High TSH Normal T4: What Does it Mean? Thyroid Lab Patterns Explained (2023)

Are you experiencing a high TSH but normal T4?

Are you confused about interpreting these values?

Is your Doctor telling you that your tests are normal even though you are experiencing abnormal symptoms?

This article will help shed light on this thyroid lab pattern and help you understand what it means.

You'll learn more about the symptoms associated with this pattern (and other patterns) and how to treat them below:

More...

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Download my Free Resources:

Foods to Avoid if you have Thyroid Problems:

Symptoms Associated with a High TSH

Treatment Options + What to do next

#1. Treatment with thyroid medication

#2. Treatment with Alternative Therapies Including Diet and supplements.

What if you have a High TSH and a Low T4?

Other Thyroid Lab Patterns which May Result in Hypothyroid Symptoms

Conclusion

References (Click to Expand)

(Video) TBS #11 Thyroid Lab Patterns Explained: Hi TSH, lo T3, lo T4 & More

Is This Thyroid Lab Testing Pattern Bad?

The first thing you should know is that having a high TSH, even if accompanied by a normal T4, is never a normal sign.

A high TSH is a marker that the connection between your brain and your thyroid may not be functioning at 100%.

What do I mean?

In order to understand this concept, you have to understand how TSH functions in your body.

TSH (also known as thyroid stimulating hormone) is a hormone that is produced by the pituitary gland.

Its job is to act on your thyroid gland (in your neck) to tell your thyroid to produce more thyroid hormone.

If your TSH is elevated this means your brain is trying to increase the "stimulus" to your thyroid gland in an attempt to compensate for decreased thyroid hormone (1).

This process is how your brain and your thyroid gland regulate thyroid hormones in your blood.

As thyroid hormones drop your TSH will rise to compensate to tell your gland to produce more.

This rise in TSH is almost always seen as an early and sensitive marker for thyroid dysfunction!

So, while TSH tells you how responsive your thyroid gland is to thyroid hormone it doesn't give information on your free thyroid hormone levels.

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Foods to Avoid if you have Thyroid Problems:

I've found that these 10 foods cause the most problems for thyroid patients. Learn which foods you should absolutely be avoiding if you have thyroid disease of any type.

How to Calculate "Optimal" Free T4, Free T3, & Reverse T3 Ratio:

Calculating these ratios is important because it can help you determine if your efforts are on the right track and whether or not your medications are working.

Download more free resources on this page.

What your Free Thyroid Hormones Mean for You (Free T3 & Free T4)

Most physicians (Doctors) tend to order what is known as a TSH with reflex to free T4.

This lab test is supposed to only order the free T4 IF the TSH is abnormal (2).

The idea is that it saves on the cost of unnecessary lab tests because why would you need to see the free T4 if the TSH is normal?

(Video) What are the normal levels of T3, T4,TSH & causes for Thyroid Disorders? - Dr. Sanjay Panicker

So, what ends up happening, is many patients get their thyroid "checked" which results in this TSH with reflex to free T4.

When they find that their TSH is abnormal the lab company will automatically order free T4.

But they might get confused when the free T4 comes back as "normal" or within the normal range.

How can this be if your TSH is high?

Several things may account for this phenomenon.

#1. Your thyroid gland is struggling but still able to keep up... for now.

The rise in your TSH is a normal physiologic response for lower than normal free thyroid hormones and it indicates that everything is working properly.

But as TSH rises it means that your thyroid gland is no longer responsive to the lower doses of TSH that it once was.

This usually indicates an early problem with the thyroid gland itself.

Why?

Because your thyroid gland is getting the stimulus from the brain to produce more thyroid hormone (hence the high TSH) but it's only capable of producing a "normal" amount of T4.

We know this because we know what a HEALTHY TSH level is supposed to be (3).

We also know that a high TSH is not necessary to produce adequate thyroid hormones.

So this early rise in TSH can be used as a sensitive marker for early thyroid GLAND dysfunction.

By the way, you may find that both your free T3 and free T4 stay "normal" despite having a very high TSH.

This is seen as your body is attempting to compensate for the early problems described above but it does NOT mean that this is "normal".

Eventually, your thyroid will be unable to meet the demand and you will experience severe symptoms (if you aren't already).

#2. The lab tests may not be accurate.

This one is rare but it certainly does happen.

