# Lab numbers



## Scooky (Sep 5, 2016)

I'm looking for others opinion on my lab results. I think I may have something going on with my thyroid and have been pushing my primary MD to run these tests. I am scheduled now to see an Endo, but that won't be until mid November. My primary kept telling me all my results were normal, until the antibody test came back, then he referred me to an Endo

First off, I was diagnosed with depression a few months ago and was started on anti-depressants, they have helped to a degree but I still feel fatigued all the time. I also have a hard time sleeping, my weight has been fluctuating up and down over the last few years, I still tend to get very irritable, and my cholesterol levels are slightly elevated. I have been finding it harder to tolerate extreme temperatures(hot and cold), and probably the most annoying of them all is the brain fog.

These are the results from the recent tests I had my PMD run:

TSH -

0.913 mcUnits/mL

0.350 - 5.000 mcUnits/mL

T4, FREE -

0.9 ng/dL

0.8 - 1.5 ng/dL

TRIIODOTHYRONINE, FREE -

3.1 pg/mL

2.2 - 4.0 pg/mL

Thyroglobulin Antibody -

58.0 IU/mL

0.0 - 4.0 IU/mL

T4, TOTAL -

6.9 mcg/dL

4.7 - 13.3 mcg/dL

CORTISOL,SALIVA -

4.2 NMOL/L

REFERENCE RANGE:
11:00 PM <0.3 - 4.3 nmol/L

CORTISOL,SALIVA -

9.5 NMOL/L

REFERENCE RANGE:
11:00 PM <0.3 - 4.3 nmol/L


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## joplin1975 (Jul 21, 2011)

Have you had a thyroid ultrasound? Did they run any other thyroid antibody tests?


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## Scooky (Sep 5, 2016)

THYROID PEROXIDASE AB value - <28 Units/mL range - <60 Units/mL

Sorry, I thought I put this one in there as well, must have missed it.

No ultrasound has been done, only blood work at this point


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## joplin1975 (Jul 21, 2011)

You are trending toward hypo, but that high thyroglobulin AB number jumps out at me. You TPO antibodies aren't crazy high. I think you'll want an ultrasound first to rule out thyroid cancer.


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## jenny v (May 6, 2012)

> CORTISOL,SALIVA - 4.2 NMOL/L
> 
> REFERENCE RANGE:
> 11:00 PM <0.3 - 4.3 nmol/L
> ...


Are these correct? You've got two different results for the exact same time period?


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## Scooky (Sep 5, 2016)

Could my AB levels indicate cancer? Ill see if my Primary would be willing to do one since I won't be able to see the endo until November.

Thanks for the replies!


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## Scooky (Sep 5, 2016)

jenny v said:


> Are these correct? You've got two different results for the exact same time period?


Yes those numbers are correct. They had me collect 2 samples. One the first night and then the next night at the same time


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## joplin1975 (Jul 21, 2011)

TgAB reacts to thyroglobulin. A normal thyroid produces some thyroglobulin, but a cancerous nodule produces fairly high levels of Tg.

A high TgAB results doesn't = thyroid cancer, but it's a red flag. You likely have higher than normal levels of Tg (because of the TgAB result) and I'd want an ultrasound just to make sure. If cancer in the mix, it can be harder to sort out meds etc.


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## Scooky (Sep 5, 2016)

joplin1975 said:


> TgAB reacts to thyroglobulin. A normal thyroid produces some thyroglobulin, but a cancerous nodule produces fairly high levels of Tg.
> A high TgAB results doesn't = thyroid cancer, but it's a red flag. You likely have higher than normal levels of Tg (because of the TgAB result) and I'd want an ultrasound just to make sure. If cancer in the mix, it can be harder to sort out meds etc.


Alright. Thank you for the information! I'll definitely see if I can get an ultrasound done, if my primary won't, then I'll probably have to wait until I get into the endocrinologist.


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## Scooky (Sep 5, 2016)

Could the TgAB results indicate hashimotos? Or would both antibodies be higher if it was hashi?


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## joplin1975 (Jul 21, 2011)

Yes, it can. It indicates something is up...an ultrasound is needed to help figure out what that something is.


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## Scooky (Sep 5, 2016)

Well I asked my primary if he'd do the ultrasound but he won't order any more tests until I have seen the endocrinologist, they wont even tell me what he makes of the results for the blood tests.. So looks like I'll be waiting until November to hopefully get some answers.

