# First trip to the endo



## mememe (Mar 18, 2010)

Had 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)

So today I finally had my first endo appointment. He pretty much said that there's most likely nothing to worry about, but did order an ultrasound which I am getting later today, and ordered a Panel-T-Thyroid, which I will get drawn within the next days.

He said that my T4 may be elevated from my oral contraceptive. He said that the antibodies may go away or they may stay there forever and not really do any harm, or they could start to do damage, but at this point he doesn't believe so.

I feel somewhat disappointed. Now that I think of it, when I spoke of being tired that conversation never really went anywhere except he asked if I get good sleep. Also when going over my medication list he saw and mentioned adipex. I said that I am so tired all the time, that sometimes I need to take one to have energy to get stuff done. I would have expected a doctor to discourage the use of adipex and get to the root of the problem. I dunno. I have an appointment in 2 more weeks, so I will go to that appointment and I will discuss my exhaustion in more detail and in more seriousness. I just keep thinking I wonder if I should have went to another doctor. He didn't say what any of this could _mean_


----------



## mememe (Mar 18, 2010)

p.s. can anyone tell me what exactly is included on a "Panel-T-Thyroid" blood test?


----------



## GD Women (Mar 5, 2007)

Thyroid Panel consist of: TSH, FT-4 and FT-3 and depending on the doctor,
antibodies. However, if the doctor knows how to read the relationship between TSH and the FTs, antibodies would not be necessary. Nothing can be done about them anyway. They are not treated or nor are they cureable - science hasn't gotten that far yet. If your Labs shows either Hashi or Graves' then doctor knows you have the antibodies.

My T-4 is always higher then my FT-4. However, if T-4 is high then the FT-4 will be high as well, but to know how high test will be needed.

Oral contraceptive will interfere with the T-4 level and give false reading.
Oral contraceptive do not interfere with the FTs (FT-4).

Good luck!


----------



## mememe (Mar 18, 2010)

GD Women said:


> Oral contraceptive will interfere with the T-4 level and give false reading.
> Oral contraceptive do not interfere with the FTs (FT-4).
> 
> Good luck!


Thank you for your reply. So how would they differentiate between a false reading from oral contraceptives on the T4? Is this where the FT4 comes into play? Like, if the FT4 is high, then that means the T4 _is actually_ high? If the FT4 is normal or low, then the T4 was a false reading?


----------



## Andros (Aug 26, 2009)

mememe said:


> Had 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)*
> ...


I am glad you saw the endo and depending on what tests he ran, I believe we all will know more on your next visit.

Your Total 4 is very high. That makes me suspect that your probably have TSI (thyroid stimulating immunoglobulin) and Trab (Thyroid Stimulating Hormone) antibodies. I hope he ran those tests.

If you wish, you may look them up here http://www.labtestsonline.org/


----------



## mememe (Mar 18, 2010)

I just got my ultrasound done. (Doctor should receive results tomorrow) Is it normal to have a headache after having yout thyroid palpated and pressure from the ultrasound?

About the lab tests he ordered-all I know is he ordered the thyroid panel. If that is not included, would it be rude to request the TSI and the Trab antibodies? or how could i go about getting that checked at the same time? Could I simply request it to be checked when my blood is drawn? I think I am going tomorrow to get it drawn.


----------



## mememe (Mar 18, 2010)

is it possible to get these tests done with a finger prick-like test instead of the standard suck-up-your-blood method?


----------



## GD Women (Mar 5, 2007)

mememe said:


> Thank you for your reply. So how would they differentiate between a false reading from oral contraceptives on the T4? Is this where the FT4 comes into play? Like, if the FT4 is high, then that means the T4 _is actually_ high? If the FT4 is normal or low, then the T4 was a false reading?


It depends if there is a thyroid condition and in which condition levels relate.

An out of Lab range of high F/T-4 with a low TSH would indicate hyerthyroidism not necessarily autoimmune thyroid. However, all three levels need to be tested. FT-3 will tell more on how it relates to FT-4 if its actually autoimmine thyroid. TSH indicates if it is hyper or hypo thyroid. Your TSH is not out of Labs, so does not indicate thyroid.


----------



## mememe (Mar 18, 2010)

I asked the place that will be drawing my blood tomorrow and was told they could add the antibodies on to it, so as per your suggestion, Andros, I will see if I can add the TSI and the trab.


----------



## Andros (Aug 26, 2009)

mememe said:


> I just got my ultrasound done. (Doctor should receive results tomorrow) Is it normal to have a headache after having yout thyroid palpated and pressure from the ultrasound?
> 
> About the lab tests he ordered-all I know is he ordered the thyroid panel. If that is not included, would it be rude to request the TSI and the Trab antibodies? or how could i go about getting that checked at the same time? Could I simply request it to be checked when my blood is drawn? I think I am going tomorrow to get it drawn.


