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Free T4 Level Is High, TSH Is Low And Folate Level Is High. Should I Be Concerned?

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Posted on Sat, 16 Nov 2013
Question: Just got some labs done and its states folate 20.0 high --- range 3.1-17.5
And thyriod tests
Free t4. 2.0 high
TSH. 0.07 low ??? I am very concerned about the folate ? What should i do? Is this a heart disease risk? I am going to try IVF next month is this serious ? Please asvise

doctor
Answered by Dr. Manoranjan Chowhan (3 days later)
Brief Answer:
detailed below

Detailed Answer:
As you mentioned that your free T4 level is high and TSH is low this shows you are suffering from hyperthyroidism and also you have high level of Sr Folate level.
In many cases it is seen that people with hyperthyroidism may have high folate level and after correction of the later may come back to normal.
As regards risk of heart disease it is important to know that there is some correlation with Homocystine level and heart disease but there is no direct link with that of Sr folate by most of the scientific research study.
Thoudh deficiency of serum folate is often seen with neural tube defect (this is important as you are planning for IVF) but as in your case Sr Folate level is high that risk is not raised
However it's necessary for you to undergo treatment for hypethyroidism for which some underlying thyroid abnormality can be ruled out doing certain tests to rule out any possibility of Nodular toxic goiter or Graves disease etc, that can be apparent after you consult your treating physician( who may order some additional tests like USG and Thyroid tests)
with best wishes
Dr Chowhan
Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
Answered by
Dr.
Dr. Manoranjan Chowhan

Radiologist, Nuclear Medicine

Practicing since :1991

Answered : 103 Questions

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Free T4 Level Is High, TSH Is Low And Folate Level Is High. Should I Be Concerned?

Brief Answer:
detailed below

Detailed Answer:
As you mentioned that your free T4 level is high and TSH is low this shows you are suffering from hyperthyroidism and also you have high level of Sr Folate level.
In many cases it is seen that people with hyperthyroidism may have high folate level and after correction of the later may come back to normal.
As regards risk of heart disease it is important to know that there is some correlation with Homocystine level and heart disease but there is no direct link with that of Sr folate by most of the scientific research study.
Thoudh deficiency of serum folate is often seen with neural tube defect (this is important as you are planning for IVF) but as in your case Sr Folate level is high that risk is not raised
However it's necessary for you to undergo treatment for hypethyroidism for which some underlying thyroid abnormality can be ruled out doing certain tests to rule out any possibility of Nodular toxic goiter or Graves disease etc, that can be apparent after you consult your treating physician( who may order some additional tests like USG and Thyroid tests)
with best wishes
Dr Chowhan