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unclear thyroid values

November 1, 2017 | 20,00 EUR | answered by Hans-Peter Schmidt

Hello, I have a question about my thyroid. My TSH (5.0), FT4 (1.71), and FT3 (4.97) levels are all elevated, which seems paradoxical to me if the thyroid's regulatory system is functioning properly. I am experiencing symptoms of hyperthyroidism (rapid heartbeat, pulse 90-130, high blood pressure, frequent diarrhea, irritability, difficulty concentrating). The suspected diagnosis in the lab report is central hyperthyroidism. My doctor believes that the values are too low for this diagnosis and suspects that the symptoms may be triggered by psychological factors. I have had elevated TSH levels for years and treatment with L-thyroxine worsened my symptoms, so I had to stop taking it. Currently, I am on beta blockers for high blood pressure and heart rate, for which there is no organic cause. (Weight: 65kg, height: 185cm, male, age: 26) Reference ranges in the lab report: TSH 0.27-4.20, FT4 0.93-1.71, FT3 2.00-4.40. I would appreciate it if you or someone knowledgeable about this topic could provide me with an assessment of how relevant or pathological these values are, especially in relation to my symptoms. Antibodies TPO-ak and TAK are not elevated, and the ultrasound of the thyroid was normal.

Hans-Peter Schmidt

I believe that you do not have a thyroid disease. One should not overestimate the significance of the basal TSH value, as it can fluctuate even within 24 hours. The peripheral values are in the - albeit upper - normal range. This would therefore definitionally correspond to a manifest hypofunction. But what is the cause? There is nothing to suggest Hashimoto's thyroiditis: neither are antibodies detectable, nor do we have any changes in the sonographic structure or size before us. Therefore, in our opinion, there are no indications that your symptoms are thyroid-dependent. Laboratory values are not diseases!
Best regards