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Doctor insights on: Tsh Thyroid Stimulating Hormone With Reflex To Free T4

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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. John Landi
1 Doctor shared a insight

Hormone (Definition)

A hormone (from greek ὁρμή, "impetus") is a chemical released by a cell or a gland in one part of the body that sends out messages that affect cells in other parts of the organism. Only a little amount of hormone is required to alter cell metabolism. In essence, it is a chemical messenger that transports a signal from ...Read more


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I need to make a Thyroid-stimulating Hormone (TSH) and Free T4 test. How can I have it?

I need to make a Thyroid-stimulating Hormone (TSH) and Free T4 test. How can I have it?

Blood test: It is a standard blood test. Get a prescription from your doctor and a recommendation for a local laboratory.
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. 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. Drink enough water daily so that your urine is mostly colorless.
Practice safe sex. ...Read more

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Isn't the effect of thyroid hormones at pituitary level altered in patients without a thyroid under levothyroxine monotherapy? Therefore, TSH cannot always be considered an appropriate marker? Isn't free T4 & T3 a more approriate marker in levothyroxine-

Isn't the effect of thyroid hormones at pituitary level altered in patients without a thyroid under levothyroxine monotherapy? Therefore, TSH cannot always be considered an appropriate marker? Isn't free T4 & T3 a more approriate marker in levothyroxine-

No: If your body is not handling the levothyroxine well, your TSH level will be off and you will need to increase the dose. As long as your TSH is "normal", then it is accepting the levothyroxine as a hormone and is a good measuring parameter. Ft4 and ft3 varies throughout the day (especially if you are taking levothyroxine), thus they are not good tests to base your treatment on. ...Read more

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My dad is worried because his Thyroid Stimulating Hormone (Serum) is High (5.370) but Free T4 (Serum) is within range (14.80). Please explain and help?

My dad is worried because his Thyroid Stimulating Hormone (Serum) is High (5.370) but Free T4 (Serum) is within range (14.80). Please explain and help?

Ranges?: The TSH is slightly high but and free T4 of 14.80 (if that is not an error) is high. You say his free T4 is normal, however if this the case, he may have what we call subclinical hypothyroidism. Further testing may be needed (thyroglobulin antibody, thyroid peroxidase antibody) before any decision to treat can be made. ...Read more

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Tsh w reflex to free t4 component results value std range 2.55 0.45-4.5 is my test results good or bad at 2.55?

Tsh w reflex to free t4 component results value std range 2.55 0.45-4.5 is my test results good or bad at 2.55?

Normal: The value for TSH in the scenario you decribed is normal. However, like all lab tests, interpretation must be done with attention to the bigger picture. ...Read more

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Tsh w\reflex to free t4 is. 22. Free t4 is 1.65 is this normal. I take 75 synthroid?

Yes.: 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, free T4 value is normal. The low TSH suggests need for a discussion with your doctor about reducing the dose of synthroid.
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.
Get HPV vaccine, if you are under 27 years of age. ...Read more

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I have a blood test done and my TSH reflex to free T4 is 4.53. 50-4.30 miu/l is that bad?

I have a blood test done and my TSH reflex to free T4 is 4.53. 50-4.30 miu/l is that bad?

I agree to a point!: Tsh slightly elevated. Your body thinks your thyroid is low. The most common cause for hypothyroidism is hashimoto's thyroiditis, which can be indentified by the presence of anti-thyroglobulin antibodies and anti-TPO antibodies. Have these tests. If positive, I would place you on thyroid immediately. I would also have my free-t3 checked as well. Some do not convert T4 to t3! ...Read more

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My TSH is 9 & my TSH Reflex to Free T4 is 1.29, I still feel Fatigued & I don't feel well should I have my Dosage of Levothyroxine increase to 100 MCG?

My TSH is 9 & my TSH Reflex to Free T4 is 1.29, I still feel Fatigued & I don't feel well should I have my Dosage of Levothyroxine increase to 100 MCG?

TSH values: The TSH is your pituitary gland at the bottom of your brain talking to your thyroid gland saying "I don't see enough thyroid hormone around here." It stands for Thyroid Stimulating Hormone. You should speak to a good endocrinologist about your situation pronto and yes you should be on a higher dose of thyroid replacement hormone. ...Read more

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What to do if I had a blood test done and my TSH reflex to free T4 is 4.53. 50-4.30 miu/l is that bad?

