# 2nd labs



## mememe

labs drawn on 3/8/10:
TSH= 1.730 (0.450-4.500)
*Thyroxine (T4)= 14.4 (4.5-12.0)*
*T3 Uptake= 23 (24-39)*
Free thyroxine index= 3.3 (1.2-4.9)
*Thyroid Antibodies Thyroid Peroxidase (TPO) Ab= 304 (0-34)*
Antithyroglobulin Ab= 28 (0-40)

labs drawn on 4/13/10:
TSH= 1.090 (0.450-4.500)
*Thyroxine (T4)= 14.1 (4.5-12.0)*
*T3 uptake= 22 (24-39)* 
Free thyroxine index= 3.1 (1.2-4.9)
T4, Free (Direct)= 1.38 (0.82-1.77)
*Thyroid Peroxidase (TPO)Ab= 374 (0-34)*

I am still waiting on the TSI, for some reason it is taking longer to process. Based on what I was told on my other thread, and also according to my doc., the throxine is most likely a false reading due to oral contraceptive, since my freeT4 is in normal range. My T3 uptake is down, and my antibodies have increased! What does this say?What could it mean? Hopefully my doctor will see that those antibodies are up to _something_!


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## mememe

is there any significance to a low T3 uptake? I've read online that it is basically an obsolete test.

So based on this (if it's true) and the whole Thyroxine/FT4 thing, the only abnormal part about my labs are the TPOAb. (TSI still pending)

Would you agree? And what could normal labs w/TPOAb indicate? Hashimoto's or some other autoimmune disorder?


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## Andros

mememe said:


> labs drawn on 3/8/10:
> TSH= 1.730 (0.450-4.500)
> *Thyroxine (T4)= 14.4 (4.5-12.0)*
> *T3 Uptake= 23 (24-39)*
> Free thyroxine index= 3.3 (1.2-4.9)
> *Thyroid Antibodies Thyroid Peroxidase (TPO) Ab= 304 (0-34)*
> Antithyroglobulin Ab= 28 (0-40)
> 
> labs drawn on 4/13/10:
> TSH= 1.090 (0.450-4.500)
> *Thyroxine (T4)= 14.1 (4.5-12.0)*
> *T3 uptake= 22 (24-39)*
> Free thyroxine index= 3.1 (1.2-4.9)
> T4, Free (Direct)= 1.38 (0.82-1.77)
> *Thyroid Peroxidase (TPO)Ab= 374 (0-34)*
> 
> I am still waiting on the TSI, for some reason it is taking longer to process. Based on what I was told on my other thread, and also according to my doc., the throxine is most likely a false reading due to oral contraceptive, since my freeT4 is in normal range. My T3 uptake is down, and my antibodies have increased! What does this say?What could it mean? Hopefully my doctor will see that those antibodies are up to _something_!


Right you are about the T3 uptake

T3 Resin Uptake or Thyroid Uptake. (T3RU) This is a test that confuses doctors, nurses, and patients. First, this is not a thyroid test, but a test on the proteins that carry thyroid around in your blood stream. Not only that, a high test number may indicate a low level of the protein! The method of reporting varies from lab to lab. The proper use of the test is to compute the free thyroxine index

http://www.amarillomed.com/howto

I'll tell you; I believe the antibodies are wreaking havoc w/your lab results here.

Okay; we see that the uptake is low which means the protein is high. If the uptake is high, it means the protein count is low. So, you have a high protein count which is why your T4 is high.

It is a useful test but can be affected by the amount of protein available in the blood to bind to the hormone....as per....
http://www.labtestsonline.org/understanding/analytes/t4/test.html

And right about this also.......

Many medications-including estrogen, certain types of birth control pills, and large doses of aspirin-can affect total T4 test results, so tell your doctor about any drugs you are taking. In general, free T4 levels are not affected by these medications ......as per the same link above.

And your doc did run the FT4 which clarifies.

TSI "will" be interesting. You should not have one iota of TSI (thyroid stimulating immunoglobulin.)

