Medical Questions > Conditions and Diseases > Gland Disorders Forum

Does a low T4 Free mean I'm hypothyroid now?

I was diagnosed with hyperthyroidism in February. My blood work showed the following at the end of February:
TSH was <0.015 L normal range - 0.465 - 4.680 uIU/mL
T4, Free was 3.22 H normal range - 0.79 - 2.35 ng/dL
T3, Total was 2.72 H normal range was 0.97 - 1.69 ng/mL

I was put on 10 mg Methimazole 2 times a day.

I had a follow up in March, where it was lowered to just once a day with the following blood work results:

TSH was <0.015 L normal range was 0.465 - 4.680 uIU/mL
T4, Free was 1.43 normal range - 0.79 - 2.35 ng/dL
T3, Total was 1.27 normal range was 0.97 - 1.69 ng/mL

My April appointment was cancelled by the office because the doctor wasn't in the office. I just got the blood work results for my May appointment which show the following:

TSH was 3.539 normal range was 0.465 - 4.680 uIU/mL
T4, Free was 0.69 L normal range - 0.79 - 2.35 ng/dL
T3, Total was 1.16 normal range was 0.97 - 1.69 ng/mL

Does that mean I'm hypothyroid now for sure because my T4,Free is low?

I was scared this would happen since my numbers fluctuated for so long and it took about six months to even be diagnosed, but last month the nurse from my endocrinologist's office assured me that the cancelled appointment wouldn't make a difference and that I didn't need to be squeezed in earlier.

My CBC also showed a slightly low WBC 3.8 when the normal range is 4.0-11.0 10^3/cumm and ABS Neutrophils 1.80 L when the normal was 2.00-7.50 10^3/cumm. I'm not sick, so what would account for that?
Did you find this post helpful?

User Profile
replied May 25th, 2012
Extremely eHealthy
It's really the TSH that is the most important number. The T3 and T4 tests aren't always accurate and don't always indicate a problem unless they are really out of range and the TSH is normal or something like that. But that's not really the case here. Your T4 isn't that far off and your TSH is high of normal. Your doctor may adjust your meds down a little, but he may not.

Some of that may depend on how you are feeling, as well. If you aren't feeling well, make sure to say so.
Did you find this post helpful?

User Profile
replied June 9th, 2019
Thank you for asking at Ehealth forum!

I read your question and I understand your concern.
You are not hypothyroid but thyroxine dose should be adjusted. Thyroid hormone and TSH should at lower end of reference range.
Methimazole affects bone marrow. But any viral illness can cause this. Its better to discuss your results with your endocrinologist.
I hope it helps. Stay in touch with your healthcare provider for further guidance as our answers are just for education and counselling purposes and cannot be an alternative to actual visit to a doctor.
Take care
Did you find this post helpful?
Quick Reply
Must Read
What does it mean to have low levels of thyroid hormone in the body? We outline how doctors define hypothyroidism here....
What medical conditions cause hypothyroidism? And what puts you at risk of developing these conditions? More hypothyroid basics here....
When are symptoms of hypothyroidism serious? When should you seek medical help. Click here to learn when doctors recommend you come in for a visit....
DISCLAIMER: "Ask a Doctor" questions are answered by certified physicians and other medical professionals. For more information about experts participating in the "Ask a Doctor" Network, please visit our medical experts page. You may also visit our Gland Disorders , for moderated patient to patient support and information.

The information provided on eHealth Forum is designed to improve, not replace, the relationship between a patient and his/her own physician. Personal consultation(s) with a qualified medical professional is the proper means for diagnosing any medical condition.