Further workup: A TSH above normal indicates that your brain is telling your thyroid it needs better thyroid function. Have your free T4, free T3 (liothyronine), (liothyronine) Reverse T3 (liothyronine), (liothyronine) thyroglobulin and TPO antibodies, Ferritin, and SHBG levels checked to ensure the thyroid and tissue utilization/conversion to active thyroid is occurring. Furthermore, these levels should be optimized...TSH 3.6, low Rev T3 (liothyronine) ...Read more

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Blood results came back with a 4.27 (h). Tsh, reflex to free T4 tsh, highly sensitive. Leukocyte esterase - moderate hemoglobin - trace / WBC 6 (h)?

Blood results came back with a 4.27 (h). Tsh, reflex to free T4 tsh, highly sensitive. Leukocyte esterase - moderate hemoglobin - trace / WBC 6 (h)?

Reverse T3 (liothyronine): Check free T3 and reverse t3. Ft3 should be in upper range and rt3 in lower range. If your ratio is off, you may need Armour Thyroid or t3, and synthroid (thyroxine) would be the wrong med for you. Also consider checking thyroid antibodies. ...Read more

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My TSH with reflex to free T4 and T3 (liothyronine) came out to a range of 1.0. Is that normal? Been feeling horrific since I gave birth 5 months ago.

My TSH with reflex to free T4 and T3 (liothyronine) came out to a range of 1.0. Is that normal? Been feeling horrific since I gave birth 5 months ago.

That's a normal TSH: Hi. That's a normal TSH, but testing TSH alone only tests dysfunction of the thyroid gland itself. You need to get a TSH AND a free T4 (i.e., NOT "reflex") to see pituitary hypothyroidism (which, btw, can occur in rare cases associated with a particularly bloody delivery). Of course many problems can make you feel horrific. Can you make milk? I don't know what is wrong, but you need further eval. ...Read more

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I had a TSH REFLEX TO FREE T4 blood test done, my result is 3.70 (0.40-4.50 mIU/L), is this normal? Thank you.

I had a TSH REFLEX TO FREE T4 blood test done, my result is 3.70 (0.40-4.50 mIU/L), is this normal? Thank you.

Thyroid function: That appears to be within the normal range, based on the laboratory standard you provided. ...Read more

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Hi, I am a 37 year old female. History of excessive thinning hair. My TSH reflex to free T4=. 9. My ferritin= 17. My calc % Iron Sat= 20. Thoughts?

Hi, I am a 37 year old female. History of excessive thinning hair. My TSH reflex to free T4=. 9. My ferritin= 17. My calc % Iron Sat= 20. Thoughts?

Normal: Hair thinning is a very common complaint. Usually one can find no particular cause, though many medical conditions, medications, stress, age, genetics, nutrition, all influence hair growth. Your thyroid, and iron levels appear normal and are therefore unlikely to be a cause for hair loss. ...Read more

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Retested: tsh:11.5 (range 0.3-4.2) but normal free t4: 19 (ref12-22), vit d 11.3, triglyc 195 (nor 50-150, type 2 diabates, thyroid medication reqd?

Retested: tsh:11.5 (range 0.3-4.2) but normal free t4: 19 (ref12-22), vit d 11.3, triglyc 195 (nor 50-150, type 2 diabates, thyroid medication reqd?

Need thyroid med: Although your ft4 is normal, the repeatedly elevated TSH suggests that your thyroid is failing. Most docs would start you on levothyroxine, and retest to make sure you don't become hyperthyroid. But this may not affect your symptoms, diabetes, or tg. ...Read more

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TSH reflex free T4 test = 2.51 (normal range 0.35-4.50). I've read hyperthyroidism still possible if TSH normal. Do I need another test?

TSH: Highly unlikely.
That said, your doctor should have ordered TSH and T3 (liothyronine) as well as T4. Please go back to him/her or if you are not satisfied have a friend or family refer you to a better doctor. ...Read more

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My TSH is. 02, free T4 is 1.9. thyroid antibody panel results are thyroid per oxidase Ab of 338 And thyroglobulin Ab is 1.7. What does this mean?

