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Hypothyroidism, TSH 6.5, FT4 14, synthroid, TSH 2.5, FT4 12. Pituitary problem ?

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Practicing since : 2002
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I'm confused about my thyroid. One year ago, I was diagnosed with subclinical hypothyroidism. TSH was 6.5 and FT4 was around 14 (10-20 scale).

Six months later, after the lowest dose of Synthroid, my TSH was 2.5 and FT4 around 12 something. Shouldn't my FT4 be higher? Is this a pituitary problem?

I also have prematurely white hairs and a few white eyelashes (I'm only 30). I'm worried about a premature ageing disorder or something. My FSH level is slightly elevated at 12 in my early cycle. All other tests (prolactin, etc. ) are normal.
Posted Sun, 29 Apr 2012 in Thyroid Problem and Hormonal Problems
Answered by Dr. Robert Galamaga 47 minutes later
Hello and thanks for your query.

Your question is a good one and I will try to give you some insight to interpret the test results. First of all it is important to understand that all lab tests will have a bit of variability in test results which is why we depend on a range value for results. This is important in looking at your results particularly in the setting of subclinical hypothyroidism.

The decline in the TSH is expected and appropriate in your case. I am also not surprised that your T4 is where it is in this setting. Remember now that your body is producing thyroid hormone and you are also providing a source of it via the thyroid supplement. In doing so you downregulate the TSH while providing some active thyroid hormone to work along with the basal amount your body is making.

For you the judgement regarding management of this relies in your subjective reports of symptom improvement. If you feel better we tend to pay less attention to the fluctuation in lab results. Also important for you would be continued followup and a recheck of the thyroid labs in 3 to 6 months.

In summary - no need to be concerned about the lab results. I would continue the med as prescribed for now with a followup checkup to include a discussion of how you feel in the context of followup lab results.

I hope you have found this answer to be both helpful and informative. Should you have additional questions I would be happy to address them.


Dr. Galamaga.
Above answer was peer-reviewed by
Follow-up: Hypothyroidism, TSH 6.5, FT4 14, synthroid, TSH 2.5, FT4 12. Pituitary problem ? 21 hours later
Thank you!
So I shouldn't worry about pituitary then?

Answered by Dr. Robert Galamaga 8 hours later
Hello again and thanks for the followup.

The simple and clear answer is NO! No worry about the pituitary at this time. I am confident that you have a very mild case of the subclinical variety which often responds very well to low doses of levothyroxine. I think you will do quite well.

I thank you again for your query and hope you continue to enjoy good health and a future filled with enjoyment.


Dr. Galamaga
Above answer was peer-reviewed by
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