High TSH and high T4

Posted by Lex @alexandriagarcia0611, Apr 30 10:34am

Hello All,

7 months ago September 2025, I noticed my throat was enlarged and that's when I got an ultrasound on my thyroid. The findings where the texture was heterogenous, left lobe was increased 5.1 x 1.5 x 2.7cm and right lobe was 5.3 x 1.7 x 3.3cm. no nodules were noted.

I got a thyroid panel done at the same time sept 2025, I found that my T4 was 2.17 ng/dl and my TSH was 15.227 ulu/ml, T3 is normal, my thyroid peroxidase AB is 600 iu/ml and thyroglobulin is 4,000 Ui/ml. Since sept 2025- Mar 5 2026 my TSH and T4 are both consistantly high.

So I was referred to an endocrinologist and I mentioned if this had to do with my pituitary gland so at first he was saying no because my prolactin levels were good but a couple days later he called and put in an order for me to get one. The results were that pretty much everything was normal except my pituitary gland was midly prominent in size. thats all.

I am and have been experiencing all the symptoms of hypo and hyper, waking up feeling hungover, heart racing and heart fluttering, headaches, foggy vision, brain fog, bone pain, along with back pain, heat and cold intolerance extreme fatigue and dry eyes. My next appointment is later this month.

Id like to know your thoughts and what I shouldnt except for treatment and what ideas you have that should be ruled out. I have felt like death for 2 years now and only 7 months ago im getting an idea on why.

I am 24yr FM.
No kids
Never been on hormone medication
I don't take Biotin

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dragonflylady | @dragonflylady | May 13 7:13pm

In reply to @alexandriagarcia0611 "@dragonflylady do you have high tsh and high t4?" + (show)

@alexandriagarcia0611
Hi! My TSH seems to spike every other year but my T4 as far as I can remember has always dropped when my TSH went up. Don’t know about my T3 they don’t seem to think it’s important.

lkirnbauer | @lkirnbauer | May 14 10:20am

In reply to @alexandriagarcia0611 "@lkirnbauer Thank you, I appreciate your quick response, I am a female but yes, that's just..." + (show)

@alexandriagarcia0611 I see your AB is 600 and thyroglobulin is 4.000, you have Hashimoto’s. It’s all about your diet. Has your doctor mentioned foods to avoid? I would start by avoiding gluten, dairy, soy and seed oils. They are inflammatory foods and cause body inflammation. Hashimoto’s will also slow your healing process. Don’t wait too long to get this under control. Wishing you all the best!

Cheryl, Volunteer Mentor | @cehunt57 | May 25 6:06pm

@alexandriagarcia0611 Welcome to Mayo Clinic Connect. The symptoms you describe sound like both hyper and hypothyroidism! Curious! I was diagnosed with hyperthyroidism / Graves Disease about 25 years ago by an endocrinologist. She treated me with a medication. She also told me it was not uncommon for the condition to flip to hypothyroidism over time. Your story reminded me of that. I took the medication for a while and my thyroid levels became normal. I’m no longer on the medication and my condition hasn’t “flipped” but my endocrinologist continues to monitor me. It is good that you have an appointment coming up with endocrinology. That is the best specialty to sort this out and develop a treatment that works for you. Perhaps you can share this discussion with your provider at your appointment. Make sure the Dr. sees the list of symptoms that you’ve been dealing with.

lkirnbauer | @lkirnbauer | May 26 8:18am

By the numbers on your lab work, it looks like you have Hashimoto’s. This is an autoimmune disease and there is not a medication to control it. You control Hashimoto’s with diet, which is what I have done. I have eliminated eating gluten, dairy, soy and seed oils. They are inflammatory foods and cause body inflammation. You may also need medication to treat either Hypothyroidism or Hyperthyroidism as you seem to fluctuate. Doing the food elimination should help you. It doesn’t cost anything either. Give it a try, what have you got to loose? Good luck!

Lex | @alexandriagarcia0611 | Jun 1 10:22am

In reply to @cehunt57 "@alexandriagarcia0611 Welcome to Mayo Clinic Connect. The symptoms you describe sound like both hyper and hypothyroidism!..." + (show)

@cehunt57 thank you! I do experience symptoms of both hyper and hypo and its horrible. I had a week ago my most recent appointment and they are having me take another set of labs, they said this will be my confirmation. Both my TSH and T4 levels are still elevated. They still don't know what the issue is. I didn't know you could have hypo and hyper either, thank you for sharing.

gymnast1 | @gymnast1 | Jun 16 10:42am

In reply to @intheorchard "@alexandriagarcia0611 When I was first diagnosed, my TSH was high and T4 was, I believe, low..." + (show)

@intheorchard I was first diagnosed with Hypothyroid at 50 years old but when asked how I got it no answers. I finally decided to go to an Endocrinologist who told me I how the antibodies of Hashimoto. Also found out that it is in one side of my biological family. I had symptoms for years had a throat doctor notice enlarge thyroid but never referred me to a specialist. i know when I got the diagnosis I had no idea what that meant for my body in general. I was shocked at the ramifications. I did in my 40's experience an asthma like effect. It would last a day and go away. Take 0.100 of Synthyroid and doing well.

luppychic | @luppychic | Jun 16 5:36pm

I can understand your frustration with how long it took for the doctors to figure it out. I’ve always been a very sickly person, but no one was ever able to tell my parents why. As I grew older, it just got worse. When I became pregnant with my first child I was constantly sick. After giving birth my energy level, and being sick got much worse, then I started gaining a lot of weight for no reason. I went to a different doctor and he was finally able to figure it all out. He started doing every test and scan possible. I was diagnosed with systemic lupus which had killed my thyroid. I have to take levothyroid daily. Due to the lupus and several other problems, I’m on a total of 11 different medications. It’s my life and I’ve placed it all in God’s hands. God bless you.