My TSH is. 02, free T4 is 1.9. thyroid antibody panel results are thyroid per oxidase Ab of 338 And thyroglobulin Ab is 1.7. What does this mean?

Hyperthyroid: Your free T4 level is mildly high, TSH low, both consistent with hyperthyroidism. The positive antibodies indicate that you likely have autoimmune thyroid disease (Graves disease or Hashitoxicosis) causing the levels to be high. You should see an endocrinologist to help decide on the best treatment ...Read more

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I am wondering if I may be headed toward hypothyroidism? I have a lot of the symptons, but test are normal. I have cysts on my thyroid and my tsh is 1.95 and free t4 is 0.96.

I am wondering if I may be headed toward hypothyroidism? I have a lot of the symptons, but test are normal. I have cysts on my thyroid and my tsh is 1.95 and free t4 is 0.96.

Possibly...: If you are experiencing symptoms of hypothyroidism but initial thyroid tests appear normal, consider asking for Free T3 (liothyronine) and reverse T3 (liothyronine) ratio--this blood testing can uncover "thyroid resistance" which is treated by giving T3 (liothyronine) or a mixture of T3 (liothyronine) and T4 (thyroid hormones). You'll also want to rule out Hashimoto's or iodine deficiency given the multiple cysts (if fine needle biopsy was reassuring). ...Read more

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My t4 free is 0.70 and my tsh reflex free t4 is 29.2. What does this mean and what do I need to do?

My t4 free is 0.70 and my tsh reflex free t4 is 29.2. What does this mean and what do I need to do?

Hypothyroidism: This is diagnostic of hypothyroidism and should be treated with thyroid hormone replacement which hopefully was done by the doctor who got these labs. While without a little more history is there is the remote chance of thyroiditis, it is unlikely with a TSH in this range. While EASILY TREATABLE, hypothyroidism can be a serious and even eventually a life threatening disease. ...Read more

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Do you need to test free T4 for an accurate thyroid test, or is TSH enough?

Do you need to test free T4 for an accurate thyroid test, or is TSH enough?

Yes: Tsh is a very good screening test for thyroid function but it's not produced by the thyroid. If your TSH is low you probably have hyperthyroidism (overactive thyroid), if it's high you probably have hypothyroidism (low thyroid function); however, other mechanisms may account for abnormal TSH levels (abnormal pituitary function). Testing your thyroid hormone levels (t3, t4) is more complete. ...Read more

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Can dr interpret my thyroid levels What should be the Right dose tsh 1.50 ulU/ml freeT3 2.3pgml free t4 1.4ngdl Now taking 37.5mcg is tht a right?

Can dr interpret my thyroid levels What should be the Right dose tsh 1.50 ulU/ml freeT3 2.3pgml free t4 1.4ngdl Now taking 37.5mcg is tht a right?

Yes: 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, your results are in the normal range. You may consult this site for information.
https://www. Endocrineweb. Com/conditions/thyroid/thyroid-function-tests
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. ...Read more

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Free T4 = 0.86, thyroid peroxidase ab = 26.6, tsh, 3rd generation = 0.358. I need help with the interpretation of these results. Thanks!

Free T4 = 0.86, thyroid peroxidase ab = 26.6, tsh, 3rd generation = 0.358. I need help with the interpretation of these results. Thanks!

Can not tell: Please resend with the normal values for your lab and they are normal for most labs but not all. ...Read more

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Blood pressure reading of 120/50 is this normal also thyroid blood results TSH 0.21 and Free T4 is 19.3. are these now within 'normal' range?

Blood pressure reading of 120/50 is this normal also thyroid blood results TSH 0.21 and Free T4 is 19.3. are these now within 'normal' range?

Looks okay: If you feel okay, there is no such thing as "low blood pressure"; it need be only high enough to keep your body perfused. Whether these thyroid labs are okay depends on the units. Reference ranges are arbitrarily set so that several percent of healthies fall outside. Glad you're staying proactive. BEst wishes. ...Read more

Dr. Quang Nguyen
938 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


Dr. Cornelius O'leary jr
275 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