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Gaining weight, have high blood pressure and thyroid test done. Any advice?

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Posted on Mon, 7 Jan 2013
Question: I have under thyroid test for 3 times in the last two months as the t3, t4 levels have been considerably below the reference range. But My TSH level is normal. Free t4 is just below the reference range. I have consulted two doctors their opinions were opposite. I have gained 11 kg weight in last one year. My blood pressure is around 140/100 for last 4 months.
Please advice me. I can upload the lab reports for your reference.
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Answered by Dr. V. Kumaravel (27 hours later)
Hello,

Welcome to health care magic.

I had gone through your reports and I do understand the concern regarding your thyroid functions.

You had recently gained weight and have been on treatment for psoriasis and hypertension. Your TSH has been normal and your T3 and T4 are low, that raises a suspicion of central or secondary hypothyroidism. Since your Free T4 is normal, I feel your thyroid should be normal as Free T4 is a better indicator of thyroid function than Total T4 and you may not require any thyroid replacement.

But since there has been so much confusion regarding your hypothyroidism, I would also prefer to do an imaging of your pituitary gland, to make sure everything is perfect.

Do not hesitate to contact me if any queries.

Regards

Above answer was peer-reviewed by : Dr. Mohammed Kappan
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Follow up: Dr. V. Kumaravel (19 hours later)
Hi Doctor,

One of the doctor whom I have consulted had asked me to do the MRI scan of my pitutary glad. So I have got Brain MRI scan done. I have updloaed the reports for the same. BY looking at that reports the doctor has diagnosed that is secondary Hypothyroid due to Partially empty sella and due to deficiency Thyroid binding globulin.
But other another doctor has contradicted with that opinion and said that it is Euthyroid. She suspected it to be Cushings syndrome and got the tests done for blood cortison and 24 hour urine cortisol. Both of these tests turned out be normal.

I have uploaded the Summary reports of the MRI scan . If can upload the scanned copies of the original images if you want to have a look at them.
doctor
Answered by Dr. V. Kumaravel (4 hours later)
Hello,

Thanks for your follow-up. Partial empty sella in your pituitary gland may or may not be associated with your pituitary function abnormality. Having seen your normal Free T4 value, I fell you are euthyroid and no thyroxin treatment would be warranted.

Your cortisol reports are also normal and that rules out cushing's syndrome. Your vitamin D levels are low and you can continue the vitamin D replacement as suggested.


Regards
Above answer was peer-reviewed by : Dr. Mohammed Kappan
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Dr. V. Kumaravel

Endocrinologist

Practicing since :2001

Answered : 297 Questions

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Gaining weight, have high blood pressure and thyroid test done. Any advice?

Hello,

Welcome to health care magic.

I had gone through your reports and I do understand the concern regarding your thyroid functions.

You had recently gained weight and have been on treatment for psoriasis and hypertension. Your TSH has been normal and your T3 and T4 are low, that raises a suspicion of central or secondary hypothyroidism. Since your Free T4 is normal, I feel your thyroid should be normal as Free T4 is a better indicator of thyroid function than Total T4 and you may not require any thyroid replacement.

But since there has been so much confusion regarding your hypothyroidism, I would also prefer to do an imaging of your pituitary gland, to make sure everything is perfect.

Do not hesitate to contact me if any queries.

Regards