# Confused by lab results



## poohbear61 (Oct 11, 2010)

Hi, can anyone w/ more experience with this than me (diagnosed Nov) help me figure out what's going on? Been having monthly blood tests, no meds as yet because have been hypo. Dec. tests Free t4 so low as to be unreadable,TPO high at 230, and TSH about 53. Jan. tests Free T4 low/normal range (Yay!), TSH 10: nearly normal. Feb. tests Free t4 normal range, TSH down to 5: even closer to normal (yay again!), but- TPO up to 341 from 230. WTF? Apparently my thyroid & stimulating hormones coming back on track all on their own, but immune system going berserk? They have only done the 2 TPO tests, don't check it every month. Does this even sound like Graves'? Confused as heck, appreciate any input I can get.


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## Andros (Aug 26, 2009)

poohbear61 said:


> Hi, can anyone w/ more experience with this than me (diagnosed Nov) help me figure out what's going on? Been having monthly blood tests, no meds as yet because have been hypo. Dec. tests Free t4 so low as to be unreadable,TPO high at 230, and TSH about 53. Jan. tests Free T4 low/normal range (Yay!), TSH 10: nearly normal. Feb. tests Free t4 normal range, TSH down to 5: even closer to normal (yay again!), but- TPO up to 341 from 230. WTF? Apparently my thyroid & stimulating hormones coming back on track all on their own, but immune system going berserk? They have only done the 2 TPO tests, don't check it every month. Does this even sound like Graves'? Confused as heck, appreciate any input I can get.


Why have you not had meds Rx'd to treat your hypothyroid? Are you saying you have TSI (thyroid stimulating immunoglobulin?)


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## poohbear61 (Oct 11, 2010)

My labs came back quite hyper Oct & Nov. and my TPO was high then as well. Had RAIU test in Nov., no nodules or cancer, so was diagnosed w/Graves'. Was given meth prescription in Dec and had more labs done same day: results came back hypo, so endo called me (3X!) and insisted I not take the meth as I was currently hypo & it would make me worse hypo. So waited for Jan. tests, which came back low normal as indicated above, and again he called me and said not to take the meth, and since T4 was low normal no hormone replacement meds either. Now I seem to be in a fairly normal range w/TSH & T4, but the TPO has shot up. So far, they have not tested TSI at all, just TPO. Thanks for any input!


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## Andros (Aug 26, 2009)

poohbear61 said:


> My labs came back quite hyper Oct & Nov. and my TPO was high then as well. Had RAIU test in Nov., no nodules or cancer, so was diagnosed w/Graves'. Was given meth prescription in Dec and had more labs done same day: results came back hypo, so endo called me (3X!) and insisted I not take the meth as I was currently hypo & it would make me worse hypo. So waited for Jan. tests, which came back low normal as indicated above, and again he called me and said not to take the meth, and since T4 was low normal no hormone replacement meds either. Now I seem to be in a fairly normal range w/TSH & T4, but the TPO has shot up. So far, they have not tested TSI at all, just TPO. Thanks for any input!


It is quite common in the early stages of Graves' to flip flop back and forth between hypo and hyper.

How do you feel? What criteria was used to make the diagnosis of Graves'?

Is your doctor not running the FREE T4 and FREE T3? I see your reference to T4 which is Total 4.

Understanding thyroid lab tests.....http://www.amarillomed.com/howto/#Thyroid


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## poohbear61 (Oct 11, 2010)

Sorry, they run Free T4 every month, not just T4. T3 only ran last Oct. Graves' diagnosis was based, as far as I can tell, on low TSh, high T3 & free T4, and high TPO in Nov, as well as RAIU scan in Nov. But the results seem to have flip-flopped like you say happens, maybe this is just one of those things....I guess what will happen next, is high antibody count will cause TSH to go up, which will cause free T4 to go up, which will cause TSH to go down, and so on, huh?


