A 23-year-old female asked:
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can a high tsh level but normal t4 cause hypothyroid symptoms or not?

2 doctor answers
Dr. Philip Kern
42 years experience Endocrinology
Maybe: Your symptoms may be from subtle hypothyroidism. Although your T4 is in the normal range, it may be lower than it was. Some people are sensitive to minor variations in t4. On the other hand, the symptoms of hypothyroid can be due to other things. Once you get treated with levothyroxine, you will know.
Answered on Feb 3, 2015
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Dr. Michael Rothman
34 years experience Internal Medicine
Yes: Hypothyroidism can be primary - caused by a weak thyroid gland or secondary to other hormonal problems, like a pituitary problem. Or your thyroid can become dysfunctional secondary to high insulin, estrogen or cortisol. If you have functional hypothyroidism, this problem can go undetected by routine screening tests. More extensive testing can often reveal abonormalities. This is very common.
Answered on Feb 3, 2015
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Dr. Wendy Askew
Dr. Wendy Askew commented
23 years experience Obstetrics and Gynecology
Dr Rothman is correct. T4 is inactive, only T3 relieves symptoms. If you can't convert T4 into T3 you can have hypothyroid symptoms. Also, we don't have a way of testing thyroid receptors to know if they are functioning properly.
Dec 21, 2013

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