You most certainly could request it. It's your body and you are entitled to know.

I (and the others)will be most anxious to share in the results of your ultra-sound. I hope you can get a copy.

And yes; palpitation of the thyroid gland could concievably cause a headache and also a painful thyroid.

You don't have to do both. Usually where there is TSI, there is Trab and vice versa. If I were to pick one, it would be the TSI (thyroid stimulating immunoglobulin.) You should have absolutely no TSI. And..............if it comes in low, that means Trab is probably at word as Trab is a blocking antibody to the autoantibody. Blah and bleck. It's complicated as you can see.

But, you use that link to the lab I provided and get familiar and no one will be able to pull the wool over your eyes, that is for sure. The more we learn, the better we can advocate for ourselves and protect ourselves.

Here is a really cool link to learn about labs............

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


----------



## mememe (Mar 18, 2010)

thanks Andros. I will ask for the TSI and also the TPOAb again just to see


----------



## daisy_ysiad2002 (Aug 17, 2009)

I knows its frustating waiting...I was in the same boat last week and yet still this week am waiting on the remainder of my tests. They don't seem too concerned about thyroid issues really if there are no nodules etc...but they do want to alleviate our symptoms...which is better than nothing I suppose. There is no cure for this disease. I too am tired but it takes months to get back on track and get into a rhythm....zzzz i could go for a nap but I won't. ((Hugs))) My endo said it can take 2 months to start feeling energy back for some...for most its about a month or so.


----------



## mememe (Mar 18, 2010)

Yeah, I always fight the urge to nap because I feel like there's always too much to do, but yet I still never get all of it done, like stuff around the house. Even simple day-to-day "chores" seem like a battle. I hope my doctor recognizes this and even if he doesn't think it's my thyroid, I hope he helps me get to the bottom of it.

***I am curious-are thyroid antibodies _always_ an indicator of an autoimmune disease? I just kept thinking before my appointment that he would say something like "yep, you've got hashimoto's" or somethin' like that. I guess I am most disappointed in the fact that I came from there without any diagnosis and without any more information that I already had before.

I am going to call the place where I got my ultrasound in the morning to see if I could get a copy of the report. If/when I do, I will share that on here.


----------



## mememe (Mar 18, 2010)

Just went to pick up my report from the ultrasound.

"*Findings:* The right lobe measures 5.2x1.8x1.6 cm and the left lobe 5.5x1.4x1.8 cm. The right and left lobes of the thyroid are diffusely heterogenous with no discrete right or left lobe nodule identified. The isthmus measures approximately 0.3 cm."

"*Impression:* Diffusely heterogenous echogenicity of the thyroid likely representing multinodular goiter with no discrete dominant nodule identified."

Haven't heard form my doctor yet. So can anyone tell me wehat this is basically saying?


----------



## Andros (Aug 26, 2009)

mememe said:


> Just went to pick up my report from the ultrasound.
> 
> "*Findings:* The right lobe measures 5.2x1.8x1.6 cm and the left lobe 5.5x1.4x1.8 cm. The right and left lobes of the thyroid are diffusely heterogenous with no discrete right or left lobe nodule identified. The isthmus measures approximately 0.3 cm."
> 
> ...


Heterogeneous means there are variations. Homogeneous means no variations;of the same kind which is what we hope to see in a healthy gland.

As far as nodules, it appears the ultra-sound did not pick up anything. Instead, there could be diffuse thyroidal hyperplasia of the micronodular variety, consistent with multinodular toxic goiter. Which would be a common finding in Hashimoto's (hyper stage) and/or Graves'.

Will be anxious for your doctor's comments. If it were me, I would want an uptake scan. Because ultra-sound does not pick up everything.

Here is credible information to support that.
http://www.radiologyinfo.org/en/info.cfm?pg=us-thyroid

Micronodular is characterized by very small nodules and most likely sonogram would not pick that up.

This is complicated stuff and I certainly am not a radiologist. But, as I mentioned, I personally would pursue this further w/ an uptake scan.


----------



## mememe (Mar 18, 2010)

thanks for the info. I'm also anxious for my doctor's comments. I don't want to be injected with anything, so hopefully if I do end up having that uptake scan, I could just swallow the stuff, right?

I had my labs drawn today that were ordered, and I also added the tsi and the tpo! So I will post those when I get them. Should be two days or so since I went so late in the day. Should I post those on the labs board?


----------



## mememe (Mar 18, 2010)

Is "free thyroxine index" not the same as free t4?


----------

