First TSH/T4 results.... what does this mean?

Got my 4 month post op blood work back today.... TSH is at 41.6 (yes, 41.6), and T4 is 7.8.... what does that mean? Does not sound good to me. Great news to hear on your birthday!! Sheesh!

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How long have you been on meds and what is your dose?

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3 months.... 150 synthroid.

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It means more Synthroid is needed! That is crazy high TSH after being on meds for that long. :(

So you have been on the meds for 4 months and this the first blood test? I think it is more standard to test every 6-8 weeks to check levels in the beginning.

Are you making sure to take your meds the same way each day? Taking it alone and not eating for about an hour. Not taking it with any calcium or antacids within several hours. Stuff like that.

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It means you need more Synthroid!
And I agree about it being standard to test every 6-8 weeks initially rather than once in 3 months.

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yup to all of the above, except been on meds 10 weeks.... done all else to a 'T'....

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Definitely need more synthroid.

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What is the reference (or normal) range for the T4 on the lab report? I'm thinking it may be odd that you have a nice mid range T4 with such a high TSH. Is that 7.8 mcg/dl or some other measurement?

If that 7.8 is a Free T4 level reported in pmol/L then your level is less than the accepted range.

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I think they said T4 should be between 4-12, and it is at 7.8 so I am OK there.... but TSH should be between .4 and 4 and it is basically 42.... not good. That is why I am a little concerned. However, I have only been on Synthroid for 10 weeks so I guess they were right when they said it would take some time to get the dose right. I was taking 150's, now they got me on 200's, with an appointment set up for an Endo. They are kind of surprised that I say I feel fine, they said with a TSH at 42 I should feel a little hypo, but I feel pretty good. Heck, what do I know, I have been sick for so long that Hypo may be my new normal and I'm used to it..... know what I mean?

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I felt much better when my TSH was over 100 than I do now with my TSH at the lower level.

I guess hypo was my normal and I was used to it and now that I am in their normal, it is not working for me. :(

Good luck! I hope you feel better when your TSH gets to an appropriate level.

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I have a funny feeling this is going to be a heck of a ride for the first year.... but I have been warned, so this is no surprise.

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"They are kind of surprised that I say I feel fine, they said with a TSH at 42 I should feel a little hypo, but I feel pretty good. Heck, what do I know, I have been sick for so long that Hypo may be my new normal and I'm used to it..... know what I mean?"

You gave me such a good laugh!!! Too true man, too true.

Okay, it IS odd that you have a nice normal T4 with such a high TSH. Maybe your Endo will figure it out - maybe this is not all that rare? Who knows? Maybe you have interfering antibodies? Maybe a bit of a pituitary glitch? Probably have to still have your numbers out-of-whack for 6 months or so before anyone will seriously investigate it, especially if you are functioning and feeling more or less okay. The endocrine system is so complicated that it may be quite ordinary to have a longish while before all the aspects get themselves back toward what looks like an ordinary balance.

Full replacement of thyroid, with moderate suppression of TSH takes about 1.75-2.0 mcg per kilogram body weight (that's 2.2 pounds per kilogram). It generally takes 10 days to feel the full clinical effect of an increase or decrease of T4 medication (Synthroid in your case) and a full 6 weeks until the TSH blood level will fully reflect the dose change. The 6 week thing is a good part of why it takes so long to hit just the right dose for each individual. Most docs seem to like to build up the dose at a conservative speed - this helps avoid the ordinary symptoms of getting hyper if an individual is more sensitive to the T4 than most people. Plus, if the patient has been hypo for some time and has any blood pressure, heart rhythm, or coronary artery difficulties a slow return to euthyroid is required.

:-)

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