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Doctor insights on: Low Free T4 Normal Tsh

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Hello, I have low free t4 but normal t3 tsh and all other metabolic panels. What could be causing this?

Hello, I have low free t4 but normal t3 tsh and all other metabolic panels. What could be causing this?

Thyroid: A low free T4 may be important but surely your doctor has discussed this with you.
If this has not happened but you feel OK, relax for a bit.
However, if you really are concerned please have your Primary doctor refer you to an Endocrinologist.

All should go well! Please let me know. ...Read more

Dr. Quang Nguyen
943 Doctors shared insights

Thyroid Stimulating Hormone (Definition)

A TSH test measures the amount of thyroid stimulating hormone (TSH) in your blood. TSH is produced by the pituitary gland and tells the thyroid gland to make and release the hormones thyroxine ...Read more


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What is significance of low free T3 (liothyronine) and free T4 & normal tsh?

What is significance of low free T3 (liothyronine) and free T4 & normal tsh?

Hypothyroidism: Some scientific studies show that the optimal range for TSH is 0.8-2.1

in fact a TSH >2.5 is associated with Insulin resistance, as the TSH increases (above 2.5) the LDL goes up and the HDL goes down. There are countless patients walking around with undiagnosed hypothyroidism because the normal range of TSH is way too broad. ...Read more

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Normal TSH but low free t4? What's th3 difference between these 2 test? Do I have a thyroid problem?

Normal TSH but low free t4? What's th3 difference between these 2 test? Do I have a thyroid problem?

Reproducible?: Hi. Is the lab profile with normal TSH and low free T4 reproducible? The labs should be repeated. If the free T4 was just below the normal range, and on repeating it's in the normal range, then your thyroid function is normal. If free T4 is significantly low and TSH is normal, that suggests pituitary disease affecting the pituitary cells that make TSH. Good luck! ...Read more

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Tests show I have a normal tsh, T3 (liothyronine) but low T4 & free T4 and antibody of. 7 what do these results mean?

Tests show I have a normal tsh, T3 (liothyronine) but low T4 & free T4 and antibody of. 7 what do these results mean?

See below: All laboratory results need to be interpreted in the clinical context and the doctor who ordered the tests is usually in the best position to do that. It would help to know the actual values of all the hormones. ...Read more

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What does a normal TSH but low free T4 level mean? Can you have an underactive thyroid with a low T4 alone? Tsh 2.45 T4 7

What does a normal TSH but low free T4 level mean? Can you have an underactive thyroid with a low T4 alone? Tsh 2.45 T4 7

Thyroid function: When TSH is normal and T4 is low this is called subclinical hypothyroidism. It is not treated unless if you have symptoms.
Also if TSH > 10 some would start treatment. Hope that helps answer your question. ...Read more

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Hypo symptoms but endo will not treat as Free T4 normal&TSH ranges 2.8 to 4.4. Hashimitos confirmed many time by excess TPO/ab. Could treating help?

Hypo symptoms but endo will not treat as Free T4 normal&TSH ranges 2.8 to 4.4. Hashimitos confirmed many time by excess TPO/ab. Could treating help?

Not deficient: Hashimotos can go through three phases, 1. uncommonly it may cause hyperthyroidism in an early phase of the disease, 2. followed by normal thyroid function and the 3. long phase of hypothyroidism. At this time you do not thyroid deficiency and taking thyroid medication is unlikely to be helpful. ...Read more

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What does normal tsh, but high free T4 mean?

Recheck the labs: Normally, if the ft4 is high, either due to hyperthyroidism or taking too much synthroid, (thyroxine) your TSH is low. Mistakes in labs can occur, so first have them rechecked. Rarely, you can have a pituitary tumor that makes TSH and causes hyperthyroidism, giving you both increased TSH and ft4. But this is rare, and more likely there is a simple explanation. ...Read more

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Tsh levels are these normal? Tsh- 3rd generation- 1.04 miu/l, then another one was 0.63 miu/l. Tsh w/free T4 rfx 1.50 miu/l. Are these normal levels?

Tsh levels are these normal? Tsh- 3rd generation- 1.04 miu/l, then another one was 0.63 miu/l. Tsh w/free T4 rfx 1.50 miu/l. Are these normal levels?

Probably: Most labs include a reference range (or normal range) in their reports. While there can be some variation from one lab to another, almost all labs would consider TSH values between 0.5 to 3.0 to be normal. All three of your levels fall in this range, and so would be considered normal. ...Read more

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Normal TSH, high free T4 mild elevation, what might be the cause?

Normal TSH, high free T4 mild elevation, what might be the cause?

Repeat the labs: Hi. In all likelihood, it's a lab error or some trivial explanation. Repeat the labs to see if the lab profile is reproducible. Among the very rare possibilities that it's real would be thyroid hormone resistance, a condition wherein a mutation in a subunit of the thyroid hormone receptor is present (these people are euthyroid), or a pituitary adenoma that makes thyroid hormone (these are hyperthy ...Read more

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I have a normal TSH and free T3 (liothyronine) but elevated free t4. What does this mean?

