# New and confused! Lab results



## Teggy100 (Jun 8, 2015)

Hi Everyone. I'm a complete newbie to this forum and Thyroid related issues.

I went to the doc experiencing extreme Left side pain and they ran a load of bloods as you'd expect. I've had weight related problems for about 8 years. Never terribly overweight but not able to lose no matter what I do, also suffered terribly with ridiculously heavy periods (sorry guys) so when the doc called me in saying I had Thyroid issues I thought 'that explains a lot'

But then he hit me with these labs:

Serum Free T4 32.9 pmol/L (9.0-23.0)

Serum TSH level <0.01 mu/L (0.20 - 4.50)

Serum Total T3 2.2 nmol/L (1.1 - 2.6)

And said I was hyPERthyroid not Hypo like I was expecting.

He then ran a Thyroid Peroxidase Antibody level test which came back as <10 kiu/L (0 - 35)

BUT all of my symptoms point to Hypothyroid. Weight gain, heavy periods, feeling freezing all the time, depression, joint aches.

While I was waiting to see the Endo, I actually felt better than I had for years and my pain went away.. now, literally all of a sudden, everything has gotten worse. I've gained 1/2 stone in 2 weeks, serious joint pain, feeling crazy tired and down.

My question is, has anybody had labs that point to Hyper but actually, eventually had a hypo diagnosis? And is there a possibility that because they didn't do a free T3 test, my body could be producing lots of T4 but not actually able to use it? I don't really understand how it works!

Sorry, that was a lot of info and questions but I'd be so grateful for any light anyone could shed. I'm waiting on another Endo appointment in about 6 weeks and a Thyroid scan but I feel so rotten and if I need different labs I'd like to get them done privately so I can be armed with a lot of questions the next time I see my Endo.

Thanks all of you for reading this. Wishing you all good health. Thyroid problems are horrible. xx


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## joplin1975 (Jul 21, 2011)

It's really hard to judge thyroid issues by symptoms alone because symptoms cross over all the time -- so classically hypo symptoms show up when you are hyper and vice versa. Also, its entirely possible that you are flipping (rapidly) from hyper to hypo.

You do look hyper. Do you know what kind of thyroid scan you are going to get? An ultrasound or a radioiodine uptake scan?


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## Teggy100 (Jun 8, 2015)

Thanks so much for replying.. its a bit of a lonely process trying to get a definitive diagnosis!

Scan is an ultrasound I believe. I'm not sure what they're looking for with this? Nodules? Cancer? The Endo did say I had a goitre.


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## joplin1975 (Jul 21, 2011)

Usually they are looking for nodules.

I think, given that you are leaning hyper, you might want to eventually consider a RAIU...but the Grave's experts will be along shortly to let you know for sure.


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## Octavia (Aug 1, 2011)

That Free T4 result is incredibly high. That alone would indicate hyperthyroid. I'm glad you're getting some attention.


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## Teggy100 (Jun 8, 2015)

Thank you both so much for your thoughts! Its a pretty confusing world. Nice to be amongst people who know what they're talking about  xx


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## Andros (Aug 26, 2009)

Trab
http://www.ncbi.nlm.nih.gov/pubmed/17684583
(Copy and paste into your browser)

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
(Copy and paste into your browser)

Substances not found in normal serum (scroll down to autoantibodies)
http://www.thyroidmanager.org/chapter/evaluation-of-thyroid-function-in-health-and-disease/
(Copy and paste into your browser)

Understanding the Thyroid: Why You Should Check Your Free T3
http://breakingmuscle.com/
(Copy and paste into your browser)

Symptoms can and do cross over. You appear hyper but it would be a good thing to get the FREE T3 test instead of the Total and seriously, you need RAIU (radioactive uptake scan.) Please insist on it.

And the tests listed.

Welcome to the board!


