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Thyroid Advice - Abnormal T4 and TSH

Hello everyone… I’ve been on TRT now for a couple of years, and have my numbers fairly stable. I was just told I was hypothyroid though, and looking for others viewpoints before I go back into my follow up. Basically, I need to know what to ask I guess.

My numbers were as follows:

TSH: .614 range .358-3.74
Free T4: .7 range .76-1.46
Free T3: 3.2 range 2.18-3.98

My thyroid antibodies were below range on both test, so not looking like an auto immune attack.

I also had an MRI done on my head, and the pituitary didn’t have any shrinkage or tumors.

So, this is where I stand. I don’t really want to jump right into treating it, but if it looks like the case I’m open. Are there other tests I should be asking for? I’m guessing this is a pretty big lifelong decision here…



Normally when T4 is low and TSH isn’t elevated usually indicates pituitary gland is more likely to be the cause for the hypothyroidism. Just because your thyroid is in range doesn’t mean you don’t have a problem, everyone operates in a particular optimal range that’s best for them and doctors fail to understand this fact. You pituitary gland should see the low T4 hormones and kick into high gear producing more TSH to compensate for the low T4 and create more, it isn’t doing that which suggests a pituitary gland disorder. If you are secondary hypogonadism that to is a pituitary gland failure for which you sought out treatment in the form of TRT, now a few years later your pituitary gland is failing you in another area and is starting to affect other functions. Your body converts T4 to T3 efficiently otherwise it would as be low.

Thanks system… That is my understanding as well. So I guess I have two follow up questions:

  1. Are there other tests I should be looking at prior to any treatment? And,
  2. Is there anything naturally that would elevate T4 back to optimal ranges without looking toward synthetic hormones first?

They can do a lot sometimes but as time goes on you might need retesting to see it it continues on a downward spiral. What has your doctor said about your low T4? I understand your reluctance of putting anything synthetic into the body as I took Klonopin for 30 years and it has caused a lot of problems, I hate synthetic drugs.

You might look into getting your reverse T3 checked.

Thanks High… I’ll query him on Thursday. I also heard there is an SHBG equivalent with the Thyroid (TBH?). Is that something to consider?

I haven’t talked to him yet. Thursday’s appointment is a post MRI consult

It’s Thyroid Binding Globulin (TBG) and I don’t think it’s the problem as your fT3 is pretty good. With your fT3 at 3.2, your rT3 should be 16ng/dL or less. Elevated rT3 could block your fT3 from the receptor site and cause hypothyroid symptoms.