What is a TSH with reflex T4 test mean?

Question

Why would my Dr. want to test me?

Answer 1

Your doc wants to test your thyroid gland (which is in your neck and helps to control your metabolism). It can be underactive or overactive, though the vast majority of thyroid tests come back normal. There are loads of reasons why your doc might want to test it, such as tiredness, losing weight, gaining weight, thin hair, eye problems, high cholesterol, etc etc. It's an extremely common thing to test.

TSH and T4 are two hormones that can tell you about how the thyroid is working. The lab is going to measure your TSH, then if the TSH is abnormal they will also measure T4 to give some more information. If you only measure something when there is an abnormal result for something else, it's called reflex testing.  

Answer 2

TSH stands for Thyroid Stimulating Hormone

the T4 is the test done to check for hyper/hypo thyroidism.

If you are hyper is overworking and hypo the thyroid is under working.

It gets very complicated after this explaination.  The thyroid gland is enlarged in goiter.