Here is My Question:
I have RRMS and am taking Ocrevus. When seeing my PCP for unrelated issues, she tested my TSH and after T4. My TSH has always been normal but now my free T4 is low. I'm in the medical field and I’m familiar with the thyroid function and pituitary involvement etc. My question is, is this something I should have investigated with thyroid antibody testing etc. or check more info pituitary involvement? If I have some corpus collosum atrophy (according to my MS specialist) would this possibly cause this issue and is there any way to really know the cause? Would levothyroxine be effective if it is caused by a pituitary problem? Can Ocrevus cause this type of issue? Just want to know what to look for when I follow up with my PCP.
Most patients with low free T4 and normal TSH levels actually have normal thyroid function. The low free T4 is simply caused by altered Thyroid hormone binding proteins, which does not effect thyroid function. An endocrinologist can figure this out for you, if necessary.
Two other things to remember about thyroid function tests
Revere (Rip) Kinkel MD
Professor of Clinical Neurosciences
Director of the Multiple Sclerosis Program
Clinical Neurosciences Director
University of California San Diego
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