the path to wellness. It will take some time for your meds dose to be titrated to a point that will eliminate symptoms but, it will happen if your dose is appropriate.
I guess I didn't know if the cause needs to be found out or not - hence unsure about an endo. But reading around I get the feeling not really needed.

Well it did take months of work to get this far and it is only 25mg for a month and then retest but it is start.

 
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Old 05-18-2012, 07:25 AM   #7
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Re: High TSH, normal (low-end) free T4

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Originally Posted by MoleBob View Post
I guess I didn't know if the cause needs to be found out or not - hence unsure about an endo.
The cause is usually revealed by those raised antibodies which mean Hashimoto's thyroiditis. Even if you don't have elevated Abs the treatment is the same (unless it's a rare case of adrenal insufficiency causing hypothyroidism but don't worry about that at this point). If you have no problems with your medication and symptoms start to subside then you can be pretty sure thyroid replacement is what you need.

Last edited by FinnMaid; 05-18-2012 at 07:26 AM.

 
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