# Preparing for Endocrinologist Appointment



## girlfrommaine

I am visiting an endocrinologist next week, after having my doctor give me a tentative diagnosis of Graves. For about four weeks I've had all the classic hyperthyroid symptoms, hoping they would go away. Fast heart, pounding heart, losing around 15 pounds (don't have THAT much to lose), out of breath, no energy, tired, episodes of being very hot, hard time sleeping at night and more. 
After bloodwork, my TSH was 0.04, (ref 0.34-5.00), then my Graves antibodies test done (TSI I think??) and that was 150, with ref range being 0.9- 9.0. I also had an ultrasound done that showed some enlargement (not huge) and no nudules or cysts. 
My question to those of you who've been here before is: Should I have more bloodwork, or information before I go to the specialist? I'm hearing all of you talk about all the different levels, and I only know two. Is this enough for the Dr to have, to help me feel better?
(I have been put on a low dose beta-blocker that has helped some)
Also, how can anyone tell if what I have is thyroiditis? I had some viral infection the week before last and I still have a lingering sore throat. 
Thanks for any ideas.


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## GD Women

TSH, FT-4, FT-3, and thyroglobulin to see if the antibody is present and interfering with the test results. However, certain amount of healthy people test positive for TPO antibodies, so the presence of these antibodies doesn't always indicate that you have an autoimmune disorder.

Normally TSH is low, often suppressed to levels <.01 mu/ml. or lower.

Was TSI not mentioned as 150*%*, if so that would be 1.5 and within your Lab range as you printed.

Would need to know all your TSH and both FT levels drawn at the same time to guesstimate thyroiditis.

Nodules can present sore throats.

Let us know Endocrinologist outcome.

Good Luck!


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## hillaryedrn

Hi there!! I'm glad you are getting this checked out! It isn't necessary to have any additional labwork done before you go to the endocrinologist. Make sure you bring copies of everything you have had done up to this point. The Endo can order anything else needed. Make sure you have a complete list of your symptoms. Write them down is best. I know I have a bad habit of forgetting things in the "heat of the moment" when the doctor is there. In the time you have before the appointment, write down questions that you think of. It is guaranteed that you will forget some if you don't write them down! LOL! Good luck!


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## girlfrommaine

Thanks to both of you! I was already thinking of writing down questions and symptoms. I too get flustered and forget things in the moment. I'm also thinking of calling my doctor to see what her opinion is of more testing. I just want to get back to normal as soon as possible, and if more results would help with that, then I will do it!! 
I'm thankful for these boards.....very informative for this new girl.


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## Andros

girlfrommaine said:


> I am visiting an endocrinologist next week, after having my doctor give me a tentative diagnosis of Graves. For about four weeks I've had all the classic hyperthyroid symptoms, hoping they would go away. Fast heart, pounding heart, losing around 15 pounds (don't have THAT much to lose), out of breath, no energy, tired, episodes of being very hot, hard time sleeping at night and more.
> After bloodwork, my TSH was 0.04, (ref 0.34-5.00), then my Graves antibodies test done (TSI I think??) and that was 150, with ref range being 0.9- 9.0. I also had an ultrasound done that showed some enlargement (not huge) and no nudules or cysts.
> My question to those of you who've been here before is: Should I have more bloodwork, or information before I go to the specialist? I'm hearing all of you talk about all the different levels, and I only know two. Is this enough for the Dr to have, to help me feel better?
> (I have been put on a low dose beta-blocker that has helped some)
> Also, how can anyone tell if what I have is thyroiditis? I had some viral infection the week before last and I still have a lingering sore throat.
> Thanks for any ideas.


The endo should want to run his/her own labs. As you already know, the healthy patient should have no TSI. That reference range for the TSI does not look right to me! Wonder if you could re-check that? It should be (example only) 60 - 300 ??? Something like that!

Good luck w/ the endo. I wish that for you! Let us know.


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## klungkung

Having seen three endocrinologists my advice is do as much reading as you can so that you know all the options (Graves Disease by Elaine Moore and Living Well with Graves Disease & Hyperthyroidism by Mary Shomon seem to be the most widely recommended). If you don't get what you want from your endocrinologist try another one. I'm now looking for a fourth. The three I've seen so far have shown me nothing to suggest that they are any more than glorified pharmacists. Not a stroke of evidence of clinical experience (in the sense that you gain expertise and understanding by dealing with patients). I was hoping that clinical experience might mean that they would have a few "tricks of the trade" in how to best deal with symptoms but I've got more useful advice from my doctor and zilch from the endocrinologists. The experience so far makes me think I could be as good a specialist for hyperthyroidism with a weeks training (maybe a day would be enough) on the facts of anti-thyroid drugs, radioactive-iodine and surgical treatment. But I'm convinced that there must be an experienced endocrinologist out there somewhere with a goldmine of clinical experience gained from real engagement in his/her patients treatment.


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## CheleRose

Hi, I would really recommend also a TPO and a Thyroglobulin ABS, this way it can give the endo the clearest picture of what you are dealing with regarding your thyroid and go from there. I agree that the TSI range seems strange...my newest one says 0-139% as the range. Good luck, look forward to hearing how it went for you.
_CheleRose


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