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Posted in: General Discussion.

High free t4 (46) but normal TSH and T3

From: ALT1975 - 2 years 9 weeks ago

Hi! Thanks for letting me join! I'm really confused... my 5 year old daughter's results have come back as normal TSH (2.57) but high free T4 (46)
We live on a small island, and are waiting for her records to be sent away to be reviewed, but this has been 2 months so far, and we're not holding our breath! So I Googled... and nothing! I can't seem to find any condition or scenario where T4 is high but TSH is normal...
Can anyone point me in the right direction? I don't know if this is some thing where a delay makes little difference, or if I should be pressing to get things moving...
Thanks for reading!
:-)
Anna.

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Hi Anna,
I was actually researching the same exact numbers ( literally I have high T4 of 46 and everything else normal. I know you're question was asked weeks ago, but I wanted to let you know what my endocrinologist has explained why this happens.
First of all, my thyroid is basically non functioning, but it will still show up in the normal range in tests. This is not to alarm you, because your body doesn't necessarily need it, because you can take hormone pills ( synthroid) that will do the same thing ( and no, there's no need to remove the thyroid)
The reason for the high 46 is because your pituitary gland is sending messages to your thyroid 24/7 to make more hormone and it doesn't know how to stop sending these signals as it is unaware that your thyroid isn't producing correctly, therefore sending your pituitary levels extremely high because it is working overtime. Once they stabilize your daughters medication, that number will go down to normal when she is on the right dosage and everything will function correctly from that point on. Meanwhile, she needs to see a thyroid specialist/ endocrinolist. You probably notice that she is frequently tired, that is because your pituitary glands control all organs and when they are not getting the correct hormones, they are not functioning at their full potential. But she will be fine!! If you have any other questions, I'd be glad to help!
Jeanne

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Who is this endochronologist please? I have the same issues and would love to go see him

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Although well-intentioned, this is INCORRECT or incomplete advice.

With a "non functioning" thyroid, you will expect to see the following: low thyroid hormones (T4 and/or T3), and a HIGH TSH. The T3 or T4 being low represents a thyroid gland that is not working well to make enough thyroid hormones. In response to this low level of thyroid hormones, the pituitary releases TSH to try and stimulate thyroid hormone production.

In cases of equivocal lab results, a TRH stimulation test will help clarify the correct diagnosis.

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