# Lab Results - Questions about possible diagnosis



## j2887 (Jun 5, 2015)

Hello. I posted here some time ago but I hadn't seen any other doctors and was looking for some information.

I just saw another doctor and my lab results were as follows:

*TSH:* 2.44

*T4*: 7.0 (4.5-12.5)

*T-Uptake*: 30.7 (22.5-37.0)

*Anti-TB AB* 41 (0-35)

*Anti-TPO AB* 167 (0-35)

*T3 Total:* 1.85 (0.62-1.70)

This doctor told me based on my symptoms he prescribed Synthroid 88mcg. I suggested that I honestly felt the 88 was too high to start out with (I have never taken any medication before) and the nurse told me he recommended THIS dosage, even though I wasn't significantly hypothyroid.

I was happy to find a doctor to actually consider prescribing me Synthroid based on my symptoms. However, with this blood work I was confused. My TPO hasn't gone higher than it had 3 months ago. I've been being really good about eating healthy, often gluten free but not 100%. I had my first child 9 months ago and I did have a rough delivery and became very anemic so I feel a lot of it had to do with that.

However, my throat is extremely swollen now. I have one nodule that's bigger than 3cm but I didn't use to even feel it much, but now my lymph nodes feel very swollen.

So I am concerned about starting this higher dosage of Synthroid because I see my *T3 total* is high? Is that normal? Should I just avoid the medication altogether or wait and see what else my thyroid is doing? Should I get tested for anything else?

Thanks for reading and any advice appreciated.


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## Octavia (Aug 1, 2011)

I think you are correct to be concerned about starting the medication. I sure wish that was a Free T3 test, not total T3.

Have you had that 3cm nodule biopsied? That size is very concerning. I had a nodule of similar size, and two ENTs suggested I have it (along with the thyroid lobe) surgically removed, regardless of my biopsy results (which weren't in yet). I'm so glad I did...it was causing some discomfort, not to mention the fact that it was quite visible on the outside.


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## joplin1975 (Jul 21, 2011)

Yup, I agree with everything Octavia said. What kind of doctor are you seeing?


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## j2887 (Jun 5, 2015)

This s is an endocrinologist. I have gone to two so far and the first did a biopsy.

The nodule came back benign. That doctor however was not communicative. They did not respond to me about the biopsy. I had to keep calling them, and then she did not want to see me again, even though I showed tpo of 150 then as well (this was 3 months ago) she didn't really give me any input/advice on what I should do at all, and said I was "normal" so I didn't like the fact that to her that tpo and tsh above 2 was normal, she also didn't listen to my symptoms.

This doctor I was referred to by a family member with thyroid issues as well. He seemed to be very generous in wanting to help me but I also think maybe both endo's don't really know what is going on, because I feel hypo ALOT and have this TPO but I also have other symptoms that might be hyper sometimes? I don't really know.

I am very thin and often feel good, energetic. Sometimes I would say the only hyper actions would be if maybe I get anxiety a lot and sometimes I wake up very hot/sweaty at night and have trouble sleeping. I have mild depression, but this also seems to come and go. I hate the fatigue, it's very intense at times. One time I thought I was going to have a stroke because half of my body felt numb/tingling and I had a terrible migraine, extremely fatigued.

I have been keeping up with eating very well, almost gluten free, and also exercising, avoiding coffee and alcohol as much as possible. That helped me in feeling better a lot.

Any recommendations on anything else I should get checked out? Is another biopsy necessary? I really can't afford the high cost of the biopsy to be honest with you I am more looking towards just figuring out how to help my symptoms/the annoying swelling at this point.


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## Andros (Aug 26, 2009)

TBII
http://www.ncbi.nlm.nih.gov/pubmed/9364248
http://en.wikipedia.org/wiki/Anti-thyroid_autoantibodies
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Blocking TRAbs (also known as Thyrotropin Binding Inhibitory Immunoglobulins (TBII)) competitively block the activity of TSH on the receptor. This can cause hypothyroidism by reducing the thyrotropic effects of TSH. They are found in Hashimoto's thyroiditis and Graves' disease and may be cause of fluctuation of thyroid function in the latter. During treatment of Graves' disease they may also become the predominant antibody, which can cause hypothyroidism.

TSI
Normally, there is no TSI in the blood. If TSI is found in the blood, this indicates that the thyroid stimulating immunoglobulin is the cause of the of a person's hyperthyroidism.
http://labtestsonline.org/understanding/analytes/thyroid-antibodies/tab/test
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Understanding the Thyroid: Why You Should Check Your Free T3
http://breakingmuscle.com/
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Dr. Mercola (FREES)
http://www.mercola.com/article/hypothyroid/diagnosis_comp.htm

Free T3 and Free T4 are the only accurate measurement of the actual active thyroid hormone levels in the body. This is the hormone that is actually free and exerting effect on the cells. These are the thyroid hormones that count.
TPO and thyroglobulin
http://onlinelibrary.wiley.com/doi/10.1111/j.1699-0463.1994.tb04888.x/abstract
http://www.wikigenes.org/e/gene/e/7173.html
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Understanding Thyroglobulin Ab.
http://www.labtestsonline.org/understanding/analytes/thyroglobulin/test.html
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Thyroglobulin Ab and cancer
http://qjmed.oxfordjournals.org/content/59/2/429.full.pdf
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Really you should have an ultra-sound because of those high antibodies.

Also, you could very well be hyperthyroid instead of hypo.

Posting info for you; do read it.

You also need the FREES, not the Totals re 3 & 4

Let us know what develops.........................


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## j2887 (Jun 5, 2015)

Thank you for all the replies.

I think I'm mostly worried about the swelling. Today for example it felt swollen all day long and it's on the right side of my thyroid (the larger 3cm nodule) and I sometimes feel numbness/tingling on the right side of my body/lymph nodes especially.

Should I just wait it out longer and let whatever's happening take it's course, even though I don't feel that great now :/?

//Edit: I did have an ultrasound done and showed up large nodule and indicative of hashimoto's.


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## joplin1975 (Jul 21, 2011)

I think you should get a surgical consult. It's not likely to get better and if you are having symptoms that are impacting your life, then it's time to get it out.


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