TSH very low but T3, T4 wnl and TPO high

[peter8620]

A middle age woman with unremarkle PMH except taking ANSAID/prn for LBP with no clinical sx for hyperthyroidism (no hot sensation, no palpitation, heart rate around 70)
with lab:  TSH  < 0.006 but T4. T3 within normal limit and TPO high.


This discussion is related to Critically Low TSH BUT normal T3 & T4 Levels???.

[goolarra]

Are the T3 and T4 free T3 and free T4 or total T3 and total T4.  The numbers and ranges look like totals to me.  If it doesn't specifically say "free" on your lab report, it's total.

TPOab is elevated, so you have an autoimmune thyroid disease, either Hashimoto's thyroiditis (hypo) or Graves' (hyper).

TSH is very low, which often indicates hyper, but TSH is a pituitary hormone and can be affected by any number of factors.  You mention LBP, which is usually a symptom of hypo. Do you have any other hypo symptoms...low HR, weight gain, fatigue and/or drowsiness, constipation, hair loss, depression, etc.?

[peter8620]

T4  7         (4.5-12)
T3   78      (71-180)
TPO  251   (0-34).
TSH:  < 0.006      (0.450 - 4.500)

[goolarra]

Please post your actual FT3, FT4  and TPOab results with reference ranges.  Ranges vary lab to lab and have to come from your own lab report.