I have a normal TSH and free T3 (liothyronine) but elevated free t4. What does this mean?

Probably nothing: Are you taking thyroid replacement? A normal TSH usually means all is ok. See a thyroidologist. ...Read more

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T4 is elevated. 14.4 but Free T4 and Free T3 normal, TSH normal, antithroglobulin AB is 14, normal range 0-115?

See below: All laboratory results need to be interpreted in the clinical context and the doctor who ordered the tests is usually in the best position to do that. Having said that, if free T4 and T3 and TSH are normal, there is no cause for concern. T4 may be elevated in women on birth control pills.
For good health - Have a diet rich in fresh vegetables, fruits, whole grains, milk and milk products, nuts, beans, legumes, lentils and small amounts of lean meats. Avoid saturated fats. Drink enough water daily, so that your urine is mostly colorless. Exercise at least 150 minutes/week and increase the intensity of exercise gradually. Do not use tobacco, alcohol, weed or street drugs in any form.
Practice safe sex, if you have sex. ...Read more

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I had a us of my thyroid and they found a hypoechoic nodule measuring 0.413 x 0.546cm. Blood test came back normal TSH and free T4 really nervous.?

Please don't worry: One of the next steps is usually a fine needle aspiration biopsy, which involves using a very skinny needle to remove cells from the nodule. In my experience, most of these cells are benign, especially give the size of your nodule. However, if they are malignant or suspicious, you will need thyroid surgery. Most thyroid cancer (papillary type) can be cured. ...Read more

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Normal TSH and free T3 (liothyronine) but elevated free t4; is that still hyperthyroid?

Normal TSH and free T3 (liothyronine) but elevated free t4; is that still hyperthyroid?

Can still be normal.: Hyperthyroidism is considered when the TSH is low and the T4 is high. Otherwise the thyroid function may still be considered normal. There are many causes of high thyroiod hormone like thyroiditis, surreptitious use of thyroid hormone, amiodarone use, and postpartum thyroiditis which occurs in 7% of patients after pregnancy where patients are hyperthyroid, then return to normal levels without rx. ...Read more

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Can someone have an enlarged thyroid (not from nodules), but completely normal tsh, free T4 and T3 (liothyronine) studies?

Can someone have an enlarged thyroid (not from nodules), but completely normal tsh, free T4 and T3 (liothyronine) studies?

Yes: The size of the thyroid does not relate to the function. People can have large thyroids with low, normal, or high thyroid levels. Most people with goiters (enlarged thyroid) have normal thyroid function. ...Read more

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I am on Synthroid (thyroxine) 0.1mg. Recent blood work showed normal TSH, free T4 but antithyroid peroxidase antibody was 451. Should I be concerned?

I am on Synthroid (thyroxine) 0.1mg. Recent blood work showed normal TSH, free T4 but antithyroid peroxidase antibody was 451. Should I be concerned?

Yes: TPO antibodies indicate that your immune system is producing AB against your Thyroid.
Look up Leaky Gut and address it by diet, (no gluten or dairy) supplementation, and life style changes.
Once resolved you AB will get to normal levels. ...Read more

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Mildly elevated CPK and sed low iron abnml TSH but free T4 normal what does all this mean?

Mildly elevated CPK and sed low iron abnml TSH but free T4 normal what does all this mean?

Not enough info: How high is the tsh? Any anemia? Other health issues? Any other health history, physical or lab findings? Please provide more info. ...Read more

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What do I do if my TSH levels are normal, but my free T4 is low, and I am having hypothyroid symptoms?

Central hypothyroid: Free T4 assays can sometimes be unreliable and you and your physician will be better off if you have your total T4 measured instead along with T3 (liothyronine) update to calculate what we call free thyroid index. If you have symptoms of hypothyroidism and your T4 remain level despite normal TSH then you may have a type of hypothyroidism called central hypothyroidism (your pituitary hormones should be checked). ...Read more

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My TSH levels are normal, but my free T4 is low...Hypothyroidism?

My TSH levels are normal, but my free T4 is low...Hypothyroidism?

Pituitary evaluation: If the TSH is normal, it means that you do not have primary hypothyroidism. However, you could still have secondary hypothyroidism because of a pituitary problem. You should see an endocrinologist for further evaluation. ...Read more

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My 19 year old son has labs showing low TSH but normal free t4. What could that indicate?

My 19 year old son has labs showing low TSH but normal free t4. What could that indicate?

Depends: On the level of tsh. If TSH level remains in the range 0.2-0.6, he is at very low risk of developing hyperthyroidism. Retesting is not recommended. ...Read more

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What does low TSH 0.2 with normal free T4 mean? What is its treatment and does it need to be taken all life long?

Likely normal: Your TSH may be slightly low and may be normal for you. Do you have any symptoms? It is generally not a good idea to treat lab values. All lab results need to be interpreted in the clinical context and the doctor who ordered the tests is usually in the best position to do that. It is likely that you need no treatment, however, it would be prudent to follow your doctor's advice for follow up tests. ...Read more

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Very low TSH with high normal free T4. Twitching. Changed dose. How long til levels normal out? Still twitching 2 weeks later. Had basic neuro exam.

