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Doctor insights on: Pituitary Tsh

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My free T4 is high 19.30 pmol/l and my TSH is also high 4.530 mlu/l. What does this mean?

My free T4 is high 19.30 pmol/l and my TSH is also high 4.530 mlu/l.  What does this mean?

Few possibilities: These labs seem at odds, with TSH suggesting overactive thyroid and ft4 underactive thyroid. Free T4 tests can be inaccurate in some people who have interfering substances present. Another possibility is a tumor in the pituitary secreting too much TSH resulting in thyroid overactivity, and high thyroid hormone levels. This is quite rare, however. Your doctor can help sort this out. ...Read more

Dr. Quang Nguyen
926 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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3.1 Prolactin level? Pituitary Microadenoma TSH levels up and down, no other tests done. Is this level okay?

3.1 Prolactin level? Pituitary Microadenoma TSH levels up and down, no other tests done. Is this level okay?

Normal prolactin: This is a good prolactin level for a follow-up assessment. Surprisingly so. Are you on any medications? have you had surgery on the pituitary? Regardless, with these labs, the appropriate course is follow-up. Re-check the labs in 6-12 months depending on symptoms. ...Read more

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Had TRH (thyrotropin) stim test to evaluate pituitary/thyroid func.TSH base=3.27 TSH @ 0, 30, 60 min, respectively 1.48, 1.34, 1.10, opposite of norm?

Had TRH (thyrotropin) stim test to evaluate pituitary/thyroid func.TSH base=3.27 TSH @ 0, 30, 60 min, respectively 1.48, 1.34, 1.10, opposite of norm?

TRH Stim Test: You are right. TSH should have elevated from TRF infusion. The flat response indicates pituitary hypofunction. This can be due to adenoma, pituitary "infarction" with pregnancy delivery associated blood loss and hypotension, or surgical removal. (You would be aware of that for sure...). So, MRI is essential. And some other hormone testing, such as ACTH and cortisol, prolactin, etc ...Read more

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Controversy surrounds those patients with a suppressed tsh. Isn't it true that when a hypothyroid patient starts taking exogenous th, a negative feedback system reduces the pituitary gland's output of tsh. This decreases the thyroid gland's output of en

Controversy surrounds those patients with a suppressed tsh.  Isn't it true that when a hypothyroid patient starts taking exogenous th, a negative feedback system reduces the pituitary gland's output of tsh.  This decreases the thyroid gland's output of en

Endo feedback: With primary hypothyroidism, TSH is elevated in an effort to push the thyroid gland to make more thyroxine. Treatment with levothyroxine indeed signals the pituitary to reduce TSH output. Secondary is when either/or pituitary +/- hypothalamus is damaged but unable to produce tsh. Then, thyroxine levels drop but the pituitary can't respond. Tsh can't monitor treatment but free T4 levels can. ...Read more

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What can cause low TSH of its not a Thyroid or pituitary problem? 0.01 TSH T3 (liothyronine) and T4 free normal, graves and hasmitos negative

What can cause low TSH of its not a Thyroid or pituitary problem? 0.01 TSH T3 (liothyronine) and T4 free normal, graves and hasmitos negative

2 possibilities: Hi. First of all, Hashimoto's doesn't cause a suppressed TSH, and YES, your TSH is SUPPRESSED, not "low", because your free T4 and total T3 (liothyronine) are "normal". A low TSH (pituitary defect) would cause low free T4 and possibly/probably low T3 (liothyronine). The most likely is a "hot" thyroid nodule (autonomously hyper-functioning); second most likely would be a phase of subacute thyroiditis. Follow over time to tell. ...Read more

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Pituitary failure responsible for hypo or hyperthyroid & TSH goes to low or high side of normal range?

Pituitary failure responsible for hypo or hyperthyroid & TSH goes to low or high side of normal range?

Hypopituitarism: Specifically on the thyroid, pituitary failure as seen in sheehan syndrome can lead to low tsh, low signal to the thyroid and low production of thyroid hormone. ...Read more

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What does it mean if a patient has a pituitary tumor that secretes large amounts of tsh?

What does it mean if a patient has a pituitary tumor that secretes large amounts of tsh?

Tumor forming TSH: TSH-secreting pituitary adenomas are benign tumors of the pituitary gland. They produce too much thyroid stimulating hormone (TSH) which causes the thyroid gland to enlarge and produce thyroid hormone in excess, leading to an overactive thyroid (hyperthyroidism) .most common initial therapy for patients with a TSH-secreting pituitary adenoma is transphenoidal resection of the tumour. ...Read more

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Could TSH 0.6 & ft4 0.9 & extreme fatigue/low body temp possibly suggest pituitary problems? More workup or seek other etiology?