Thanks again for your responses!


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## Octavia (Aug 1, 2011)

Sounds to me as if your primary care provider is "in over his head" and isn't confident in his thyroid knowledge. Nonetheless, he SHOULD order that ultrasound. Sending me for an ultrasound was the first thing my primary did when my thyroid issues first became evident.


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## Scooky (Sep 5, 2016)

Octavia said:


> Sounds to me as if your primary care provider is "in over his head" and isn't confident in his thyroid knowledge. Nonetheless, he SHOULD order that ultrasound. Sending me for an ultrasound was the first thing my primary did when my thyroid issues first became evident.


Yea, that's the feeling I've gotten from him. It's just very frustrating. I have sent a message to the endocrinologist I'll be seeing in November to see if she'd be willing to order it since he wont. Waiting to hear back still.


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## jenny v (May 6, 2012)

I would also ask to be placed on the endo's cancellation list, in case you can get in earlier.


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## Scooky (Sep 5, 2016)

jenny v said:


> I would also ask to be placed on the endo's cancellation list, in case you can get in earlier.


When I made my appointment they did also place me on their cancellation list. The nice thing about this endo is their office is about 3 minutes from my house so it wouldn't be a problem if they called last minute even. Fingers crossed that it happens lol


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## Scooky (Sep 5, 2016)

TOTAL BILIRUBIN 1.1 mg/dL 0.2 - 1.0 mg/dL

AST/SGOT 53 Units/L <38 Units/L

ALT/SGPT 90 Units/L <79 Units/L

Any one know if my thyroid could also be causing these levels to be elevated or would they be unrelated? These were from 8/6/16


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## Lovlkn (Dec 20, 2009)

Scooky said:


> TOTAL BILIRUBIN 1.1 mg/dL 0.2 - 1.0 mg/dL
> 
> AST/SGOT 53 Units/L <38 Units/L
> 
> ...


Probably not the thyroid - what supplements or other medications are you taking? Do you consume alcohol? Eat a high fat diet?


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## joplin1975 (Jul 21, 2011)

Untreated Hashimoto's and Non-Alcoholic Fatty Liver disease is related. I had a fatty liver and high-ish liver enzymes before I had my thyroid removed. It's possible the two can be related: http://www.endocrineweb.com/professional/research-updates/thyroid-disorders/connection-between-hypothyroidism-non-alcoholic-fatt


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## Scooky (Sep 5, 2016)

I hardly ever drink, maybe once a year lol. I'm taking Zoloft, have been on it since May or June of this year and I don't eat a high fat diet.

These levels were normal in 12/2013, 6/2015 they were high and this year again they were elevated

The beginning of 2015 is when I started having the fatigue, so I was wondering if they could have been connected.

Thanks for the replies!


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## joplin1975 (Jul 21, 2011)

If you have elevated liver enzymes, you should think about possibly having an ultrasound of your liver done, just to be sure.


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## Scooky (Sep 5, 2016)

I'll look into having it done after I get them to look at my thyroid and I'm able to get the ball rolling on figuring that out. Thanks!


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## Scooky (Sep 5, 2016)

So update...

Got a call this morning from the endo's office, they had a cancellation and were able to get me in today at 2pm.

I met with the endo and she told me my labs all looked fine, that the TgAB results weren't high enough to cause thyroid dysfunction and that TPO antibodies are the ones that indicate hashimoto's, not TgAB. She asked about my not sleeping well, only since she seen I had been prescribed temazepam by my primary(which didn't help), I told her I don't sleep well and no matter how much sleep I do get I'm tired all the time. She then asked if anyone had told me I snore, my girlfriend has told me I do but on rare occasions usually when I'm getting sick, I told her as such and then she suggested that I take vitamin D during the winter to help with the tiredness.

She then brought up my weight and said that it was good I had lost 10lbs since the last weight they had on record, now 189lbs, and that I should lose 15 more to be in normal range and that I'm clinically obese. I told her my weight fluctuates quite a bit and that about 10 days ago I weighed 183lbs. She replied that I can't compare their weights to mine on an at home scale, I told her that that weight was from a scale at the hospital, I work at the same hospital she does and will weigh myself on our surgical departments scale from time to time. She just smiled and continued on with what she was saying. She did not ask about any other symptoms. She told me to have the blood tests re-done after December 5th as thyroid labs don't change much until after at least 4 months and that she'd see me again in a year if no other problems arise.

