TSH was 7.94 and T4 normal I’ve had RA for over 35 years, hashimotos?

Hi suncominup!
May I ask why you have been on Prednison for 30 years?
What is your main diagnosis?
Have you seen a rheumatologist for your RA? There have been many advances in the last 3 decades.
I would suggest that assessments by
1. a rheumatologist, including a bone scan and
2. an endocrinologist: an endocrinologist would look at all of your hormone levels: you may need some 'tweeking after taking prednisone for so many years.
I think thorough evaluations in these two specialties would be an excellent start.
All the best to you and let us know how you get on!

@sunscominup. Welcome to Mayo Clinic Connect! I’m glad you found this site. We have a wonderful, very helpful group so I’m sure you will get more answers. I do agree with @thisoldewe and her suggestions.
What about Hashimoto’s worries you?

Hi, 7.94 to some doctors is not considered elevated for your age. I’m also 69 and considered clinical hypo because I have a controlled pituitary tumor. I do take a very low dose of Tirosint. I find when my numbers hit 8 to 10 my already digestive disorder makes my constipation worse but my hypo tuff to regulate and they don’t know why. I see an endocrinologist too.

I would suggest an endocrinologist let her or him do a full thyroid work up. That way you can figure it out. Your tsh can be high but all other tests be normal and most endocrinologist will start with low dose meds.
You need to figure out what’s causing it and more labs can help narrow it down. I’ve also tested positive for ANA but they did lots of tests years ago and one came back slightly elevated so no confirmation. I’ve never been tested since.
Right now I have a rash on the nape of my neck and terrible burning mouth and tongue and it’s daily. All I get is it’s left over from Covid. Sometimes you feel at this age they lose interest, Medicare pays them so terribly so they just do nothing. It’s disappointing but keep pushing for more tests.
Best of luck.

The median TSH for our age and gender is about 2-2.2 (table in below link). I'm a 69 yo woman that has had hypothyroidism for ~25 years. I do best with a TSH of about 1, and certainly less than 2. A TSH of 3 gives me constipation, fatigue, and have to starve myself to keep my weight under control. TSH is a hormone from the pituitary glad that helps regulate thyroid hormone levels; normal range is about 0.4 to 5.5. My T3 and T4 levels (thyroid hormones) are within normal range even with TSH levels of 0.15 to 3 (0.15 approaches hyperthyroid). My doctor doesn't believe me when I tell her I have hypothyroid symptoms with a TSH of 3 because my free T3 and T4 thyroid hormone levels were normal range. She finally increased my Synthroid and I'm back to my normal (no constipation, being able to eat normally, biking/hiking). I collect autoimmune diseases (celiac, collagenous colitis, Reiters...) but am able to control them with diet (food logs are handy to see if you have any food intolerances), exercise, enough sleep, and managing stress. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5794073/

Your TSH is definitely indicating hypothyroidism. It's too high regardless of your age. If your general practioner does not address the issue, find another who will (I suggest an internal medicine doc for a GP) or ask for a referral to an endocrinologist.

You should see an endocrinologist and have them do a full thyroid panel. Hashimoto’s is when your body attacks your thyroid gland and your bloodwork would show thyroid autoantibodies (like TPO). High TSH alone would not mean you have Hashimoto’s. You need to find out why your brain/body is working so hard to produce thyroid hormone. Did you have your free T3 included when your TSH and T4 were checked?

@sunscominup
There are several responses. I forgot to include your @ name to ensure my response went to your email.

Joanne, thank you for your reply, I have also had a rash at the nape of my neck. I also agree that I should see an endocrinologist and I will try to get a referral to one. I definitely feel that there is a total lack of interest in my health at my age. My pcp is young and just keeps telling me, “well you’re getting up there in years, you’re not getting any younger” ugh.

Dlydailyhope, I did not have a t3 drawn but should in a couple of months.

@sunscominup
I meant to also say that it is concerning your doctor is dismissing you and your symptoms as not important but it is your health and declining quality of life. I would get a new doctor for sure and really advocate for yourself. Doctor dismiss women more, especially older women (I am 54). I, too, have had a positive RA/ANA/CRP but told it was due to depression or dismissed as no big deal even though I feel terrible! My mom had RA/lupus/Hashimotos/fibromyalgia but it is “all in my head” according to a rheumatologist I saw 13 years ago and a PCP 5 years ago (both women). Hashimoto’s is autoimmune but my rheumatologist did not tell me anything about my elevated thyroid autoantibodies in my bloodwork or told to go to an endocrinologist. Your body may be attacking your thyroid. For at least 4-5+ years I had thyroid autoantibodies showing Hashimoto’s but my TSH and T3/T4 was in the “normal” range but I certainly did not feel “normal!” I feel better when my TSH is below 1.0. The only way I could get officially diagnosed with Hashimoto’s and hypothyroidism was after they surgically removed my right lobe due to a suspicious 2.5 cm nodule incidentally found on a CT scan by me! I was finally put on 88 then increased to 100 mcg levothyroxine. After surgery, my TSH rose above 4+ and at that point I could not get out of bed (felt like a dying zombie). It may also be good to have your doctor/endocrinologist do an ultrasound of your thyroid to make sure you do not have any nodules. Good luck and God bless you! Hang in there…you are not alone❣️