Too bad your doc did not do a Free T3; it would have made things a lot clearer.

How are you feeling? Those antibodies are high!


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## mememe

Thanks for all the info, I will check out those links after this post. My doc. *may* have wanted a Free T3, but all it said on my script was thyroid panel, and when I went to get it done, There wasn't a "thyroid panel" in the book of lab tests, just "thyroid profile" which didn't include Free T4 OR Free T3, so I added the FreeT4 because I specifically remember he asked for that one, and _*I*_ was the one to order my antibodies as well, since he didn't seem too concerned.

Usually, I feel pretty good when I wake up for about 1-3 hours, then usually the rest of the day I am tired. This is most days. Some days I get a burst of hyperactivity that is short lived, but I'm always happy when that happens because then I can go with it and get some things done around the house or accomplish something that needs to be done without it feeling like pure and complete torture!

p.s. does anyone know if it is normal for a TSI test to take days to complete?


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## Andros

mememe said:


> Thanks for all the info, I will check out those links after this post. My doc. *may* have wanted a Free T3, but all it said on my script was thyroid panel, and when I went to get it done, There wasn't a "thyroid panel" in the book of lab tests, just "thyroid profile" which didn't include Free T4 OR Free T3, so I added the FreeT4 because I specifically remember he asked for that one, and _*I*_ was the one to order my antibodies as well, since he didn't seem too concerned.
> 
> Usually, I feel pretty good when I wake up for about 1-3 hours, then usually the rest of the day I am tired. This is most days. Some days I get a burst of hyperactivity that is short lived, but I'm always happy when that happens because then I can go with it and get some things done around the house or accomplish something that needs to be done without it feeling like pure and complete torture!
> 
> p.s. does anyone know if it is normal for a TSI test to take days to complete?


I am not sure about how long TSI should take but I wonder if you should call the lab and make sure they "are" running it? Tch!! It's a shame but we can take nothing for granted.


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## mememe

On my lab paper, it shoes it on there, saying "specimen has been received and testing has been initiated", I know I thought the same thing at first before I saw that. Well, hopefully monday I will know!lol


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## Andros

mememe said:


> On my lab paper, it shoes it on there, saying "specimen has been received and testing has been initiated", I know I thought the same thing at first before I saw that. Well, hopefully monday I will know!lol


I hope so too because no one wants to know more than I do;except for you, of course. LOL~~


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## mememe

Thyroid Stim Immunoglobulin= 92 (0-139)


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## Andros

mememe said:


> is there any significance to a low T3 uptake? I've read online that it is basically an obsolete test.
> 
> So based on this (if it's true) and the whole Thyroxine/FT4 thing, the only abnormal part about my labs are the TPOAb. (TSI still pending)
> 
> Would you agree? And what could normal labs w/TPOAb indicate? Hashimoto's or some other autoimmune disorder?


This is a protein that transports thyroid hormone around in your blood stream. If high, that could mean a low level of protein. In my mind, that would warrant further testing because like the ferritin (protein that store iron for cellular uptake), the protein stores what you need making it available for cellular uptake.


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## mememe

Thyroid Stim Immunoglobulin= 92 (0-139)


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## Andros

mememe said:


> Thyroid Stim Immunoglobulin= 92 (0-139)


Aha, aha!!! There you go!! Remember, you should have none; 0, zilch, nadda!!!

TSI is only present in hyperthyroid.

Has your doctor commented?

You are going to become informed about TSI so I will provide some "stuff!"

http://www.hopkinsmedicine.org/endocrine/graves/Answer.asp?QuestionID=22

individuals who are normal do not produce TSI and have levels 
http://graves.medshelf.org/Lab_Tests

Results and Values
What do the test results mean?
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://www.medicineonline.com/topics/t/2/Thyroid-Stimulating-Immunoglobulin/TSI.html


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## mememe

doctor has no yet commented. He probably hasn't even seen the labs yet. They just got faxed over there about an hour ago, I'd say.