It is estimated that up to 5% of all lab tests may be inaccurate or spurious.

This is as high as 1 in 20 lab tests and if you get a full panel of lab tests you can count that at least a few of those results are not 100% accurate.

This inaccuracy stems from the fact that lab testing machines must be calibrated to normal each and every day.

If there is something wrong with the machine for one test or the calibration is not done accurately, then some of the lab tests may not be accurate.

So what should you do if you feel that your results are not accurate?

The best thing to do is to simply re-test your TSH and free T4 within 1-2 weeks.

The chances of your lab tests being inaccurate are very low, but it's worth going through this song and dance if you don't have any symptoms and feel great.

#3. You may have Hashimoto's Thyroiditis.

Another possibility is that you have an autoimmune disease known as Hashimoto's thyroiditis.

It is well known that this thyroid condition can cause changes to thyroid lab tests which are not considered to be "normal" (4).

In fact, many patients with Hashimoto's are not treated sufficiently because their symptoms do not always correlate with their lab results.

When in doubt, make sure that you always look at your body and your symptoms and don't focus solely on your lab tests.

If you suspect that you may have Hashimoto's you can easily check for this condition with a blood test which checks for thyroid antibodies.

#4. You may not be converting T4 to T3.

Lastly, it's possible that you may not be seeing the "whole picture" when it comes to your thyroid.

(Video) Thyroid TSH Levels High - What it means and what to do!

While your TSH and free T4 are important measures of thyroid function they do not test every facet of thyroid function in your body.

One of the most important (if not the most important) lab test to look at when it comes to your thyroid is known as free T3.

Free T3 is the ACTIVE thyroid hormone and it is created through a process known as thyroid conversion.

In this process, your body takes free T4 and turns it into free T3.

So, why does free T3 matter?

Consider this scenario:

Imagine that your TSH is high and your free T4 is normal but you decide to check your free T3 as well.

You may find that your free T3 is actually quite low which indicates that your body can produce some amount of T4 but it's not able to convert that T4 into T3.

This is known as a problem with thyroid conversion and can be entirely missed unless you also check for your free T3.

For this reason, I always recommend that you look at a complete thyroid panel (if you suspect you have thyroid disease).

If you didn't get a full thyroid panel to start with you can always go back and get everything retested.

Symptoms Associated with a High TSH

Will you have symptoms if you have a high TSH and a normal T4?

You might expect that you would be without symptoms if your free thyroid level is "normal" but that isn't always the case.

In fact, most patients with a high TSH (regardless of their free thyroid hormone levels) may be symptomatic.

A handful of patients may be asymptomatic (meaning they won't experience symptoms) most likely due to their body being having a "reserve" level which can keep them going for some time.

But, if you are like most people, you may start to experience certain symptoms.

In fact, these symptoms may be the reason you went to your Doctor in the first place and had your blood work checked.

The symptoms associated with a high TSH are easy to identify because they are the symptoms of low thyroid function or hypothyroidism.

Symptoms of a high TSH and normal T4 include:

  • Mild weight gain (usually no more than 2-5 pounds)
  • Cold intolerance or feeling like you are cold all the time
  • Mild constipation
  • Dry skin
  • Feeling "down" or "depressed"
  • Mild brain fog or clouded thinking/judgment

The degree of symptoms that you will experience will depend on the degree of elevation of your TSH (5).

Put simply:

The higher your TSH, the more your thyroid gland is compromised and the more severe your symptoms will be.

So, you may experience only mild weight gain if your TSH is in the 3-5 range, but that weight gain will be more severe if your TSH is 5-10 and so on.

These symptoms are an indication that your thyroid is NOT functioning properly and are a sign that you should seek out therapies to try and fix the problem.

Treatment Options + What to do next

So what should you do if you have a high TSH? What therapies are available to you?

The first thing you should do is to make sure that your test results are indeed legitimate.

That means that your lab results should match your clinical appearance.

If you are completely asymptomatic, meaning you are not experiencing any of the symptoms listed above, then it may be reasonable to simply recheck your blood work in 6-8 weeks to see if your test was accurate.

If you are symptomatic, however, then you can safely assume that your thyroid is not functioning appropriately.

This would be an indication that some sort of intervention is warranted.

In terms of the type of treatment available you really have a couple options:

#1. Treatment with thyroid medication

The most common treatment for a high TSH is to take thyroid hormone replacement medication.

