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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Are Border Level TSH A Cause For Concern?

I have a question about my thyroid levels. I just had them checked because I have a lot of symptoms of thyroid problems (chronic constipation, cold a lot, racing thoughts, frequent heart palpitations, weight gain/not being able to loose weight, to name a few). My levels came back as TSH 2.8 and Free T4 1.1. My question is, my general practitioner said they are perfectly normal (along with all my other blood work). My friend who deals with thyroid problems says they could be a problem because they are on the high end of normal and should call an endocrinologist if I'm worried. I hate to go in for nothing though.
Wed, 30 Jul 2014
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Internal Medicine Specialist,  's  Response
Hi!Hypothyroid symptoms with an 'in range Free T4 and TSH' is not uncommon in clinical practice. You may indeed be hypothyroid even though your tests suggest otherwise. One needs to see your Free T3 (the active thyroid hormone) level and anti-thyroid antibody level to begin with. Then there are conditions which interfere with thyroid hormone function like insulin resistance states (e.g. in polycystic ovaries), high estrogen states (e.g. in those on birth control pills) or high cortisol states (e.g. in chronic stress, active infection). A thorough evaluation is needed keeping these 'confounding factors' in mind. Do write in for more info. All the best!
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Are Border Level TSH A Cause For Concern?

Hi!Hypothyroid symptoms with an in range Free T4 and TSH is not uncommon in clinical practice. You may indeed be hypothyroid even though your tests suggest otherwise. One needs to see your Free T3 (the active thyroid hormone) level and anti-thyroid antibody level to begin with. Then there are conditions which interfere with thyroid hormone function like insulin resistance states (e.g. in polycystic ovaries), high estrogen states (e.g. in those on birth control pills) or high cortisol states (e.g. in chronic stress, active infection). A thorough evaluation is needed keeping these confounding factors in mind. Do write in for more info. All the best!