Thyroid Lab Anomalies

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Have you had thyroid labwork that does not make sense?  A high TSH with high T4 and T3 or a low TSH with low T4 and T3?  Where antibody tests also run?  What did your doctor advise?

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    Well.. a high TSH with a high T4 is possible.  The most common cause is a non-compliant patient.  Say if they don't take their medication properly and then take extra before blood work to "catch up".  Another reason for high TSH with a high T4 is resistance to thyroid hormone (RTH) syndrome.  RTH is a heterogeneous group of disorders caused by mutation in the thyroid hormone receptor (THR) gene.  With only 1 in every 40,000 births having RTH, it's pretty rare.  The last cause and the most rare, is a TSH secreting pituitary adenoma.   As for low TSH with low T3 and T4, Central Hypothyroidism can cause this.

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