This medication, usually in the form of T4 such as Levothyroxine, will help supplement your body with extra T4 which will, in turn, drive down your TSH to normal levels.

This is the theory behind using thyroid medication to help if you have thyroid dysfunction.

The problem is that not everyone will do well on T4 only thyroid medications (even though they are the most commonly prescribed).

Previously, I mentioned that you may have an issue with thyroid conversion which leads to low free T3.

If you fit this category then you may need to use a thyroid medication which contains both T4 and T3.

(Video) Why Do You Still Have Thyroid Symptoms When Your Lab Tests Are Normal?

These therapies should always be combined with #2...

#2. Treatment with Alternative Therapies Including Diet and supplements.

These therapies shouldn't be considered "alternative" at all because they are really the single best way to improve your thyroid and other hormones.

Using basic therapies which include eating a more healthy diet, taking vitamins and nutrients which you may be deficient in and exercising regularly should never be ignored if you have a thyroid issue!

Study after study has shown that these therapies do indeed help to reduce inflammation (6) and promote hormone balance (7).

The problem is that many patients forgo these therapies in favor of taking medications!

This behavior only reinforces future problems and never actually allows your body time to improve.

In terms of your diet, you can read more about the type of healthy foods you should be eating in this article.

For supplements, you'll want to focus on nutrients and vitamins which have been shown in scientific studies to improve your thyroid.

I recommend a supplement such as this one which contains all of these nutrients.

In addition to these therapies, you'll also want to ensure that you are sleeping 8 hours each night and managing your stress appropriately!

Doing these things, in conjunction with thyroid medication (if necessary) will go a long way toward helping you feel better.

What if you have a High TSH and a Low T4?

Does anything change if you have a high TSH and a low T4 or low T3?

The answer is no.

The difference between those who have a high TSH and a low or normal T4 likely has to do with their "reserve capacity" for thyroid function.

In other words, some people are probably able to tolerate different levels of T4 without becoming symptomatic due to either the number of thyroid receptors they have on their cells or due to receptor sensitivity (they may be more or less sensitive to thyroid hormone than you).

So, don't be too concerned with your absolute T4 or T3 level, instead, try to focus on whether or not you have both a lab abnormality combined with symptoms.

The combination of these two factors will give you the most information and help you zone in on a diagnosis.

If you have low T4 you can read more about that condition here.

Other Thyroid Lab Patterns which May Result in Hypothyroid Symptoms

Are your lab tests slightly different than what we discussed here?

Don't worry!

I've included a list of various other lab tests below and how they may present in terms of your symptoms:

  • High TSH, normal T4, normal T3 = This is the pattern we've been discussing in this post and will usually present with hypothyroid symptoms.
  • High TSH, normal T4, low T3 = This pattern may be an indication that you are having issues with thyroid conversion and most often presents with hypothyroid symptoms.
  • Normal TSH, low T4, low T3 = This pattern is usually what is seen in those with chronic illness and in those who are taking multiple medications. If you have this pattern you will most likely be symptomatic.
  • Normal TSH, normal T4, low T3 = This pattern may be consistent with low T3 syndrome or euthyroid sick syndrome and may present with hypothyroid symptoms but not always.
  • Normal TSH, normal T4, normal T3, positive thyroid antibodies = This is a classic presentation for early Hashimoto's and most patients with this pattern will be symptomatic. If you are symptomatic this is a valid reason to consider a trial of thyroid medication even though your lab tests are "normal".
  • Normal TSH, normal T4, normal T3, high reverse T3 = This pattern is most often seen immediately after calorie restriction or after dieting and weight loss. This pattern usually indicates an adaptive response from your body and one that shows your metabolism will be slowing over the next few months (not ideal for weight loss).

This isn't a comprehensive list of all of the thyroid patterns available, but it should really give you a good starting point if you aren't sure where you "fit in".

Lastly, if you have any questions about your labs feel free to leave a question or a comment below and I can try to direct you further!

Conclusion

The bottom line?

Your TSH and your free T4 are connected and changes in one will often time result in a change in the other.

Don't let a single "normal" lab result in a sea of abnormal results alter how you look at your thyroid lab tests.

It's not abnormal for one result to be "normal" even though many others are obviously abnormal.

Lastly, make sure that you listen to your body and your symptoms.

You are more than just your lab results!

