Confused by thyroid tests

Hi everyone,

Just got my thyroid labs today and things are a bit confusing. My THS is relatively normal, but my T4 is high and my T3 is low?? Shouldn’t they both be within the same range, either high or low? One seems to point to hyperthyroidism and the other hypo? I had thought I was hypo because of my symptoms, but now I’m just confused. Anyone got any thoughts on this??

THS–3.34 (.45-4.5)
T4 --15.3 (4.5-12.0)
T3 Uptake 16 (24-39)
free thyroxine index–2.4 (1.2-4.9)
Glucose–92 (65-99)
insulin–4.8 (2.6-24.9)

Your TSH is in the normal range, yes, but it does point to the fact your thyroid gland itself doesn’t respond the way it should to TSH. First let’s look at how the thyroid works.

Your hypothalamus will secrete TRH. TRH will bind to TRH receptors on the pituitary which will then prompt your pituitary to secrete TSH. TSH then binds to the TSH receptors on the thyroid gland, which makes your thyroid gland produce T4 and some T3. Most T4 is converted to T3 in the liver.

So, if your blood levels of T4 and T3 drop a little low, TSH will rise. However, your TSH should be ideally around 1 with T4 and T3 in the normal range. A TSH of 3.34 indicates that your thyroid gland doesn’t respond as well as it could to TSH. This is fine, as long as your TSH rises and your thyroid gland responds accordingly. Which, by the looks of it, it has. Looking at your free T4, you’re not hypo nor are you hyper.

Also, T3 uptake is not your T3. In fact, this is a very inacccurate test and is long out dated. Whoever ordered it is still performing old fashion work up. I’d recommend you get free T3 test to see where your T3 is.

In conclusion, I’d say your thyroid is just fine.

Thanks for the detailed response, man! Great insight.