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What Causes Elevated TSH Levels In A Diabetic Patient?
Question: My husband is a diabetic. His endocrinologist had his thyroid checked with his last lab work. His TSH is high, his T4 is low, and his T3 is normal! Any thoughts on this?
The doctor wants to check levels again in 30 days before beginning any meds.
He retired 9-30-2013 due to problems with concentration, etc. He was a minister.
The doctor wants to check levels again in 30 days before beginning any meds.
He retired 9-30-2013 due to problems with concentration, etc. He was a minister.
Brief Answer:
Abnormal TFT
Detailed Answer:
Good day,
Noted your concern.
I would like to know if the T4 was total T4 or a Free t4 ( FT4) ? and How high was TSH.
T3 could be normal XXXXXXX to excess conversion of T4 to T3.
Free T4 is more important than Total T4 when we decide treatment.
Could you attach the thyroid blood work report??
Your endocrinologist has chosen to wait , probably due to inadequate clinical evidence of hypothyroidism.
Abnormal TFT
Detailed Answer:
Good day,
Noted your concern.
I would like to know if the T4 was total T4 or a Free t4 ( FT4) ? and How high was TSH.
T3 could be normal XXXXXXX to excess conversion of T4 to T3.
Free T4 is more important than Total T4 when we decide treatment.
Could you attach the thyroid blood work report??
Your endocrinologist has chosen to wait , probably due to inadequate clinical evidence of hypothyroidism.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
The T4 test was "Free T4" with range values of 0.59-1.17 ng/dL given. His was 0.62.
His TSH was 5.150 with range of 0.340-4.820 given.
His T3 was 125 in range of 71-180.
His TSH was 5.150 with range of 0.340-4.820 given.
His T3 was 125 in range of 71-180.
Brief Answer:
Sub clinical Hypothyroidism
Detailed Answer:
Thank you for the reply.
Now the picture is more clear. He has a mild "Sub clinical Hypothyroidism" where FT4 and Ft3 are normal and TSH alone is elevated.
You can see that FT4 is not low, it is still in normal range. Please be aware that Ft4 is expressed in ng/dl and Ft3 is expressed in pmol/L. So the Ft3 number is appearing high. I can assure that both Ft4 and Ft3 are normal.
Does he have an enlarged thyroid?? I would totally agree with your endocrinologist in waiting and repeating the test in 3 months time. There is evidence that in elderly population, a slightly high TSH is protective and treating it may be harmful. If the TSH was more that 10, we would certainly treat irrespective of Ft4 levels.
I would strongly recommend to do an "Anti TPO" blood levels along with TFT in his next blood works 3 months later.
Regards
Binu
Sub clinical Hypothyroidism
Detailed Answer:
Thank you for the reply.
Now the picture is more clear. He has a mild "Sub clinical Hypothyroidism" where FT4 and Ft3 are normal and TSH alone is elevated.
You can see that FT4 is not low, it is still in normal range. Please be aware that Ft4 is expressed in ng/dl and Ft3 is expressed in pmol/L. So the Ft3 number is appearing high. I can assure that both Ft4 and Ft3 are normal.
Does he have an enlarged thyroid?? I would totally agree with your endocrinologist in waiting and repeating the test in 3 months time. There is evidence that in elderly population, a slightly high TSH is protective and treating it may be harmful. If the TSH was more that 10, we would certainly treat irrespective of Ft4 levels.
I would strongly recommend to do an "Anti TPO" blood levels along with TFT in his next blood works 3 months later.
Regards
Binu
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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