Why does the range allow up to 139, if TSI shouldn't even be there?

I'll bet my doc. will see that it's "in range" and not do anything about it. I received a letter in the mail stating my appointment for next week has been moved to the 4th. I'm going, but this may be the last appointment I have with HIM, depending on how it goes.

ps, is feeling exhausted/fatigued all the time a symptom of hyperthyroid? I am always feeling tired, and I have a hard time losing weight, that's why I would always assume that if something were wrong with me in the thyroid, it would be hypo.


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## mememe

one test that I haven't had done yet is the Free T3-I thought it would be included in that last test I had but it wasn't. Next time, if it is not ordered, I will add it on :winking0001:


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## Andros

mememe said:


> doctor has no yet commented. He probably hasn't even seen the labs yet. They just got faxed over there about an hour ago, I'd say.
> 
> Why does the range allow up to 139, if TSI shouldn't even be there?
> 
> I'll bet my doc. will see that it's "in range" and not do anything about it. I received a letter in the mail stating my appointment for next week has been moved to the 4th. I'm going, but this may be the last appointment I have with HIM, depending on how it goes.
> 
> ps, is feeling exhausted/fatigued all the time a symptom of hyperthyroid? I am always feeling tired, and I have a hard time losing weight, that's why I would always assume that if something were wrong with me in the thyroid, it would be hypo.


And you are going to have to "explain" to your doc. All labs have to have a range. This is how they gauge an improvement or not. Even if there should be none, one needs a range to detect movement either up or down and a doctor that does not know this is well.............................(I don't want to say.)

What you have had done is what now should be referred to as a "baseline" TSI so we can see if medication will bring about a decrease which is the goal.

Ranges are mean averages derived from cohorts done w/ a certain segment of population (say 100 people) with no regard to age,ethnicity,gender and so on. (" most usually") Don't get me started on that one. There are some good cohorts being done but few and far between.

No, you can gain weight w/hyper. I have and so have many others. The metabolism is skewed big time. Symptoms do cross over. I have seen many hypos as skinny as a bean pole, I kid you not.

Also,even at rest, your metabolism is in high high gear. This is exhausting. The patient usually crashes and burns just trying to through the day. It is "very" insidious.


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## mememe

Andros said:


> Also,even at rest, your metabolism is in high high gear. This is exhausting. The patient usually crashes and burns just trying to through the day. It is "very" insidious.


that makes sense. Thanks for the links, I've scanned over them, but will spend more time on them later when I get more time!

BTW, I still haven't heard from my doc. about my ultrasound, so I may call later today and ask if he's reviewed the labs and ultrasound just to keep him on his toes lol


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## Andros

mememe said:


> one test that I haven't had done yet is the Free T3-I thought it would be included in that last test I had but it wasn't. Next time, if it is not ordered, I will add it on :winking0001:


You do need the FREE T3; if for no other reason than to use as a "baseline" also. Dang!! I knew it was to good to be true. They say, "yeah, yeah, yeah!" and then don't do it.


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## Andros

mememe said:


> that makes sense. Thanks for the links, I've scanned over them, but will spend more time on them later when I get more time!
> 
> BTW, I still haven't heard from my doc. about my ultrasound, so I may call later today and ask if he's reviewed the labs and ultrasound just to keep him on his toes lol


You are welcome; very! We need to get you well. Whatever it takes!explode


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## mememe

Good thing I called the other day to see if my doc. had reviewed my labs and ultrasound report, because according to the secretary, they hadn't even received them! By the end of the day I checked back and they had them.

I am going to get more labs drawn, without an order, so I will have them prior to my doctor's appointment. I am going to get my FREET3 tested, and perhaps a couple others, depending on if anyone can suggest any good ones for me to get. I'd rather get as many done in one sitting, (and one STICK lol) than to keep going back all the time.

Any suggestions are welcome. I will get this done no later than Tuesday, and if at all possible, I will try to do it tomorrow.


