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Does normal T4 exclude thyroide malfunction?

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Old 06-14-2005, 04:31 AM   #1
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Does normal T4 exclude thyroide malfunction?

HI, it's me again:

Summary of symptoms:
weight loss (8 kg in two months)
abdominal pain (now over)
very, very tired all the time (not over)
pretty depri feeling (at occasions)


TSH 6.1
free T4 9.2

Since I had a lymphoma 10 years ago my neck was irradiated (high dose).
Now (after a set of scans = no cancer relapse (huraaaay )) but also no diagnosis. I told the doctor that I found this forum and that I suspect my problems are thyroid-related, but she said she doesnt think so: I possibly had a severe infection and the elevated TSH is is due to that. But she will repeat the test after six weeks (because of the irradiation history) + T3 which was not done yet. She is of the opinion that if T4 is normal my complaints are not thyroid caused/related. Probably true but I wanted to chek it here: does it comply with the experience of the people who had/are having thyroid problem?

Last edited by Pavell; 06-14-2005 at 04:54 AM.

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Old 06-14-2005, 06:05 AM   #2
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Re: Does normal T4 exclude thyroide malfunction?

I found some answers to your questions at the site of the National Assn of Clinical Biologists. This is a PDF file; if you can't read it on your computer, you can ******** the Word document from the site. The relevant information is found on pages 8 and 9 of the PDF file. ~

Anyway... what is the lab range for the FT4? Where your result falls within the range is important, because what's "normal" is proportional. The NACB report says that an abnormal FT4 result in a hospitalized patient should be confirmed by a T (total) T4 measurement. If both TT4 and FT4 are abnormal (in the same direction) a thyroid condition may be present. When TT4 and FT4 don't agree, the FT4 abnormality is unlikely due to thyroid dysfunction and more likely a result of the illness or medications.

The main gist of the NACB information agrees with what your doctor has told you. Severe non-thyroidal illness skews thyroid results. TSH often elevates, and either or both FT4 and TT4 can look abnormal as well.

It seems reasonable to take a wait and see approach; but as you know, the neck radiation has put you at high risk for hypoT, so it's very wise to keep an eye on things and test regularly.

Old 06-14-2005, 08:14 AM   #3
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Re: Does normal T4 exclude thyroide malfunction?

Thanks for valuable info and the link. It really confirms what I was told, an infection (which is now over or subsiding) or a result of earlier irradiation. I have an appoitment with the doctor after six week: all wil be checked again, so I will wait it out.

I am getting in a more peaceful mood now, it was a hell of a time, waiting for scans (did the cancer come back?) feeling ill around the clock...But I am grateful that it is not the cancer (all test/scans were negative) so I hope I am on a recovery track now.

Thanks again,


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