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Doctor insights on: What Is Normal Level Reflex Free T4

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

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

Dr. Gregory Moneta
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


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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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Blood test shows TSH w/ reflex to FT4 is 13.62 (high) & Free T4 is 1.1 (normal). How would you describe what these results mean?

Blood test shows TSH w/ reflex to FT4 is 13.62 (high) & Free T4 is 1.1 (normal). How would you describe what these results mean?

Thyroid tests: 26F US had TSH 13.6 and Ft4 1.1. Asks: How could you describe what these results mean? ANS: Need 2 know lot more about U which ur Drs already knows so better to ask them. Such as 1. U on BCP? 2. Why was test done? 3. Hx of thyroid problems n past? 4. Taking thyroid meds? 5. Pregnant? As TSH is high, u did not give normal lab range for FT4 but it seems lowest range of normal. Hypothyroid? ...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 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 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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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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My TSH w/reflex to FT4 test came back at 6.73, but my free T4 came back at 1.24. I have previous has similar results to these tests.

Mild hypothyroidism: The elevated TSH means that your pituitary gland is not happy with your thyroid level, and would like to see it higher despite the "normal" free T4 level. If you do not have any symptoms of hypothyroidism, we call this "subclinical hypothyroidism". Treatment may not be needed unless you develop symptoms or the TSH goes progressively higher. You should not start treatment based on one abnormal test ...Read more

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TSH W REFLEX FREE T4 TSH, 3RD GENERATION (0.40-4.00) uIU/ML My results are 1.10 I had this test taken. Can you explain what the results mean?

TSH W REFLEX FREE T4 TSH, 3RD GENERATION (0.40-4.00) uIU/ML My results are 1.10 I had this test taken. Can you explain what the results mean?

Normal, but...: THIS IS A NORMAL THYROID SCREENING TESTS. There are rare diseases thyroid that can happen with an normal normal TSH, but you would have symptoms of thyroid disease or other evidence of central hypothyroidism or thyroiditis in a "euthyroid phase, " which would be rare and require much more history. If there is ongoing concern see an endocrinologist. IF YOU GENERALLY FEEL WELL GREAT, IT IS NORMAL! ...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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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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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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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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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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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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Tsh with reflex free T4 1.09, free T4 1.00 t3 (liothyronine) total 91. Feel horrible very weak, hair falling, weight gain endo and GP said I'm fine no further tests?

Tsh with reflex free T4 1.09, free T4 1.00 t3 (liothyronine) total 91. Feel horrible very weak, hair falling, weight gain endo and GP said I'm fine no further tests?

Thyroid: The lab numbers look OK.
Weight gain is no good for you as you know.
Please go online and look up the many articles about food. My favorite is "NuVal" - look it up.

Also consider seeing an athletic trainer. ...Read more

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Could you have high total T4 levels but have normal free T4 levels?

Could you have high total T4 levels but have normal free T4 levels?

Yes: Total T4 reflects T4 bound to proteins in your blood. Free T4 measures the amount of T4 that is free and not bound so that it can be metabolically active. Thus women taking Estrogens (as in bc pills) have elevated levels of thyroid binding globulin and elevated total t4, but normal free t4. ...Read more

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Is FREE T4 LEVEL 13 pmol/L normal and my TSH is 0.5 is this normal?

Yes,,: These are technically "normal" values with fT4 normal range being 9-18 pmol/L while TSH is about 0.3-3.0 uIU/mL, though this last range can vary. Best of luck. ...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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Are these results normal serum free T4 level 12 and TSH 0.6 many thanks?

Are these results normal serum free T4 level 12 and TSH 0.6 many thanks?

T4: Different labs use different methods for measuring T4. Please check with your doctor whether this level of 12 is within normal range for the test or whether it is high. I suspect that the T4 at 12 is within range. Please let me know. ...Read more

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33 yr M 6'2 185 pounds. High TSH levels but normal free T4, whst exactly does this mean?

33 yr M 6'2 185 pounds. High TSH levels but normal free T4, whst exactly does this mean?

Subclinical hypothyr: Hi. That is commonly seen, now that we screen so well for disorders of thyroid function. It's called subclinical hypothyroidism, meaning that with extra push from the pituitary (TSH), the remaining thyroid tissue is able to make thyroid hormone in the normal range. You should start taking thyroid hormone now, and not wait till your metabolic tank is empty. Good luck! ...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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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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Could you tell me what are normal levels of free T3 (liothyronine) and free T4 for thyroid?