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## GD Women

The TSH, FT-4 and FT-3 (frees) need to be drawn same time, same test. Antibodies if drawn will probably be tested at a different Lab and take longer for results and are more expensive. Some thyroid test are sent to Calif., San Diego if I remember correctly. If you haven't had in at least a year, I'd suggest a full blood panel drawn. Some issues relate to thyroid or visa versa.

Good Luck.


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## mememe

I usually get my test results back the next day, if they were picked up by a lab person the same day they were drawn. The only one so far I had to wait longer on was the TSI. LabCorp is the one that tests them, but I have no clue how far they actually have to go.

Thanks for the info about getting the TSH, FT3, FT4 done at the same time. I've made a note of that.

Ps. Not sure what a full panel is, but I did get a comprehensive metabolic panel done on that first lab draw in March and everything came out ok.


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## GD Women

LabCorp is here in Calif., San Diego. But they can always fax Doc office the results. Probably getting the blood there takes the longest.


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## mememe

hmmm...I'm nowhere near california-there must be somewhere closer that processes my labs.

Okay, so my list right now is TSH, FT4, FT3....is there any other kind of antibody test I should get?


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## Andros

mememe said:


> hmmm...I'm nowhere near california-there must be somewhere closer that processes my labs.
> 
> Okay, so my list right now is TSH, FT4, FT3....is there any other kind of antibody test I should get?


See if you have this in your area; just put it in your search engine.

HealthCheckUSA


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## mememe

yep, there's a LabCorp, probably about 20 minutes away from where I live. Actually, I think that is where I got a drug test for a job before!lol


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## mememe

should I get tested for TrAb or TgAb? Or should I get my TPOs and/or TSIs tested again?


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## Andros

mememe said:


> should I get tested for TrAb or TgAb? Or should I get my TPOs and/or TSIs tested again?


No need to waste your money on more antibodies tests at this time. We know you have them and that gives us a "baseline."

I just think it would be good to have that TSH, FREE T3 and FREE T4 all in a row taken at the same time. It would be very very revealing.

Do you agree or disagree?


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## mememe

insurance will pay-I'm getting them drawn at a participating physician's office who's in network, so I shouldn't have to pay anything :evilgrin0036: but just in case something happens, I will be prepared to pay.

I am getting the TSH, FT4, FT3 for sure. I made arrangements to get this done on Tuesday. I just want to be ready for my next appointment. I'd hate to get there and then he order me more lab work before I even know anything else. On the FT3, I believe he wanted that done anyway, it just got lost in translation somewhere while filling out the lab work form.


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## GD Women

The TSH and both FTs on how they relate to each other will tell if you are Hashi or Graves'. If you are either one then yes you will have the corresponding antibody. That is why all three levels need to drawn and tested at the same time. Saves a lot of time and money. If TSH and FT results deem necessary, doctor will request antibody test.
There is no treatment nor cure for antibodies. For some unknown reason to scientist, antibodies come and go, wax and wane, go into hiding to reappear weeks, months or years later.

Get a hard copy of your Lab results with Labs ranges. Post them here and someone can interrupt them.

I am assuming you are not on meds. yet. Level relationship to each other differ in ATDs, and Armour/T-3 and synthetic T-4.

Good Luck with the test.


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## mememe

GD Women said:


> The TSH and both FTs on how they relate to each other will tell if you are Hashi or Graves'. If you are either one then yes you will have the corresponding antibody. That is why all three levels need to drawn and tested at the same time. Saves a lot of time and money.
> 
> Good Luck with the test.


That makes sense. No, not on any thyroid related meds. Yes, I will post my labs when I get them back. Should be Wed or Thurs next week if I go in Tuesday to get the blood drawn.


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## Andros

mememe said:


> That makes sense. No, not on any thyroid related meds. Yes, I will post my labs when I get them back. Should be Wed or Thurs next week if I go in Tuesday to get the blood drawn.


Good! We will be waiting w/ bated breath!! Ha, ha!!


