Thyroid Tests Explained: TSH, Free T4 & Antibodies
8/17/2025
The pituitary releases TSH which drives thyroid hormones T4/T3. Read tests together and use your lab's reference intervals.
Common patterns
- Primary hypothyroid: high TSH + low free T4.
- Subclinical hypothyroid: high TSH + normal free T4 (repeat and check antibodies/symptoms).
- Primary hyperthyroid: low TSH + high free T4/T3.
- Central: low/normal TSH + low free T4 — clinician review.
- Sick-euthyroid: illness/meds may distort tests — avoid over-interpretation.
Educational next steps
- Borderline results: repeat in 6–8 weeks.
- Antibodies: TPO/Tg (autoimmune); TRAb/TSI (Graves pattern).
- Medication education (not a prescription): levothyroxine is standard; typical adult starting ~1.6 mcg/kg/day but individualized by a clinician; separate from iron/calcium.
Disclaimer: Educational information only — not a diagnosis, treatment, or prescription.
Educational information only — not a diagnosis, treatment, or prescription.