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DrRussMD
DrRussMD, Board Certified Physician
Category: Medical
Satisfied Customers: 65673
Experience:  Internal Medicine--practice all of internal medicine, all ages, family, health, prevention, complementary medicine, etc.
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In Nov. 2016 my TSH=.98, Free T4=1.3 and Free T3=2.7. Now

Customer Question

In Nov. 2016 my TSH=.98, Free T4=1.3 and Free T3=2.7. Now Nov. 2017 i went to the emergency room for chest and they measured my TSH=4.78 & Free T4=1.3. Is this suggestive of Hypothyroidism or Hashimoto's? What could cause that much of an increase in TSH in 1 year?
JA: How long have you been dealing with the issue? In general, how has your health been lately?
Customer: currently have a throat ache and symptoms that suggest Gerd
JA: Anything else in your medical history you think the doctor should know?
Customer: no
Submitted: 10 months ago.
Category: Medical
Expert:  DrRussMD replied 10 months ago.

Hi.
Welcome to just answer. I am here to answer questions for education and information. I will respond shortly with an answer, or a question for you

Expert:  DrRussMD replied 10 months ago.

A TSH at this level is suggestive of sub clinical hypothyrodism.

Anything over 2.5 can indicate possible underactive thyroid function.

Many doctors will not realize this.

You should see an up to date endocrinologist.

OK, let me know if you have more questions.

Also: Hopefully this helps and I have earned a 5 rating from you today. [This has to be clicked on the rating scale on your page.] A 5 rating specifically allows me to have full credit and continue my accurate service as well as providing follow up to you as needed, and it costs you nothing more. Thanks.

Customer: replied 10 months ago.
I was unable to find any literature on the time line of thyroid failure. Is it common for failure to occur within a year after a normal test. Are there any possibilities that it could be caused by an increase level from the adrenals. My understanding is that adrenal activity can suppress the thyroid when they are over active or releasing large amount of cortisol in the event of a panic attack or some other stressful event. I do have a appointment with an endocrinologist but since the appointment is some time away, was trying to get some answers to ease alittle of the worry while waiting for the appointment. In short does a high TSH always mean hypothyroidism.
Expert:  DrRussMD replied 10 months ago.

Sorry for the delay. It was 3 hours before you answered and I was off line for the day.

Interesting questions, I will explain further.

It means that they depressed thyroid function is sub clinical if you have no symptoms. if you have symptoms, such as weight gain, mental sluggishness, then it is clinical hypothyroidism.

There is no such term as thyroid failure, just an increasing degree, gradually, of low function.

We treat if there are symptoms and a TSH above 2.5 [international guidelines] or if there is a TSH over normal according to all guidelines, which is 4.2 to 4.5.

OK, let me know if you have more questions.

Also: Hopefully this helps and I have earned a 5 rating from you today. [This has to be clicked on the rating scale on your page.] A 5 rating specifically allows me to have full credit and continue my accurate service as well as providing follow up to you as needed, and it costs you nothing more. Thanks.