Could you tell me what are normal levels of free T3 (liothyronine) and free T4 for thyroid?

T3 (liothyronine) 3.5to7.7pmol/l: Free T3 (liothyronine) is 3.5to7.7 pmol/litre or 0.2to0.5 ng/dl
free T4 is 0.8 to 1.7mcg/dl. ...Read more

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My TSH levels are 4.57; Free T4 =1.2; T3 (liothyronine)=103. Are my Free T4 and T3 (liothyronine) levels normal? If they are normal why is my TSH elevated?

Slightly low: I see that you are on thyroid hormone. The TSH will be the best indicator of whether you need more or less medication. The ideal TSH is around 1-2, so currently you could use a slightly higher dose. The "normal range" applies to a population of people. Your individual normal range is much more narrow. If your pituitary wants your free T4 to be 1.3 or 1.4, it will put out TSH to try to do so. ...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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I'm 42 type2 diabates for 10 yrs (avg 180 sugar level), recent lab test shows high tsh:11.5 (range 0.3-4.2) but normal free t4: 19 (ref12-22), vit d 11.3

I'm 42 type2 diabates for 10 yrs (avg 180 sugar level), recent lab test shows high tsh:11.5 (range 0.3-4.2) but normal free t4: 19 (ref12-22), vit d 11.3

Lab error?: The TSH is elevated, but the free T4 is in the upper range of normal. One can have subclinical hypothyroidism where the TSH level is high, with normal free t4, though usually the free T4 is in the low range of normal. You should have the test repeated after 1 month. Your vitamin d level looks low, you should take a vit d supplement of around 2000 iu daily. ...Read more

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My estradiol level was 305 around day 10. My FSH was 8.4 and Lh 2.7. tSH 0.44 and free T4 14.4. Do these seem normal?

My estradiol level was 305 around day 10. My FSH was 8.4 and Lh 2.7. tSH 0.44 and free T4 14.4. Do these seem normal?

TSH and T4: Your TSH is slightly on the low side and free T4 a bit high.
If you are not taking any thyroid meds you should probably have some thyroid imaging done. Check with your doctor.

Your estradiol level can be evaluated once more is known about your thyroid. ...Read more

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I have a TSH 2.209, Free T4 of 0.72, Ferritin level of 23, and Vit. D of 20, calcium 8.9. Tired, no energy, achy. PCP says all is normal :/?

I have a TSH 2.209, Free T4 of 0.72, Ferritin level of 23, and Vit. D of 20, calcium 8.9. Tired, no energy, achy. PCP says all is normal :/?

Vit D not ideal: Your thyroid, calcium, and ferritin levels are okay, but we would like to see the Vit D level above 30. You should be on a Vit D supplement to do this. However, it is unlikely to make you feel less tired. Tiredness is a very tough symptom to find a cause, as it is a subjective symptom that has thousands of different possible causes. A good diet, exercise, good sleep practices should help ...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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Is it life threatening to have a Tsh level of 0.01 Free T3 (liothyronine) 4.3 Free T4 1.8 I know TSH is not normal but how dangerous is this? Thy ultrasound today.

Is it life threatening to have a Tsh level of 0.01 Free T3 (liothyronine) 4.3 Free T4 1.8 I know TSH is not normal but how dangerous is this? Thy ultrasound today.

Thyroid: With a normal Free T3 (liothyronine) and FT4, I would not consider this dangerous, unless you are having symptoms of hyperthyroidism, such as increased blood pressure, rapid heart rate, sweating, anxiety, etc. The numbers are not so important, it's what your body is saying. Also, the normal T3 (liothyronine) and T4 are reassuring. ...Read more

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Had chemical pregnancy of 4 wks & TSH levels nw are 0.25 & free T4 1.8.My doc dnt want 2 reduce Synthroid (thyroxine) dose (75mcg) n want 2 check in 4 wks. Normal?

Yes: Hormonal changes associated with your circumstances alter thyroid function tests and your doctor is correct in waiting to repeat the studies before changing the drug dosage. Please follow the doctor's advice. ...Read more

Dr. David Sneid
1,420 Doctors shared insights

Thyroxine (Definition)

Thyroxine is a thyroid agent. ...Read more