Advice required on lab results

[Guest guest]

My Wife has just received her latest lab results from Genova.

Total T4 77.5 nmol/L ref range 58-154 nmol/L

TSH 0.731 mIU/L 0.4-4.0

Free T4 13.6 pmol/L 10-22

Free T3 3.78 pmol/L 2.8-6.5

FT4/FT3 Ratio 3.6 2-2.5

Reverse T3 0.32 pmol/ml 0.14-0.54

TgAb 20 IU/ml 0-40

TPO Ab 15.5 IU/ml 0-35

The commentary says Secondary or Tertiary Hypothyroidism is possible due to

anterior pituitary or Hypothalamic Hypofunction. Is this due to the low TSH

which we know is due to taking T3 and T4?

My Wife is taking 75mcg Levothyroxine and 12.5mcg of Cynomel daily and these

were not taken for 24hrs before test. She is also on 30mg Hydrocortisone Roussel

per day.

Any attempt to increase the dose of Cynomel causes tachycardia but we don't know

why.

Any advice would be appreciated

Many thanks.

Ian