Get your Health question answered in 3 easy steps
A Doctor will be with you shortly
Ask a Doctor Now
144 Doctors are Online

Low TSH, low T3 and T4. Thyroid problem or pituitary problem?

User rating for this question
Very Good
Answered by

Practicing since : 2001
Answered : 1663 Questions
what kind of thyroid problem ?
Hello Doctor,

My 19 years old daughter recently had a blood test on 3/13/2012. The results showed the

TSH = 0.762 ( 038-3.79)
T3 (free) = 1.45 (1.8-4.2) Low
T4 (total) = 3.9 (4.5 - 12.5) Low

Both Antibodies are normal < 20.

I have Hashimoto's hypothyrodism. my husband had hyperthyrodism and now is completely normal after many years of medication. We are just wondering why my daughter has low TSH and Low T3 & T4 at the same time.
Is this a thyroid problem or Pituirary problem.

Also her Red blood cell count is 3.72 (3.87-5.15) and high MCV 101.9 (72.7-97.7), high MCH 34.1 (23.5-32.8).
Does these numbers mean she has some kind of Anemia. Is it related to the above thyroid problem ?

Please advise. THANKS very much.
Posted Tue, 22 May 2012 in Thyroid Problem and Hormonal Problems
Answered by Dr. Shehzad Topiwala 25 minutes later

Thanks for the query.

Thyroid disorders tend to run in families. So given the fact that both you and your husband have a thyroid condition, your daughter may be prone to developing it too. However, since you say the thyroid antibodies are both negative, the chance is less but sometimes underactive or overactive thyroid problems can occur without detectable antibodies in the blood tests.

Now you have raised a good point about the diagnostic considerations ie thyroid versus pituitary. In order to fully interpret the thyroid laboratory tests that you have shared here, we need more tests. I would recommend repeating the TSH, Total T4 and do Total T3 with T3 resin uptake along with prolactin. There is no need to fast for these tests and they do not have to necessarily be done in the morning.

Anemia can occur in 'hypothyroidism' but if the thyroid turns out to be normal then evaluation of the hemoglobin status requires an independent work-up.

Endocrinologists are the best type of specialized doctors to competently manage these complex test results.

Hope this answers your query. Please do write back to me if you have additional queries.

Wishing your daughter a healthy life ahead.

Above answer was peer-reviewed by
Share on Facebook
Share on Twitter
Share on Google+
Question is related to
Medical Topics

The user accepted the expert's answer

Ask an Endocrinologist

© Ebix, Inc. All Rights Reserved.
All the information, content and live chat provided on the site is intended to be for informational purposes only, and not a substitute for professional or medical advice. You should always speak with your doctor before you follow anything that you read on this website. Any health question asked on this site will be visible to the people who browse this site. Hence, the user assumes the responsibility not to divulge any personally identifiable information in the question. Use of this site is subject to our Terms & Conditions
Already Rated.
Your rating:

Ask a Doctor