Thyroid Function

High TSH with Normal T4



  • An elevated TSH with a normal T4 is suggestive of subclinical hypothyroidism, though may also occur in several other circumstances.
    • Causes of Elevated TSH with Normal T4

    • Subclinical hypothyroidism
    • Poor compliance with thyroxine
    • Assay interference
    • Drugs - amiodarone, sertraline
    • Nonthyroidal illness (recovery phase)
    • TSH receptor defects
    • TSH resistance
    • Pearls

    • Ask about symptoms of hypothyroidism
    • Take a careful medication history
    • Ask about recent illnesses
Last updated on November 28th, 2019
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