Intermittent or non-compliance with levothyroxine (L-T4) replacement therapy will result in discordant serum TSH and FT4 values (high TSH/high FT4) because of a persistently unstable thyroid state ...
When TSH is unexpectedly high, ask the laboratory to re-measure the specimen diluted, preferably in thyrotoxic serum, to check for parallelism. Request that the laboratory analyze the specimen by ...