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## mememe

TSH *1.76* (0.450-4.500)
Free T4, direct *1.26 *(0.82-1.77)
Triiodothyronine, free *2.8* (2.0-4.4)

everything is "in range"....what can it mean when everything is in range, but there are those TPO Ab and TSIs? oh, and "multinodular goiter"?


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## Andros

mememe said:


> TSH *1.76* (0.450-4.500)
> Free T4, direct *1.26 *(0.82-1.77)
> Triiodothyronine, free *2.8* (2.0-4.4)
> 
> everything is "in range"....what can it mean when everything is in range, but there are those TPO Ab and TSIs? oh, and "multinodular goiter"?


True..........these are in range but the FT4 and the FT3 are below mid-range. Something is afoot and I am sure the antibodies are sending mixed signals.

There are stimulating, binding and blocking antibodies and when all these forces are in action, the above labs often do come in in range>

Does that make sense to you?


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## mememe

yes, but what can I expect a good endo. to tell me about it? I go Tuesday, and I fear he will just be like "well there's nothing to worry about" and send me on my way-without any explanations or possible scenarios. I just get that feeling from him. This is going to be one interesting appointment, now that he has all of my labs and ultrasound.


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## Andros

mememe said:


> yes, but what can I expect a good endo. to tell me about it? I go Tuesday, and I fear he will just be like "well there's nothing to worry about" and send me on my way-without any explanations or possible scenarios. I just get that feeling from him. This is going to be one interesting appointment, now that he has all of my labs and ultrasound.


It is going to be very interesting because you are now armed with knowledge! It won't take but a few minutes for you to know if this endo knows what he/she is talking about.

If he/she orders an uptake scan,I will be impressed. Otherwise, I will be disappointed. You have not had RAIU yet, have you?

Keeping my fingers crossed for you. I hate waiting but I will do it!! LOL!! Tues.it is then.


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## mememe

no, I have not yet had one. I'm gong to leave everything in his court. I'm not going to urge him to do anything...I don't feel like he's that kind of doc. Now, if I had a doc that seemed open to everything, someone who explained everything to me, etc, then I would. I'm just going to take this appointment and see how it plays out. This appointment will make or break any future appointments with him. I will report back tuesday!


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## Andros

mememe said:


> no, I have not yet had one. I'm gong to leave everything in his court. I'm not going to urge him to do anything...I don't feel like he's that kind of doc. Now, if I had a doc that seemed open to everything, someone who explained everything to me, etc, then I would. I'm just going to take this appointment and see how it plays out. This appointment will make or break any future appointments with him. I will report back tuesday!


I like your game plan. I also agree; if you have to force someone to do something; he or she does not have your best interest in mind.

I "hear" you!


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## mememe

Doc says I have Hashimoto's Thyroiditis. I'm not hypo or hyper (yet), and I go back in 6 mos., prior to my appointment I will have another ultrasound and more blood work. I am more satisfied with this appointment than the last.


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## Andros

mememe said:


> Doc says I have Hashimoto's Thyroiditis. I'm not hypo or hyper (yet), and I go back in 6 mos., prior to my appointment I will have another ultrasound and more blood work. I am more satisfied with this appointment than the last.


Doctor did not want to run any antibodies' tests? How did this one arrive at the conclusion that you have Hashimoto's?

How are you feeling; any better?


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## mememe

Well I'll be honest, he downplayed everything. When he was going over my labs, he was saying how everything was in range, except my antibodies. I asked "what does that mean?" He said it's kind of like living in a nice neighborhood, but having a group of bullies or something down the street. You have to keep your eye on them-they haven't done anything yet.

When it came to my ultrasound report, he said there was a contradiction on there-the part where it says likely a multinodular goiter with no dominant nodule. He believes that since it says no dominant nodule, then there are is no multinodular goiter. He says to have a goiter the lobes must measure like 10 cm!

Even though I was more satisfied tthis appointment than the last, I do think I will be searching for another doc. After I wrote my last post, I talked with family and I think that's what I'm going to do. I need to find not someone that is just an "endocrinologist", but someone who specializes in thyroids!


