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HIGH TSH AND HIGH T4
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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@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.
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!
@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.