The day before my blood test I didn't eat breakfast until 530 am Answer from Deleted User on reddit.com
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Medscape
emedicine.medscape.com › tools & reference › endocrinology
Euthyroid Hyperthyroxinemia: Practice Essentials, Pathophysiology, Etiology
Euthyroid hyperthyroxinemia is defined as a condition in which the serum total thyroxine (T4) and triiodothyronine (T3) concentrations are increased, but the thyroid-stimulating hormone (TSH) concentration is normal and there are no clinical signs or symptoms of thyroid dysfunction.
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UCLA Health
uclahealth.org › medical-services › surgery › endocrine-surgery › conditions-treated › thyroid › normal-thyroid-hormone-levels
Normal Thyroid Hormone Levels - Endocrine Surgery | UCLA Health
A normal Total T4 level in adults ranges from 5.0 to 12.0μg/dL. A normal Total T3 level in adults ranges from 80-220 ng/dL. Free T3 assays are often unreliable and not routinely used to assess thyroid function.
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PubMed Central
pmc.ncbi.nlm.nih.gov › articles › PMC5922674
How to interpret thyroid function tests - PMC
For example, both fractionated ... TH levels. Interestingly, such changes are not generally associated with clinical thyrotoxicosis, and TSH is usually normal....
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Cleveland Clinic
my.clevelandclinic.org › health › diseases › 23544-subclinical-hypothyroidism
Subclinical Hypothyroidism: Symptoms & Treatment
September 4, 2025 - Subclinical hypothyroidism happens when you have elevated thyroid-stimulating hormone (TSH) levels with normal levels of the hormone thyroxine (T4).
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NCBI
ncbi.nlm.nih.gov › books › NBK83492
Introduction - Screening and Treatment of Subclinical Hypothyroidism or Hyperthyroidism - NCBI Bookshelf
A mildly elevated thyroid stimulating hormone (TSH – also called thyrotropin) concentration is the most common thyroid function test abnormality encountered in everyday practice. Most patients who have a mildly elevated TSH have a normal free thyroxine (T4) level.
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NCBI
ncbi.nlm.nih.gov › books › NBK536970
Subclinical Hypothyroidism - StatPearls - NCBI Bookshelf
February 15, 2024 - Subclinical hypothyroidism characteristically presents with normal thyroxine (T4) levels and elevated thyroid stimulating hormone (TSH) levels. The incidence of subclinical hypothyroidism is estimated at 3% to 15%, depending on the population studied. Minor fluctuations in T4 levels result ...
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Consensus
consensus.app › questions › elevated-free-t4-with-normal-tsh
Elevated Free T4 With Normal Tsh - Consensus Academic Search Engine
Elevated free T4 with normal TSH is relatively uncommon but can occur in specific clinical scenarios. A study conducted in the Netherlands found that 3.34% of patients had this combination, with 12.3% showing increased free T4 .
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Reddit
reddit.com › r/thyroidhealth › what causes high tsh but normal t4?
r/thyroidhealth on Reddit: What causes high TSH but normal T4?
August 26, 2022 -

My TSH is 10.15 (range .5-4.3) and my Free T4 is 1.1 range (.8-1.4) However, I am having many symptoms. I have been in contact with many doctors and they don’t really know what is going on. Does anyone have any suggestions or have been through this situation before? I started 25mcg levothyroxine 5 days ago but since my Free T4 is normal I am doubtful that will help.

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Your pituitary can manage to keep your T4 levels up by constantly poking and prodding your thyroid while it is exhausted. Imagine a factory that has to make 1,000 thing-a-ma-bobs a day. Now say that factory is running smoothly with 50 thing-a-ma-bob assemblers working a normal shifts of 8 hours 5 days a week. Then a few of them quit, or pass away, or retire, or whatever. The manager, Mr Pituitary, gives a speech to the remaining 45 or so worker about putting in a little extra time and working harder to make up the slack. The factory still makes it’s 1,000 thing-a-ma-bobs and everyone manages though they’re a little extra tired. But then, another guy retires, and it’s getting a bit tough, so some guy starts putting in an extra shift each week. Then the assembler putting in the extra shift falls asleep behind the wheel, and now the thing-a-ma-bob factory is down another worker, but they still need to get out that 1,000 thing-a-ma-bobs every day. Then another few assemblers quit because they are becoming unhappy. So the manager, Mr Pituitary, just starts yelling at all the remaining assemblers constantly and insisting they put in 10 hour shifts 6 days a week. The factory is still pumping out those 1,000 thing-a-ma-bobs a day for now, but it can’t keep it up. Soon more employees are going to quit or hurt themselves. It isn’t sustainable. A little levothyroxine will let it relax and work at a more manageable pace.
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This is common with Hashimoto’s which is an organ specific autoimmune disease that affects the thyroid and causes secondary hypothyroidism, which means that the hypothyroidism is caused by the Hashimoto’s. You need a doctor that will treat your symptoms and TSH lab, while also testing your T3 and reverse T3. Some people with Hashimoto’s do well on just T4, some need that and T3.
