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Questions on T4

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Thyroid Disorders
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GiGi73
New Member
Joined : Apr 2018
Posts : 9
Posted 4/30/2021 2:31 PM (GMT -8)
Hey everyone,
I've had many symptoms of hypothyroid for many years now and trying to figure out if they are thyroid-related or not. I have a couple of questions. If anyone can help me out I'd really appreciate it!
Here are my recent labs:
TSH - 2.24 (0.38-5.00)
T4 - 1.16 copy of my labs did not list a ref range
Free T4 - 2.0 (1.4-3.8)
Hashi antibodies were negative

I asked my dr to also do a free T3 but apparently they didn't bother to.

My questions are:
Is the T4 and Total T4 the same test?
When I google'd ref range for T4 all I could find was Total T4 range is 5.0 to 12.0, so can I assume the T4 results are low?
II will call my dr on on Monday to get ref range but wanted to get your opinions.

My symptoms are severe fatigue & muscle pain, heart palps & shakiness, bad acid reflux, insomnia, anxiety, exercise intolerance, hair loss of over 50%, and more but those are the worse symptoms.

Thank you for any help!!
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hypoHashi
Veteran Member
Joined : Jul 2012
Posts : 800
Posted 5/1/2021 9:41 AM (GMT -8)
"Is the T4 and Total T4 the same test?"
No, they are not the same, Total T4 measures the total amount of T4 in your blood, most of it is bounded to protein and can not be used by your body, this is why you should look at the FREE T4!

"When I google'd ref range for T4 all I could find was Total T4 range is 5.0 to 12.0, so can I assume the T4 results are low?"
Reference range change from lab to lab different labs use different reference range, in your case it is for Total T4 and thus not important, you need to look at the free t4 reference range!

"My symptoms are severe fatigue & muscle pain, heart palps & shakiness, bad acid reflux, insomnia, anxiety, exercise intolerance, hair loss of over 50%, and more but those are the worse symptoms."
Your TSH which is the golden standard to diagnose and treat hashimoto's disease is optimal, also if you do not have the antibodies for hashimoto's disease as positive then you do not have hashimoto's induced hypo or hyper, that said, there are other reasons to have hypo or hyperthyroidism such as postpartum thyroiditis !

Best,
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GiGi73
New Member
Joined : Apr 2018
Posts : 9
Posted 5/1/2021 12:59 PM (GMT -8)
Thanks for your reply. I'll have to get the ref ranges for my t4 and try to get a free T3 test since my dr didn't do it.
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astroman
Veteran Member
Joined : Mar 2014
Posts : 8890
Posted 5/5/2021 9:17 AM (GMT -8)
TSH only testing is not sufficient............which is why so many people feel hypo when the frees are not looked at.

Younger endos are finally understanding this and tossing away the old thought. Natural path Drs and Functional MD's have understood this for quite some time. Conventional medicine is very slow to change, but even my 65 year old endo "gets it" finally based on his practice experience and patients feedback.

"Gold standard" does not mean its correct.
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