Now I want to hear from you:

Do you have a high TSH with a normal T4?

What about your free T3 levels?

Have you had a complete thyroid lab panel?

Leave your questions, comments or answers below!

References (Click to Expand)

(Video) Thyroid Stimulating Hormone Nursing Considerations, Normal Range, Nursing Care, Lab Values Nursing

High TSH Normal T4: What Does it Mean? Thyroid Lab Patterns Explained (2)

FAQs

What does it mean if you have a high TSH but normal T4? ›

Early or mild hypothyroidism may present as a persistently elevated TSH and a normal FT4 hormone level. This pattern is called subclinical hypothyroidism and your doctor may recommend treatment. Over time, untreated subclinical hypothyroidism can contribute to heart disease.

Which is more important T4 or TSH? ›

Across many clinical studies it seems clear that the physiologic effects of low or high thyroid function correlate much more strongly to free T4 and free T3 levels than to TSH levels. In fact, correcting for changes in T4 and T3 levels there appeared to be no correlation between TSH level and body function.

What happens when only TSH is high? ›

TSH levels that are just a little too high may be the first sign of the early stages of hypothyroidism: The pituitary gland responds to lower levels of thyroid hormones by increasing TSH production to activate the thyroid. It is estimated that about 5 out of 100 people have subclinical hypothyroidism.

Why do I have thyroid symptoms if my TSH is normal? ›

An individual may have normal TSH levels but still not be utilizing thyroid stimulating hormone correctly, leading to a thyroid imbalance. Your doctor should also be looking at your other values such as T3 and T4 levels. These can provide more information about how well your thyroid is actually functioning.

What if TSH is high but T3 and T4 are normal? ›

When the thyroid gland becomes inefficient such as in early hypothyroidism, the TSH becomes elevated even though the T4 and T3 may still be within the "normal" range.

What TSH level indicates Hashimoto's disease? ›

However, the authors used a “prevalence of Hashimoto's thyroiditis” factor to determine the upper limit of TSH and found a range of 2.6-2.9 to be more appropriate. They state that this correlates with the National Academy of Clinical Biochemists findings of a 2.5 upper limit for TSH levels.

Which thyroid test is most important? ›

Assessment of TSH is the single most useful test of thyroid function in the vast majority of patients. Primary care providers should seldom need to order any other biochemical thyroid test. In most cases the TSH will be within the normal range, and no further testing is indicated.

What is considered dangerously high TSH? ›

A TSH over 10 mIU/L has been linked to an increased risk of coronary heart disease and heart failure, which is why you'll probably want to seek treatment if your TSH is close to (but still under) that upper limit.

What is the symptoms of high TSH? ›

Symptoms of high TSH levels
  • Fatigue.
  • Numbness and tingling in your hands.
  • Constipation.
  • Unexplained weight gain.
  • Depression.
  • Being unable to tolerate cold temperatures.
  • Decreased interest in sex.
  • Frequent and heavy menstrual periods.
25 Jul 2022

Should I worry about high TSH? ›

If your TSH level is higher than 10 mIU/L, you should start treatment, because you will very likely develop symptoms of an underactive thyroid, even if you don't have them now.

What is the most common cause of elevated TSH level? ›

High TSH is commonly caused by hypothyroidism (low thyroid hormone levels), in which case a person may experience: Fatigue [38]

What is the treatment of high TSH? ›

This condition can make your metabolism speed up. Symptoms of hyperthyroidism include a rapid heartbeat, weight loss, increased appetite and anxiety. Hyperthyroidism can be treated with antithyroid drugs, radioactive iodine, beta blockers and surgery.

Can your thyroid be off if your TSH is normal? ›

Can you have hypothyroidism with normal TSH? Yes, it is possible to have hypothyroidism and normal TSH levels in the blood. Most people with hypothyroidism have high TSH because their thyroid gland is not releasing enough hormones. In response to this, the body produces more TSH in order to get the thyroid to work.

Is TSH enough to test thyroid? ›

Your TSH test results can tell you if your thyroid is making too much or too little thyroid. But the test can't explain why your TSH levels may be too high or too low. Thyroid antibodies test to help diagnose an autoimmune thyroid disorder, such as: Graves' disease, the most common cause of hyperthyroidism.