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## mememe

oh, and the only reason why he scheduled me back in 6 mos, along with another ultrasound and blood work was just to make me happy. He doesn't take thyroid issues very seriously..The first time I saw him he said something along the lines of: if heaven/hell sent you a list of diseases that you had to choose one to have , you'd want to check thyroid. Noone dies from thyroid problems, etc, etc


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## Andros

mememe said:


> Well I'll be honest, he downplayed everything. When he was going over my labs, he was saying how everything was in range, except my antibodies. I asked "what does that mean?" He said it's kind of like living in a nice neighborhood, but having a group of bullies or something down the street. You have to keep your eye on them-they haven't done anything yet.
> 
> When it came to my ultrasound report, he said there was a contradiction on there-the part where it says likely a multinodular goiter with no dominant nodule. He believes that since it says no dominant nodule, then there are is no multinodular goiter. He says to have a goiter the lobes must measure like 10 cm!
> 
> Even though I was more satisfied tthis appointment than the last, I do think I will be searching for another doc. After I wrote my last post, I talked with family and I think that's what I'm going to do. I need to find not someone that is just an "endocrinologist", but someone who specializes in thyroids!


That is correct;you don't need an endo. You just need someone who is interested in getting you better, has a good handle on the thyroid and is willing to also learn more as the patient and the doctor work together.

My doc is a rheumatologist/immunologist. Others do exceedingly well with a DO, PCP, Internal etc.. Even a psychiatrist who is first graduated from med school before plunging into a degree for psychiatry.


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## mememe

I took my info. in to my family doctor place (it's a family care center, so there is more than one doc, etc) Well, the receptionist said I should make an appointment, and made me one for friday to go over my labs and ultrasound, etc. I just looked up this person she scheduled me with, and it is a Nurse practitioner. Do you think this will matter? If it were a nurse practitioner at a _thyroid_ place, I wouldn't mind. Should I just go and see what happens, or should I request someone else? What would you do? Have any of you seen a nurse practitioner about your thyroid, but at a family care practice?


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## Andros

mememe said:


> I took my info. in to my family doctor place (it's a family care center, so there is more than one doc, etc) Well, the receptionist said I should make an appointment, and made me one for friday to go over my labs and ultrasound, etc. I just looked up this person she scheduled me with, and it is a Nurse practitioner. Do you think this will matter? If it were a nurse practitioner at a _thyroid_ place, I wouldn't mind. Should I just go and see what happens, or should I request someone else? What would you do? Have any of you seen a nurse practitioner about your thyroid, but at a family care practice?


I would keep the appt. because you just never know. All it takes in one very interested and caring health care worker to get you set in the direction you need for diagnosis and medical intervention. Strange things happen in strange places.

I am hopeful for you!


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## mememe

Thanks Andros, I will be sure to write after hearing what she has to say


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## Andros

mememe said:


> Thanks Andros, I will be sure to write after hearing what she has to say


That will be nice and I sincerely hope that you and I both are in for a very very pleasant surprise.

:hugs:


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## mememe

I'm really happy that I went in for that appointment. She was wonderful! Very informative, caring, she told me everything she knew about all the docs in the area for thyroid stuff, and suggested one for me. She told me she will send my referral to whomever I decide to go to! Don't know when that will be, but rest assured, I will have a new thread up somewhere when it happens! arty0030:


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## stacy80

Glad your appointment went so well! It was a nurse practitioner at a local walk in clinic that was very concerned about the pain in my neck and large lump back in Feb that got my endo's office to get me in that day to been seen instead of them pushing me off for weeks like they originally did. Praying all goes well for you and that you find a wonderful doctor!


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## mememe

I have an appointment in August! I'm so super excited! I really really hope he is the one for me! I am SO SICK of feeling so tired over nothing! I have my good days here and there, and they are GREAT! I just wish they would last! This is going to be a very long wait, but I have to hope it will be worth it!


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