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Do these lab results mean hyper or hypo thyroid?

I got a voice message from the nurse saying that my Dr recommends that I see an endocrinologist because of my lab test results. I no longer have health insurance unfortunately and therefore not really wanting to go to another Doctor. However if my test results are as bad as she made it seem, I will go to the Doctor.

Results: TSH W/REFLEX TO FT4 0.06 L (range 0.40-4.50)
T4,FREE 0.8 (range 0.8-1.8 ng/dL)
That's all.

My signs/symptoms: hypertension, heart palpitations, racing pulse, trouble sleeping, swollen hands & feet, weight gain, unable to lose weight, puffy face, hair loss, brain fog

Any advice would be GREATLY appreciated!!
2 Responses
649848 tn?1534633700
You results aren't "bad" as in dangerous, but they aren't good either.  

Your TSH is way too low and so is your Free T4.  Typically, with a TSH as low as yours, we'd think you have hyperthyroidism, but since your Free T4 is also on the bottom of the range, indicating hypothyroidism, it looks like you  have Central hypothyroidism, which means your thyroid probably works find, but it's not getting the stimulation from the pituitary gland (TSH).  

What happens is when thyroid levels are too low, the pituitary gland pumps out TSH to stimulate the thyroid so it produces thyroid hormones, T4 and T3 (mostly T4).  Since your Free T4 is on the bottom of the range, we'd expect your TSH to be higher than it is, because we'd think your pituitary gland would be trying to stimulate your thyroid to produce more hormones, but for some reason it's not.  This indicates a malfunction in the pituitary/hypothalamus axis (the pituitary gets its orders from the hypothalamus).

Many doctors miss Central (also called Secondary) hypothyroidism, because they only look at the TSH level and if it's low, they automatically diagnose hyperthyroidism, regardless of the Free T4 and/or Free T3.  

Your symptoms also correlate with hypothyroidism, though many people will automatically associate the hypertension, heart palps and racing heart with hyperthyroidism... I had all of those when I was at my most hypo, so they can definitely cross over.  The rest of your symptoms are definitely those of hypo, as well.

Central hypothyroidism must be treated like any other hypothyroidism - with replacement thyroid medication.  I'd recommend that you go ahead and make the appointment with the endo.
Avatar universal
Thank you so much! I was trying to understand it, but my results had me so confused. I will make an appointment.
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