High levels of free thyroid hormones in combination with low levels of TSH indicates hyperthyroidism due to autonomous activity of the thyroid.
A high TSH excludes hyperthyroidism except in the very rare situations of:
Low serum TSH concentrations may be seen in some patients with non-thyroidal illnesses and in those prescribed certain drugs e.g. dopamine, glucocorticoids (1).
Ref: Prescribers' Journal (1999), 39 (1), 1-8.
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