What diseases can mimic hypothyroidism? ›

  • Angioedema.
  • Bronchitis.
  • Bulimia Nervosa.
  • Chronic Obstructive Pulmonary Disease.
  • Congestive Heart Failure.
  • Depression.
  • Menopause.
  • Preeclampsia.

What can mimic hyperthyroidism? ›

  • Alcoholism.
  • Alzheimer's Disease.
  • Amenorrhea.
  • Amyloidosis.
  • Anorexia Nervosa.
  • Bulimia Nervosa.
  • Chronic Obstructive Pulmonary Disease.
  • Cirrhosis.

Can high TSH cause weight gain? ›

Weight gain: Unexpected weight gain, often accompanied by persistent fatigue, is among the earliest signs of hypothyroidism. High TSH levels and weight gain often go hand in hand.

Do you increase or decrease levothyroxine if TSH is high? ›

The goal is to maintain the TSH level within normal limits; the dosage of levothyroxine should be increased if the TSH level remains above normal and should be decreased if the TSH level falls below normal.

What test confirms Hashimoto's disease? ›

Anti-thyroid antibodies (ATA) tests, such as the microsomal antibody test (also known as thyroid peroxidase antibody test) and the anti-thyroglobulin antibody test, are commonly used to detect the presence of Hashimoto's thyroiditis.

Can TSH be normal with Hashimoto's? ›

It's possible to have Hashimoto's disease but not yet have a severe enough case that your thyroid function has been impacted. In these cases, you can have Hashimoto's disease with normal TSH.

How can you tell the difference between hypothyroidism and Hashimoto's? ›

The main difference between Hashimoto's and hypothyroidism is the cause of each condition. Hashimoto's disease happens when your immune system attacks your thyroid gland. Hypothyroidism occurs when your thyroid is underactive and not producing enough thyroid hormone. And this can happen for many different reasons.

What time of day are thyroid levels highest? ›

[1] A large laboratory data-based study by Ehrenkranz et al. showed that there is a significant circadian variation in the TSH levels with peak levels occurring between midnight and 8 am and nadir levels between 10 am–3 pm and 9–11pm.

What is the best time to take thyroid test? ›

I recommend getting your thyroid function tests done first thing in the morning, bringing your medications with you, and taking them right after you have your thyroid function tests to ensure that you get accurate test results.

What is the main cause of thyroid disease? ›

The most common cause of hypothyroidism is an autoimmune disorder known as Hashimoto's thyroiditis. Autoimmune disorders occur when your immune system produces antibodies that attack your own tissues. Sometimes this process involves your thyroid gland.

How quickly can TSH levels change? ›

The TSH level should, therefore, be evaluated no earlier than 6 weeks after initiating therapy or adjusting levothyroxine dosage. The full effects of thyroid hormone replacement on the TSH level may not become apparent until 8 weeks of therapy.

What can affect TSH levels? ›

Concomitant diseases, medications, supplements, age, gender, ethnicity, iodine status, time of day, time of year, autoantibodies, heterophilic antibodies, smoking, and other factors influence the level of TSH, or the performance of current TSH assays.

What is a high TSH level in a woman? ›

An optimal TSH level in a woman is 0.4-2.5 mIU/L. For pregnant women, that upper limit is stricter than if you are not pregnant. A dangerously high level of TSH is above 5.0 mIU/L. High TSH means low thyroid hormones.

What does thyroid fatigue feel like? ›

You may feel nervous, moody, weak, or tired. Your hands may shake, your heart may beat fast, or you may have problems breathing. You may be sweaty or have warm, red, itchy skin. You may have more bowel movements than usual.

Can high TSH cause high blood pressure? ›

When the thyroid gland doesn't produce enough thyroid hormone (hypothyroidism) or produces too much thyroid hormone (hyperthyroidism), high blood pressure can result.

How can a woman lower her TSH levels by food? ›

Foods to eat
  1. Antioxidant-rich fruits and vegetables. Blueberries, tomatoes, bell peppers, and other foods rich in antioxidants can improve overall health and benefit the thyroid gland. ...
  2. Selenium. Tiny amounts of selenium are needed for the enzymes that make thyroid hormones to work properly. ...
  3. Tyrosine.

What can cause TSH to rise? ›

Your TSH levels will be increased, if: Your thyroid gland is not working as it normally should. Your thyroid gland is infected or inflamed, as in Hashimoto's thyroiditis, or autoimmune thyroiditis. This occurs when your body is attacking your thyroid gland, for some unknown reason.