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## Octavia (Aug 1, 2011)

Can we go back to your Free T4 result? Would you please double-check your result as well as the range you posted? I'm VERY concerned, assuming what you posted is accurate. Your result really is alarmingly high. When my Free T4 result is close to the top of the range (or very slightly over range), I feel pretty lousy and have heart palpitations like crazy. It can be dangerous to have a Free T4 result that high.


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## Teggy100 (Jun 8, 2015)

Hiya. Yup, Free T4 and range is correct: Serum Free T4 32.9 pmol/L (9.0-23.0)

I have print out here of the test results that I demanded when they did an ECG. Bloods were taken on 23/03.

At the time they told me the results they took my BP and HR. HR was around 100bpm (but i'd just run up a flight of stairs). Everything else fine. ECG was perfect apparently.

I have monitored my own HR in the months that followed and its been pretty normal. Sometimes a little high but never over 100bpm and usually sorts itself out pretty rapidly.

I wonder if it was a rogue test. I'm not sure I know what normal feels like any more, I've been battling with fatigue and muscle aches and weakness for 8 years.. initially put down to low serum ferritin but now I wonder if I've had a groaning thyroid the whole time. I definitely don't get constant palpitations though.. occasional high-ish HR and very occasional palpitations but nothing more than that.

They did more bloods when I went to the Endo appointment but I don't know the results yet, I was assuming that if there was something to be alarmed or take rapid action on they would have notified me but perhaps I'm being naive given the problems our poor old NHS is having (I'm in the UK btw)

Feel like I should have demanded a free T3 test but I didn't know about it at the time I saw the Endo. Its a steep learning curve this stuff isn't it?!

Thanks all of you for being so helpful. Just being able to talk to people who get it makes a big difference. I just feel like I'm moaning to my husband about a completely invisible problem most of the time!


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## Octavia (Aug 1, 2011)

Okay, thanks for checking it again. Yes, it could have been "rogue" as you say. When will you get your new results?


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## Teggy100 (Jun 8, 2015)

I think I've got to wait until I see my endo again in July. But I will call tomorrow and see if anyone will give me the results over the phone. Its such a crazy system that no-one seems to be able to join the dots very quickly. Still waiting for a date for the scan which was requested 3 weeks ago! I will post here if I get the new results


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## Teggy100 (Jun 8, 2015)

Hi again everyone.. I hope you don't mind me coming back here to mine you guys for information again!

So.. I finally got my blood results from the Hospital. It took me three weeks just to get them to agree to print them out. To recap, in March, my T4 was ridiculously high.

Got referred to an Endo, by the time I got to see him, I was feeling pretty well. They took bloods that day and the results were:

FT4 11.1 pmol/L 9.0 - 23.0

TSH 1.97 mu/L 0.20 - 4.50

They didn't do T3.

So the Endo basically put me to the bottom of the appointment pile and said I couldn't see him until mid August.

A few weeks after that, everything tanked again. The muscle fatigue came back, couldn't climb stairs without stopping, joints ache, can't lift my arms over my head for longer than a second.. feel like someone has inflated a balloon in my head, ankles look like the Michelin man (very puffy) and voice got hoarse (this is scary as I'm a singer for a living!) so I went to my GP and requested another blood test to see if anything had changed, thinking maybe i've swung the other way. Those results:

Serum free T4 11.7 pmol/L 9.00 - 23.00

Serum TSH 2.52 mu/L 0.20 - 4.50mu/L

So very little change. I requested a Free T3 test as well, but they didn't do it.

I am absolutely gutted, to say the least. I know it sounds weird to wish you had bad blood results, but I just hoped this would be the answer as to why I was feeling so awful. Now it feels like all the doctors will just write me off. Genuinely don't know what to do.

I have an ultrasound scan on Thursday, but given those blood results, I'm guessing they won't spot anything.

Can anyone see any reason why I might be feeling so rotten from those bloods?

The other weird thing is that my heart has been doing odd things. Lots of palpitations and resting heart rate exceeded 127 the other day. It wasn't even doing that when my T4 was 32.9.

I'm so confused and fed up. Don't know where to turn.

Sorry for the moan.


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