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## Andros (Aug 26, 2009)

poohbear61 said:


> Sorry, they run Free T4 every month, not just T4. T3 only ran last Oct. Graves' diagnosis was based, as far as I can tell, on low TSh, high T3 & free T4, and high TPO in Nov, as well as RAIU scan in Nov. But the results seem to have flip-flopped like you say happens, maybe this is just one of those things....I guess what will happen next, is high antibody count will cause TSH to go up, which will cause free T4 to go up, which will cause TSH to go down, and so on, huh?


What was the rate of your uptake on the RAIU?

Please ask again for.................

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://www.medicineonline.com/topics/t/2/Thyroid-Stimulating-Immunoglobulin/TSI.html


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## poohbear61 (Oct 11, 2010)

I did, endo said TSI or TPO, it doesn't matter, either or both can be high. RAIU uptake was high, the doc who read the results was actually the first one who said "Yep it sure looks like Graves'". They do test TPO and it jumped from 240 or so to 350's. So I am still confused, & he won't do TSI test- just wants to monitor T3 & freeT4 until next October. In the meantime, I am going to continue my self-medicating with herbs, as they seem to be keeping the T3 & T4 within normal levels; I can't think what else it could be, keeping the levels down even though TPO antibodies continue to climb. I am taking MSM with wolfberry, astaxanthin with lutein, and drink detox Chinese tea with lemon balm every night. I told the endo what I am taking and he said fine , fine, continue that. Not sure he even tracked on what they are, seemed pretty distracted and gave me the impression that he was just brushing me off. I feel pretty good right now and sleep much better most of the time, so I guess that is a good thing and I should quit worrying it to death huh. Maybe I am just carrying these antibodies around like a herpes virus or something and they are not always active & attacking.


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## Andros (Aug 26, 2009)

poohbear61 said:


> I did, endo said TSI or TPO, it doesn't matter, either or both can be high. RAIU uptake was high, the doc who read the results was actually the first one who said "Yep it sure looks like Graves'". They do test TPO and it jumped from 240 or so to 350's. So I am still confused, & he won't do TSI test- just wants to monitor T3 & freeT4 until next October. In the meantime, I am going to continue my self-medicating with herbs, as they seem to be keeping the T3 & T4 within normal levels; I can't think what else it could be, keeping the levels down even though TPO antibodies continue to climb. I am taking MSM with wolfberry, astaxanthin with lutein, and drink detox Chinese tea with lemon balm every night. I told the endo what I am taking and he said fine , fine, continue that. Not sure he even tracked on what they are, seemed pretty distracted and gave me the impression that he was just brushing me off. I feel pretty good right now and sleep much better most of the time, so I guess that is a good thing and I should quit worrying it to death huh. Maybe I am just carrying these antibodies around like a herpes virus or something and they are not always active & attacking.


If you are feeling good, just stay on course then. It is true that either or both can be high. He sure did not tell a lie.

Keep us in the loop here; this is all very interesting.


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## DrJim (May 5, 2011)

poohbear61 said:


> My labs came back quite hyper Oct & Nov. and my TPO was high then as well. Had RAIU test in Nov., no nodules or cancer, so was diagnosed w/Graves'. Was given meth prescription in Dec and had more labs done same day: results came back hypo, so endo called me (3X!) and insisted I not take the meth as I was currently hypo & it would make me worse hypo. So waited for Jan. tests, which came back low normal as indicated above, and again he called me and said not to take the meth, and since T4 was low normal no hormone replacement meds either. Now I seem to be in a fairly normal range w/TSH & T4, but the TPO has shot up. So far, they have not tested TSI at all, just TPO. Thanks for any input!


Only testing TPO and not TSI you cannot tell if you are suffering from Graves or Hashimoto's. This is one of the great mistakes made by Docs. Assuming its Graves when you go hyper. However its much more common that Hashimoto's will swing you back and forth between hyper and hypo. You need a doctor that works with Hashimoto's you have an immune system problem more than a thyroid problem. your immune system is attacking your thyroid gland. you need to have someone help you stop it. Read "why do I still have thyroid symptoms even when lab tests are normal" This will help you understand what is going on. Better yet get MD to order TSI


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