What causes TSH levels to be high? ›

If you have too much TSH, it may indicate that your thyroid isn't making enough thyroid hormone. This condition is called hypothyroidism, or underactive thyroid. A number of conditions can cause hypothyroidism, including Hashimoto's disease. About 5% of adults in the United States have hypothyroidism.

What is the symptoms of high TSH? ›

Symptoms
  • Fatigue.
  • Increased sensitivity to cold.
  • Constipation.
  • Dry skin.
  • Weight gain.
  • Puffy face.
  • Hoarseness.
  • Muscle weakness.
19 Nov 2020

What can affect TSH levels? ›

Concomitant diseases, medications, supplements, age, gender, ethnicity, iodine status, time of day, time of year, autoantibodies, heterophilic antibodies, smoking, and other factors influence the level of TSH, or the performance of current TSH assays.

Should I worry about high TSH? ›

If your TSH level is higher than 10 mIU/L, you should start treatment, because you will very likely develop symptoms of an underactive thyroid, even if you don't have them now.

What is the treatment of high TSH? ›

This condition can make your metabolism speed up. Symptoms of hyperthyroidism include a rapid heartbeat, weight loss, increased appetite and anxiety. Hyperthyroidism can be treated with antithyroid drugs, radioactive iodine, beta blockers and surgery.

What medications cause high TSH levels? ›

8 drugs that cause hypothyroidism
  • Hyperthyroidism medications like propylthiouracil (PTU), methimazole, radioactive iodine (or radioiodine), and potassium iodine. ...
  • Amiodarone. ...
  • Lithium. ...
  • Interleukin-2. ...
  • Interferon alfa. ...
  • Tyrosine kinase inhibitors like sunitinib (Sutent) and sorafenib (Nexavar)
29 Apr 2020

Does stress cause high TSH? ›

"Stress increases production of the hormone cortisol, which is produced by the adrenal glands. Cortisol can inhibit secretion of TSH (thyroid stimulating hormone) from the pituitary gland, leading to partial suppression of thyroxine, the main hormone produced by the thyroid gland," Dr. Guandalini explains.

Does high TSH cause weight gain? ›

Weight gain: Unexpected weight gain, often accompanied by persistent fatigue, is among the earliest signs of hypothyroidism. High TSH levels and weight gain often go hand in hand.

Can TSH levels change quickly? ›

Thyroid hormone levels may fluctuate over time. These fluctuations may occur as your thyroid condition progresses. Still, other factors like age, hormonal changes, and medication variations may also alter your thyroid hormone levels, producing a variety of symptoms.

What does thyroid fatigue feel like? ›

You may feel nervous, moody, weak, or tired. Your hands may shake, your heart may beat fast, or you may have problems breathing. You may be sweaty or have warm, red, itchy skin. You may have more bowel movements than usual.

Can high TSH cause high blood pressure? ›

When the thyroid gland doesn't produce enough thyroid hormone (hypothyroidism) or produces too much thyroid hormone (hyperthyroidism), high blood pressure can result.

How long does it take to get TSH levels back to normal? ›

Drug therapy to normalize thyroid hormone levels can require two to three months. Generally, another year or two of continued drug therapy may be required before there is a true “remission” of the disorder. Keep in mind that drug therapy does not “cure” or bring about remission.

Does dehydration affect TSH levels? ›

Dehydration can cause an increase in cortisol production stressing the adrenals and further initiate production of TSH, which again has a negative impact on thyroid.

Does coffee affect TSH levels? ›

Caffeine lowered serum TSH and GH in a dose-dependent manner with ED50 values of 30 and approximately 50 mg/kg, respectively. TSH levels were depressed 1 to 6 hr after injection and correlated with serum caffeine levels greater than 20 micrograms/ml.

Can lack of sleep affect TSH levels? ›

Sleep loss can also affect the function of the human hypothalamo-pituitary-thyroid axis. In contrast to the effects of sleep deprivation in rodents, acute sleep loss in humans is associated with increased TSH, T4, and T3,6,7 and human sleep is believed to have an acute inhibitory effect on overnight TSH secretion.

Videos

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3. Thyroid Stimulating Hormone (TSH) (Nursing Lab Values)
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4. Causes of normal T3,T4 levels but low TSH levels - Dr. Anantharaman Ramakrishnan
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