I did manage to get her to order an ultrasound of my thyroid though she was reluctant. I have that scheduled for Wednesday.


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## Scooky (Sep 5, 2016)

Forgot to mention, she told me that when they re-run my labs they won't be retesting my antibodis as once your positive you'll stay positive and the numbers will fluctuate but it won't make a difference. Looking at what she did order it looks like she only re-ordered TSH and none of the frees.


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## Scooky (Sep 5, 2016)

Sorry about the long previous post, was disappointed and frustrated with the way the endo made me feel, like it's just all in my head.

Another update though,

Went in for the ultra sound this morning and already got the results from it emailed to me. Straight from the report that was emailed to me:
"Two tiny solid-appearing nodules midportion the right lobe of thyroid,
doubtful significance."

Haven't received a call from the endos office about them yet though, I'd be surprised if I did today since it was just done.


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## Scooky (Sep 5, 2016)

Got my ultrasound report in the mail today

Right lobe:
4.1cm in length and 1.9cm x 2.1cm 2 nodules 3mm and 5mm, solid appearing

Normal isthmus

Left lobe:
4.6cm in length and 1.6cm x 1.9cm


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## Octavia (Aug 1, 2011)

Looks unremarkable. That's good.


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## Scooky (Sep 5, 2016)

Yea, the report said doubtful significance, and the endo said it wasn't anything to be concerned about right now. Looks like I'll just be dealing with things until my labs get worse. Yay lol

Thanks everyone on here for their input, I enjoy reading through these boards and learning more about the thyroid.

I'll update this once I have new labs drawn in December, if there is any significant change lol


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## Scooky (Sep 5, 2016)

Bit of an update, had my TSH run again from my Endo - 0.753 mcUnits/mL Range 0.350 - 5.00

She wont order free's unless tsh is outside of normal.

I also went online and ordered some of my own labs

Vit D: 17 Range: optimal > or = 30

Vit B12: 406 Range: 200-1100

Folate: 7.5 Low:<3.4 Borderline:3.4-5.4 Normal: >5.4

Free Testosterone: 80.3 Range: 35-155

Sex Hormone Binding Globulin: 17 Range: 10-50

Testosterone Total: 346 Range: 250-1100

I shared the results with my primary and he told me to start taking 2000units of Vit D daily. I've been taking 5000units since I already had some at home, figured it wouldn't hurt. He said everything else looks fine. I'll end up ordering my own thyroid panel as well in January since she wont run my free's.

I've been wondering if my testosterone shouldn't be higher? I'm a 24 year old male, I would think being younger it would be higher? I have nothing to compare it too though since I've never had it run before.


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## Scooky (Sep 5, 2016)

joplin1975 said:


> YES!
> 
> It should be closer to 500, minimally. More like in the 700s for a young male. Some times consulting a urologist can be helpful when dealing with testosterone issues.


That's what I thought. I gave a copy of the labs to my primary and he only mentioned about the vit d levels and said everything else is fine. I sent a message to my endo with the results, waiting on a response from her still, see what she says. I'm hoping someone will be willing to treat it, maybe that'll resolve some of my symptoms I've been having. From what I have read my levels are on par with an 80 year old mans! LOL

As always, thank you for the reply!


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## Scooky (Sep 5, 2016)

Figured I'd update again, I know this is getting away from the thyroid a bit though.

Had another appointment with the endo, asked about the testosterone levels and she said that they are normal, I pushed it asking about them being low for my age, so she is going to re run the labs, wants me to do them after January 9th. She also ordered a dexamethasone suppression test due to the one abnormal cortisol level back in august. That came back normal.

Once I redo the testosterone labs if they are still on the lower side I'll try to get her to let me try supplementing it to see if i get any improvement from it, if not I'll get a second opinion from a urologist. I also want to order my own thyroid panel again before following up with the endo to see if those numbers have changed so I can bring them up to her as well.

My primary also had me do a sleep study, got the call this morning that it came back normal.


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## joplin1975 (Jul 21, 2011)

I think it's a good idea to have to get a urologist consult if you pursue testosterone replacement. It's a really good idea to rule out testicular cancer. Also, there's a ton of options withTRT. Urologists tend to be a bit more well-versed on the options.