Find elsewhere
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American Academy of Family Physicians
aafp.org › pubs › afp › issues › 1998 › 0215 › p776.html
Subclinical Hypothyroidism: Deciding When to Treat | AAFP
February 15, 1998 - Its very sensitivity, however, may create a dilemma, since some patients are found to have elevated serum TSH levels, suggesting hypothyroidism, but have normal levels of thyroid hormone, whether measured as free thyroxine (T4) or free T4 index.
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Medical News Today
medicalnewstoday.com › articles › hypothyroidism-with-normal-tsh
Hypothyroidism with normal TSH: Causes and treatment
December 18, 2023 - A thyroid function test measures levels of thyroid-stimulating hormone (TSH) and thyroxine (T4) in the blood. This is also called “free” T4. Generally, high TSH can indicate hypothyroidism, while low TSH can indicate hyperthyroidism, though ...
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Harvard Health
health.harvard.edu › diseases-and-conditions › mild-hypothyroidism-who-should-be-treated
Mild hypothyroidism: Who should be treated? - Harvard Health
September 30, 2021 - Your free T4 level is normal, meaning ... hormone) level that is above the normal range, which indicates your thyroid gland has to work harder to pump out that thyroid hormone....
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American Thyroid Association
thyroid.org › home › thyroid function tests
Thyroid Function Tests | American Thyroid Association
June 8, 2020 - Estrogens, such as in birth control pills, or in pregnancy, cause high levels of total T4 and T3. This is because estrogens increase the level of the binding proteins. In these situations, it is better to ask both for TSH and free T4 for thyroid evaluation, which will typically be in the normal range.
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Cleveland Clinic
my.clevelandclinic.org › health › diagnostics › 24235-thyroxine-t4-test
T4 (Thyroxine) Test: What It Is, Function, Purpose & Levels
July 21, 2025 - This is a lack of T4 production due to an issue with your thyroid that’s causing your pituitary gland to release excess TSH to try to stimulate your thyroid into making more T4. Having high TSH and high T4 levels may indicate that you have an issue with your pituitary gland that’s causing it to release too much TSH, and thus triggering your thyroid to make excess T4.
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Verywell Health
verywellhealth.com › interpret-your-thyroid-test-results-3231840
Thyroid Blood Tests: Types and What Results Mean
May 15, 2000 - When thyroid hormone levels are low, more TSH is produced to stimulate production. When levels are normal, the pituitary gland stops producing TSH. The TSH test measures how much or how little TSH there is in the bloodstream. Thyroxine (T4) is one of two hormones produced by the thyroid gland.
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MedlinePlus
medlineplus.gov › home › medical tests
Thyroxine (T4) Test: MedlinePlus Medical Test
TSH tells your thyroid how much hormone to make. Normally, if your T4 levels are too low, your pituitary makes more TSH to make your thyroid work harder. If your T4 levels are too high, your pituitary stops ...
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Restart Med
restartmed.com › high-tsh-normal-t4
High TSH & Normal T4: What it Means For Your Thyroid
4 weeks ago - So this early rise in TSH can be used as a sensitive marker for early thyroid GLAND dysfunction. By the way, you may find that both your free T3 and free T4 stay “normal” despite having a very high TSH.
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Province of British Columbia
www2.gov.bc.ca › gov › content › health › practitioner-professional-resources › bc-guidelines › thyroid-testing
Thyroid Function Testing in the Diagnosis and Monitoring of Thyroid Function Disorder - Province of British Columbia
Laboratories are permitted to substitute free hormone assays when total T3 or T4 have been ordered. Measurement of fT3 is rarely indicated in suspected thyroid disease6, 13. This is reserved for situations where thyroid disease is suspected clinically and TSH is abnormal, but fT4 is inappropriately normal.
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Consensus
consensus.app › questions › very-high-tsh-but-normal-t3-t4
Very High Tsh But Normal T3 T4 - Consensus Academic Search Engine
These studies suggest that very high TSH but normal T3 and T4 levels can be due to factors such as macro-TSH complex, inadequate L-T4 therapy, pituitary alterations, or partial peripheral resistance to thyroid hormone action.
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American Thyroid Association
thyroid.org › home › patients portal › clinical thyroidology for the public › february 2024 › vol 17 issue 2 p.5-6
The “new normal” for thyroid function test ranges
February 23, 2024 - For female patients above the age of 70 who had a free T4 value above the 85th percentile of the normal range, their absolute risk of death and having heart disease was greater than 5%. For male patients above the age of 70 who had a free T4 ...
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Mount Sinai
mountsinai.org › health-library › report › hypothyroidism
Hypothyroidism Information | Mount Sinai - New York
TSH levels between 0.45 and 4.5 mU/L indicate normal thyroid function. TSH levels under 0.45 mU/L suggest hyperthyroidism, which is overactive thyroid, or overtreated hypothyroidism. ... If TSH levels appear abnormal, your provider may order a free T4 test. Low levels of T4 suggest hypothyroidism.