Could TSH 0.6 & ft4 0.9 & extreme fatigue/low body temp possibly suggest pituitary problems?  More workup or seek other etiology?

Work up: Hopefully, you have been referred to an endocrinologist to discuss these laboratory results. Single values in a vacuum often do not tell the whole story, and the hypothalamic, pituitary, thyroid, end organ axis can have a number of reasons for these results. Best to discuss with the person who ordered the tests to get an appropriate referral and make sure you're up to speed with the plan. ...Read more

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Tsh has gone to .007 to .02 now .07 still very low! my Synthroid (thyroxine) 88 my lowest dose ever. Is this showing another problem? Pituitary?

Appropriate: Your TSH level should go higher (as it has) as your dose of thyroid hormone is lowered. Tsh, a pituitary hormone which regulates thyroid output, moves inversely with the level of thyroid hormone. You latest level indicates your current dose of medicine is still higher than you need. You may need a very small dose. It's even possible that, at least for a while, you may need none at all. ...Read more

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Help my TSH was 0.83 range is 0.3 - 5.6 my cortisol am fasting serum was 254 range is 185 - 624 honstly is there a chance for pituitary microadenoma ?

Help my TSH was 0.83 range is 0.3 - 5.6 my cortisol am fasting serum was 254 range is 185 - 624 honstly is there a chance for pituitary microadenoma ?

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. The results you provided do not suggest the presence of pituitary lesion nor do the results rule it out. What makes you suspect that you have pituitary microadenoma? ...Read more

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I have enlarged isthmus measuring up to 9mm and contains a 4 mm hypoechoic nodular lesion. TSH is 1.85. Have hx of pituitary adenoma with nml prolacti?

I have enlarged isthmus measuring up to 9mm and contains a 4 mm hypoechoic nodular lesion. TSH is 1.85. Have hx of pituitary adenoma with nml prolacti?

Common: Thyroid nodule are common. Each thyroid nodule only has a apprx 5% chance of cancer. Most of the time, they are just growth and not cancerous. Yours is small. Just need to be monitored for size changes over time. ...Read more

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My one year baby female is having tsh-8.71, t3-194, t4-11.2 this means that she having pituitary disorder?

Need a specialist: These labs seem very unusual. On the surface, a TSH secreting pituitary tumor is possible. But this is extremely rare. A more likely explanation could be a mistake in the lab tests. You should see a pediatric endocrinologist before doing anything drastic. ...Read more

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What does the top number in BP mean? Trouble with tsh level - rapid HR after 2 a.m. bp 133/80 usually 110/78. Blood test - pituitary hormone waiting?

What does the top number in BP mean? Trouble with tsh level - rapid HR after 2 a.m. bp 133/80 usually 110/78.  Blood test - pituitary hormone waiting?

How high it gets: Systolic (top) blood pressure is a measure of the maximum pressure in the arteries during the cardiac cycle, and the diastolic of how low it gets (between heartbeats). Stop worrying about minor fluctuations like this; systolic jumps wildly in everybody. Hoping that you turn out to have a healthy thyroid -- you say yours was removed. Your physician's your best information source; we can still help. ...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?

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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With low TSH 0.02 but all normal thyroid and pituitary gland tests what could,be causing the suppressed tsh? Confused please help....

With low TSH 0.02 but all normal thyroid and pituitary gland tests what could,be causing the suppressed tsh? Confused please help....

Depends: Hi. How long has your suppressed TSH been present? If more than a couple months, and your free T4 and T3 (liothyronine) are normal, it's most likely an autonomous hyper-functioning ("hot") nodule (or multiple hot nodules). ...Read more

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When pituitary gland is responsible for thyroid .Then effect on TSH goes to high or low side of normal range means hypo or hyperthyroid condition?

If your: Pituitary is responsible for hypothyroidism, by definition your TSH will be low. That's what causes the thyroid deficiency. If it is normal, and your free T4 is normal, you do not have hypothyroidism or are on replacement, possibly unnecessarily. Check w/your doctor or see an endocrinologist. ...Read more

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High TSH 9.5, but normal T4 1.0. Mix of hypo and hyper symptoms. GP treating me as hypothyroid (Synthroid), but could I have a pituitary/other issue?

High TSH 9.5, but normal T4 1.0. Mix of hypo and hyper symptoms. GP treating me as hypothyroid (Synthroid), but could I have a pituitary/other issue?

Yes: Your question is VERY smart. It could be your pituitary- or other causes. Overall Endocrinologists handle this complex thyroid question, so you may want to see one. Stay well ...Read more