Does decreased TSH and normal T3 and T4 indicate subclinical hyperthyroidism?

Question

Hi doctor,

I am a female, who weighs 156.5 lbs and I am 6.3 feet tall. My TSH was 0.35, and six months later it is 0.73. T3 is 4.9 and T4 is 14.4, which is steady and normal. As I understand it, with low TSH and normal T3 and T4, I am subclinical hyperthyroid, right? My symptoms are anxiety, sweating, weight loss, recurring infections, forgetfulness, really dark and red circles under my eyes. My mother and a great aunt had Graves' disease, I also have a family history of hyperparathyroidism. Any advice is most welcome.

Answer 1

Hello,

Welcome to icliniq.com.

Yes, you are right about that, you have subclinical hyperthyroidism.

Your symptoms of anxiety, weight loss, and sweating are because of it. You have not mentioned whether you have any thyroid gland swelling. If so, then it is important to have an ultrasound of the thyroid gland. These symptoms are not warranting any treatment as of now. You must keep repeating the thyroid function test every three months. The recurring infections, dark circles, and red circles appear unrelated to the thyroid gland dysfunction and look more likely because of a chronic allergic reaction, cold or upper respiratory tract infection. Since you have a strong family history of hyperthyroidism and hyperparathyroidism, I just want to advise that you must screen yourself regularly every six months for these conditions. Try doing some yoga or meditation for your anxiety. For your weight loss, if it is very significant, only then you might need treatment for hyperthyroidism or better still try to increase your calorie intake for this by adding 500 kcal more to your regular daily diet.

Hope you find my advice of some benefit. Good luck.