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## Scooky (Sep 5, 2016)

Alright, I'll see about just getting a referral to a urologist after the labs are re done next month if they come back on the low side again.

I did forget to mention I had my TSH run again in the beginning of November

TSH 0.753 mcUnits/ml (0.35-5.00 mcUnits/ml)

Endo said it's normal so won't run frees. Given my previous numbers, being positive for the antibodies and the symptoms should I see about getting into a different endocrine for a second opinion? I guess I'm asking if you guys were in my situation what would you do?

Later in the morning I'll add all the tests and ranges into my signature to make it easier to follow.

EDIT*

Just noticed I had already posted that TSH level a couple weeks ago. Thanks brain fog! :tongue0013:


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## joplin1975 (Jul 21, 2011)

I think its a really good idea to find someone who will not strictly rely on TSH.

I generally don't always advocate doctor shopping, but for thyroid conditions, I do!


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## Scooky (Sep 5, 2016)

Thanks Joplin!

Went in for my yearly physical and my primary ordered my yearly labs, didn't notice right away but he reordered Tsh as well, had them drawn yesterday morning. TSH came back at 3.486 (0.35-5.0). In November it was 0.753, went up quite a but in just over 2 months. When they call about the results I'll ask about running the frees, he was open to it before, maybe he still will be.

Still waiting on my testosterone results, they haven't come through yet. Hopfully later today they will.


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## Lovlkn (Dec 20, 2009)

Have you ever had an ultrasound of your thyroid?


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## joplin1975 (Jul 21, 2011)

Interesting. Those aren't great testosterone numbers. They aren't awful, but they aren't great.

It becomes a chicken - egg sort of thing. What is stressing your system? A malfunctioning thyroid or a underactive gonads. My husband's T numbers drastically improved after he got on TRT.

I have a suspicion that you issue is more thyroid.


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## Scooky (Sep 5, 2016)

Lovlkn said:


> Have you ever had an ultrasound of your thyroid?


Yes, full report is on the previous page. Nothing significant was found though, 2 small nodules on one side, otherwise unremarkable

EDIT* Jk, its towards the top of this page, sorry lol



joplin1975 said:


> Interesting. Those aren't great testosterone numbers. They aren't awful, but they aren't great.
> 
> It becomes a chicken - egg sort of thing. What is stressing your system? A malfunctioning thyroid or a underactive gonads. My husband's T numbers drastically improved after he got on TRT.
> 
> I have a suspicion that you issue is more thyroid.


Yea, my free testosterone numbers aren't so bad, total is pretty low, but free is what is the most important from what I can tell? I've been doing some reading on TRT, I was going to pursue it but I'm not sure if I should or wait and see if the thyroid is causing the low T, or if it'll end up being vice versa, as you said the chicken - egg scenario lol.


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## Scooky (Sep 5, 2016)

Hi everyone, hope you are all doing well!

So I ordered my own thyroid labs to see where I was at, since my endo didn't want to order any. These are the results:

TSH: *1.59 mIU/L* (0.4-4.5)

Reverse T3: *19 ng/dl* (8-25)

Free T4:* 1.2 ng/dl* (0.8-1.8)

Free T3: *3.3 pg/ml* (2.3-4.2

TPO: *2 IU/mL* (<9)

TGAB: *83 IU/mL* (< OR = 1)

TSI: *<89% * (<140%)

My Free's seem to have improved and are in a decent spot now, but I guess I am positive for TSI as well? though it is in the normal range. I have to fax the results into my Endo, she hasn't seen them yet.

I'd be interested in your opinions as well. Thanks!


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## Scooky (Sep 5, 2016)

From what I have been reading, in a normal healthy person TSI is not present at all correct? Could the presence of it mean I could actually end up having graves disease? I know with those labs no treatment would be necessary, and could just make things worse. I think I have been swinging back and forth between hyper and hypo. At least that's the way it feels at times.

I know I've been back and forth through this, I apologize for that. At times I feel like I'm just overthinking things (which I do tend to do) and it's all in my head.. If I ever am please feel free to tell me!

I appreciate your guys' time and energy you put into these boards and the advise you give. Hope you all have a wonderful valentines day! My girlfriend is in for a nice surprise at work this afternoon, she deserves it for putting up with me :lol:


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