What did you: Change the dose of? If it's thyroid replacement, it can take weeks for the level to normalize, asumming you're now on the correct dose. If it's an ANTI-thyroid drug, it can takes months to work as it only inhibits the formation of NEW thyroid hormone, not the hormone that's already been manufactured. ...Read more

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Could a low TSH but normal Free T4 mean a Pituitary problem? Or would that be more indicative of the start of Hypothyroidism?

Sounds normal: Your description is consistent with normal thyroid function, but if you are concerned, you could provide exact numbers for us to review. ...Read more

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My TSH is high end of normal at 0.66, free T4 is 1.3 but my free T3 (liothyronine) is low end of normal at 2.7. Why does my TSH not better correlate with free t3/t4?

Hard to say,,: First, the TSH isn't at high normal, more like low normal (0.4-2.5uiu/ml), next is that the ft4 is at a high normal value. The ft3 is around low normal but it has a low half life so that might be why. You've got a history of hashimoto's which leads to hypothyroidism and take synthesis for replacement which can explain these values so it's good to see your doctor for a possible med adjustment. ...Read more

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Tsh is high end of normal at 0.66, free T4 is 1.3 but free T3 (liothyronine) is low end of normal at 2.7. T3 (liothyronine) and T4 down 1 point in 1 month. Felt better before. Why?

Tsh is high end of normal at 0.66, free T4 is 1.3 but free T3 (liothyronine) is low end of normal at 2.7. T3 (liothyronine) and T4 down 1 point in 1 month. Felt better before. Why?

Normal TSH: They key word is "normal". Your TSH is normal, which means your pituitary believes your thyroid hormone levels are normal, and the pituitary is usually right. You list a number of autoimmune rheumatologic disorders. These may be responsible for your symptoms, rather than your thyroid. See your rheumatologist. ...Read more

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I'm on 2.25 g of armour. Tsh is almost 0 and free T4 is low. Free T3 (liothyronine) is low normal.)?

Don't use Armour!: Few doctors treat an underactive thyroid with Armour Thyroid since l-thyroxine (t4) is much more precise in terms of dosing. While armour contains both T4 and t3 (liothyronine), (liothyronine) your body can convert T4 into t3 (liothyronine). You didn't say what your TSH level actually is. If it is above 0.5 you are fine but if it is below 0.5 and especially if below 0.1 you are on too much. Would see a doc who will prescribe T4 for you. ...Read more

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Blood test show thyroglobulin antibodies is high (low positive). but TSH, Free T4, and tpo is normal. Should I be concerned?

Thyroid disorders: It sounds like your thyroid is functioning well right now, but the high antibody level indicates possible future autoimmune thyroiditis in the future.
I'm not sure why you had this full work up. If you are symptomatic of thyroid disease, you might want to see an endocrinologist even with your normal results. If you do not have symptoms, your doctor may want to monitor your TSH periodically. ...Read more

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What does this mean? T3 (liothyronine) free normal, TSH normal, T4 categories-t4 high, t3u low, fti high. Tsh tested again 6 months later, lower but normal. On nuvaring only

What does this mean? T3 (liothyronine) free normal, TSH normal, T4 categories-t4 high, t3u low, fti high. Tsh tested again 6 months later, lower but normal. On nuvaring only

Normal thyroid tests: Normal TSH level indicates normal thyroid function in the majority of cases. Normal free t3 (liothyronine) and normal freet4 usually support the fact. Total T4 (t4) can be high without excess thyroid when the thyroxine binding globulin (tbg), a thyroid hormone carrier, is elevated, as in pregnancy and while taking a bcp. Then t3 (liothyronine) (resin) uptake (t3 (liothyronine)u) is low and fti normal (tests now outdated should not be checked. ...Read more

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I'm 32 weeks pregnant and have hypothyroid; TSH has been normal to this point on meds. Now TSH is low along with free t4, and t uptake. Tgb is high.?

I'm 32 weeks pregnant and have hypothyroid; TSH has been normal to this point on meds. Now TSH is low along with free t4, and t uptake. Tgb is high.?

Erroneous FT4 result: During pregnancy, hormonal changes interfere with ft4 testing kits and will often produce an erroneously low number. During this time, getting a tt4 or fti may produce more accurate results, though TBG often high. Tsh values are usually lower during pregnancy than when not pregnant. Tbg is always elevated during pregnancy because of high estrogen levels. ...Read more

Dr. Arnold Malerman
276 Doctors shared insights

Free T4 (Definition)

T4 is the main hormone produced by the thyroid gland total T4 is amount in blood stream attached to albumin, as well as 'free' in blood stream. Free T4 is just the amount free in serum, ...Read more


Dr. David Sneid
1,422 Doctors shared insights

Thyroxine (Definition)

Thyroxine is a thyroid agent. ...Read more