Thyroid - high T4, normal TSH?

[Polarbearflavour]

So I had thyroid bloods done privately. I’ve put on weight, fatigued, brain fog, achy, anxious etc.

TSH is now 2.3 - up from 1.8 12 months ago. I’m aware that this is in the UK normal range but in Australia where my female relatives are with thyroid disease, 1 is considered the maximum healthy level?!

Free T3 is 5.7 normal.

Free T4 is high - 24.57

The comments say:

“There is a slight elevation in the free T4 level. In the presence of a normal thyroid stimulating hormone level (TSH), this does not mean necesarily that there is too much thyroxine in the body but there is a chance that hyperthyroidism (overactive thyroid) is present or will develop. I suggest you make an appointment to see your doctor – as at least surveillance of thyroid function would be usual.”

I’ve made a GP appointment - what then? Do I ask for an endocrinology referral? I’m happy to pay privately.

Do you have the reference ranges for those results please?

Thyroid stimulating hormone
2.380
mU/L
(0.270 - 4.200)

Free T4
24.67 pmol/L 5.7
(12.0 - 22.0)

Free T3
5.7 pmol/L
(3.1 - 6.8)

I’m really confused as my symptoms are more hypothyroidism not hyperthyroidism apart from the sweating! But high T4 indicates that I’m hyper?!

Normal ranges are 95% confidence intervals so 24 is prob still normal. Even more likely to be normal given the plumb normal TSH and free T3.

You aren't biochemically or clinically hyperthyroid.

Most likely suggestion will be to recheck in 3 months.

Symptoms of hypo/hyper overlap a lot, mine (hyper) were: awful fatigue, constant constant feeling of apprehension, pains (like severe DOMS) in thighs then eventually arms, abs, heart rate doubled, hair fell out, exhausted beyond any normal exhaustion, so hungry all the time. Some people do gain weight.

T3 near the top of the range too? It’s important to keep an eye on it, I’ve had no or very low tsh for a few years now and lost bone density (and it’s not been good for brain health)

I was also itchy all over, it was maddening. Thyroids are mad.

Forgot, numbers are useful but symptoms matter too. Maybe you should go for an iodine uptake scan to see if this might be Graves’ disease?

Did they check TRAb? Antibodies?

GP retested and my TSH was 2.1 and T4 was 24.

Said to go back in 3 months and be retested. All other tests - FBC, diabetes, liver function were all normal.