High TSH and high T4

Posted , 4 users are following.


I'm wondering if anyone has experienced before. My TSH approx 5 weeks ago was 3.8 and my T4 20. My T3 was 4.9. 

All are in "normal range" but yet appear to be odd results. My doctor scratched her head and we haven't yet dealth with what might be going on. I am planning on discussing seeing an endo at my next visit.

I have previously been diagnosed with Graves disease and have had a 2 year round of Carbimozole. I have been off medication for a few years now. 

I have recently been under A LOT of stress and am wondering if this is the culprit. 

I am currently seeing a homeopath who also has a PhD in thyroid. We are waiting on a hair analysis test to come back.

I've also done a saliva test with my GP to check my cortisol levels. I'm also waiting on those results. 

Can anybody relate to these TSH and T4 results and what symptoms were you experiencing? 

I currently have hand tremors on and off, a feeling of being hyper but yet exhausted. And I've lost weight over the last year. I've always been a slight build as well with a very fast metabolism. 



0 likes, 12 replies

Report / Delete

12 Replies

  • Posted

    The TSH seems to be rather high even within range for you to be hyperthyroid.  Do you know what the ranges are for each of the tests?  I'm thinking the T3 is not low, especially if it is Free T3.  I understand that FT3 can vary a lot throughout the day, though. I see your FT4 would be high.

    I don't identify with much of what you are dealing with, except also not needing the Methimazole [similar to Carbimazole] that I stopped in December 2013.

    I know hand tremors are something they look at with hyperthyroidism, as are weight loss and possibly even exhaustion, but you can be exhausted with either hypo or hyper.  Stress could possibly also cause any of those symptoms.

    Usually if both TSH and FT4 are in the same part of the range it is because they are both low.  I have no idea about them both being high.  The Endocrinologist should be able to tell you.

    Report / Delete Reply
    • Posted

      Hello,  yes my results and ranges are, TSH 3.8 (0.40-4.00)  FT4 20 (10-20) and FT3 4.9 (2.8-6.8).

      All are in range but the TSH and FT4 are at the higher end of the "normal" range. 

      As far as I understand, it's confusing that my TSH is high (leaning toward underactive), and my FT4 is high too (yet leaning toward overactive). 

      I've recently learned that the TSH range should now actually be 0.3-2.0.

      I was mostly wondering if anybody had any insight on what can confuse the thyroid.


      Report / Delete Reply
  • Posted

    Hi Ruby, It sounds like you are suffering both HYPOthyroid and HYPER thyroid symptoms, this isnt unheard of.  Your thyroid sounds like it has been placed under pressure due to Graves and it may be about to flop.  Have you had antibody testing done as Hashimotos may be present causing the hypo symptoms.  

    You are having the right tests done regarding adrenals; both hair analysis and salivary testing will identify adrenal insufficiency.  Without doubt your adrenals will need support and I've written extensively on this, look at Adrenal Insufficiency forum. You don't need drugs you can do it with vitamins and minerals, etc.  check it out.  Stress most deficnately YES has a huge impact on your adrenals and hence it will impact your thyroid too; they are like sisters, find one and the other pops up too.  Stress Raises the levels of Cortisol in the body.  Rasied levels of Cortisol impact thyroid homrone.  So it is no surprise you're suffering like this.  

    Easy to say but reduce your stress levels any way that works for you.  Pay attention to those around you who have the knowledge; it sounds like you're on the right track.

    Educate yourself; don't rely solely on others and think about it before you do anything..  

    Sometimes rT3 or reverse T3 is seen in hgih levels and this can bring about hypothyroid symptoms too.  Reverse T3 is a mirror image of T3 and the body cannot use it; some say it is a primitive hibernation response when food in winter was scarce.  However, that is something to think about because it can cause similar blood levels to those you describe.  You need T3 and rT3 blood levels to work out the ratio of the two.  There is a Yahoo group dedicated to this subject and also a website too.  

    Do not rely too much on blood test results though; how you feel is THE most important factor.  The TSH and T4 blood tests don't give much help to be honest.  The rT3 ratio and Antibodies may give some indication of what is going on but actually the treatment is down to HOW YOU FEEL.

    Best of luck; keep us updated, I hope things improve for you.  But remember educate yourself too.

    Report / Delete Reply
    • Posted

      This may well be true, but don't expect a doctor of traditional medicine to believe it.  

      They will say, "There is no such thing as adrenal insufficiency." "There is no reliable test for low free T3, and rT3 just means you have a non-thyroidal illness causing your symptoms."  "The TSH test is the most reliable thyroid test and is the only one needed most of the time."  I have heard it all.

      I do believe that how you feel is the most important thing unless you really have dangerous symptoms like a resting heart rate greater than 80 beats per minute, or high blood pressure.

      It is your choice whether you go the traditional route or the one with alternative medicine.  Even if you choose traditional, though, sometimes you can work around what the doctor says and take ultimate control of your own health.

      Report / Delete Reply
    • Posted

      Thanks so much for your replies, I greatly apprectiate them. It is so hard to find good help, so thank you.

      I am expecting both results either by tomorrow or Monday. 

      I was tested for Anti-Thyroglobulin Ab, Anti-Thyroid Peroxidase Ab and TSH Receptor Antibodies years ago and all three were found to be high. This was around the time I was diagnosed with Graves disease and was put on Carbimozole. The Anti-Thyroid Peroxidase was particularly high. I'm not sure if I've had them tested recently? Or if it's necessary? Once you have antibodies, you always do? I'm not sure. 

      I feel that my adrenals are suffering somehow, but I'm confused as to how, because I seem to have a type of energy, the kind that allows me to walk around and make food, drive my car, but stress or overwhelming emotions, subconscious battles, seem to drain another kind of energy which panics me momentarily until I breathe and relax for 15 to 30 minutes before this energy restores. My physical symptoms seem really odd. They're hard to explain. I will be looking foward to reading your information once I know more from my hair and saliva results. 

      I am working on "mindfullness" among other things, for relaxation and reduced stress, I know stress and worry has been my biggest problem. 

      I am currently reading up on thyroid diseases, and natural ways to help etc. I agree, self education seems like the key. 

      I don't know anything about rT3 at this stage but I will keep it in mind.

      I definitely feel like I have both Hypo and Hyper symtoms. I'm hoping my results give an indication as to why this is. I want to start treating the cause ASAP.



      Report / Delete Reply
    • Posted

      It was my understanding that the thyroglobulin (tg) and Thyroid Peroxidase (TPO) are proteins in the thyroid that help produce thyroid hormones, mostly thyroxine.  When there are antibodies against them, it is a sign of Hashimoto's Thyroiditis, the autoimmune type of hypothyroidism.  You can have both kinds of antibodies at the same time, the Graves' Disease type which are stimulating the thyroid to produce more thyroxine and these others that are destroying the thyroid. The TSH Receptor Antibody test (TRAb), if I understand correctly, is more general, testing whether there are any antibodies present of either type.
      Report / Delete Reply
    • Posted

      Hi Fern, I had another thyroid function test and my results came back as:

      TSH 1.9 (0.3-3.5)

      FT4 14.4 (9.0-19.0)

      FT3 4.2 (2.6-6.0)

      And my saliva test came back suggesting I have low midday and low afternoon cortisol but normal morning and evening cortisol. 

      Do you know anything on this? My thyroid seems to have corrected it self?


      Report / Delete Reply
    • Posted

      Hi Ruby,  I don't know anything about the saliva test, but it looks like your thyroid tests are all in range.  

      How do you feel now?  Is it about the same as in your original post?

      Some people feel best when the FT4 and FT3 are high within the range.  Your FT4 is at about 54% of maximum, and your FT3 is at about 47%. Your TSH seems to be at the middle of the range, so it seems like it is accurately reflecting the FT4 and FT3 values.

      It is stressful and worrisome to have to deal with thyroid problems, even if there is no other problems going on.  If you are not feeling as well as the numbers seem to make it look, you might ask your doctor about stress and depression.


      Report / Delete Reply
  • Posted

    I'm also curious as to what these results mean. I have just scored 4.9 for TSH levels and 15.4 for free T4 levels. These are within the limits, according to my Doc, although at the high end.But the more I read, the more concerned I am that they are both rather higher than normal. I'm not on any Thyroid medication, but do have Hypo symptems, namely hair loss. Should I be concerned? 

    Report / Delete Reply
    • Posted

      I didn't get tested for T3. My hair loss is also very gradual.

      Interested in the B12 connection, as I take Metformin which some sources say can deplete your B12. I have been taking a B12 supplement for the last couple of months. Not long enough to see it has helped at all.

      Seeing my Doc in a couple of weeks for an unrelated issue, so will ask then.

      Report / Delete Reply
    • Posted

      Regular B12 doesn't seem to help me. I also took Metformin for a while, but I had only negative effects, so I stopped. My blood tests for B12 are tops, but the key seems to be the methylation.

      I understand the metformin is for diabetics and I may have been seen as pre-diabetic when the doctor prescribed it. maybe I still am, but my doctor didn't push for it when I told him I stopped taking it.

      As a base for understanding my situation, you may want to consider this: I am 69 years old, was found to be hyperthyroid at age 60. I am 5 ft. 6 in. tall and weigh abt. 195 lbs. I am helped by a personal trainor who styles a combination cardio and weight training excercise routine for me about once a week. I have been off anti-thyroid drugs since 2013, took a T3 supplement for a few months in 2014 and levothyroxine for a few weeks before my tests showed I was hyperthyroid again. I was taken off of them and have had my numbers in the normal range for the last three years.


      Report / Delete Reply

Join this discussion or start a new one?

New discussion Reply

Report or request deletion

Thanks for your help!

We want the forums to be a useful resource for our users but it is important to remember that the forums are not moderated or reviewed by doctors and so you should not rely on opinions or advice given by other users in respect of any healthcare matters. Always speak to your doctor before acting and in cases of emergency seek appropriate medical assistance immediately. Use of the forums is subject to our Terms of Use and Privacy Policy and steps will be taken to remove posts identified as being in breach of those terms.

newnav-down newnav-up