# Results and Advice PLEASE



## borderlinehypermaybe (Oct 21, 2010)

Hi folks,

I am a male (just in case this matters in the analysis of results) and just received lab results back from a thyroid blood tests. I wonder if anyone here could help me make sense of the results of the test and perhaps tell me if further action is necessary. Please keep in mind that we are attempting to see if my thyroid is acting up because I have had some anxiety.

TSH 2.08	(Limits 0.450-4.500)
Thyroxine (T4) 12.5h	(Limits 4.5-12.0)
Trilodothyronine (T3)	119	(Limits 71-180)

Thanks for looking and for any advice!!!!!


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## Andros (Aug 26, 2009)

borderlinehypermaybe said:


> Hi folks,
> 
> I am a male (just in case this matters in the analysis of results) and just received lab results back from a thyroid blood tests. I wonder if anyone here could help me make sense of the results of the test and perhaps tell me if further action is necessary. Please keep in mind that we are attempting to see if my thyroid is acting up because I have had some anxiety.
> 
> ...


Gender does matter when it comes to medical issues. Hi and welcome!

At a glance, I am suspicious and by the way, thanks for the ranges. Because that T4 (total 4) is so high and because the TOTAL 4 is bound and unbound hormone, that raises an eyebrow.

I would like to suggest that your request FREE T3 and FREE T4 lab tests as these are only the "unbound" portion of hormone available for cellular uptake. Your Total 3 is also below the mid-range and that also would be suspect because here again, the Total 3 is bound, unbound plus rT3 (reverse T3) and this does not give a clear picture of the FREE T3 which is your active hormone.

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

Am suspecting that you feel very tired. Are you?

And antibodies' tests would be good.

TSI (thyroid stimulating immunoglobulin),TPO (antimicrosomal antibodies) TBII (thyrotropin-binding inhibitory immunoglobulin), Thyroglobulin Ab, ANA (antinuclear antibodies), (thyroid hormone panel) TSH, Free T3, Free T4.

You can look this stuff up here and more.........
http://www.labtestsonline.org/unders...s/thyroid.html

Interestingly, most males w/thyroid disease have very low testosterone so you would want to get that checked as well.

What prompted you to get thyroid labs? Are you symptomatic? If so, care to share?


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## borderlinehypermaybe (Oct 21, 2010)

Thanks for the quick reply.  Let me go through some symptoms, please bare with me .....

1. Anxiety/Panic (this is the big one)
2. Only male losing hair out of all the siblings (could be stress could be thyroid)
3. hereditary (father and aunts)
4. Shortness of breath (could be anxiety or see number 6)
5. Very healthy and physically active besides these symptoms
6. Since I had this workup my doc thinks I may also have asthma (fun)
7. Tired

Some notes on the doctor. Very pleasant doctor but informed me that the TSH test is more than sufficient and that he will do the T4 and T3 tests just because I told him my father's hyperthyroid did not show on the TSH test. He called me two days after the test (today) and gave me the results. He said I was borderline high on the T4 but this is not a problem and we can retest in a month if I would like. This has me a little concerned in light of the above symptoms. I am more than willing to accept that I have anxiety (I have for many years) or that I am losing hair, or whatever else. I just want to rule the thyroid out as a possible inducer or contributor to the problems.


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## Andros (Aug 26, 2009)

borderlinehypermaybe said:


> Thanks for the quick reply. Let me go through some symptoms, please bare with me .....
> 
> 1. Anxiety/Panic (this is the big one)
> 2. Only male losing hair out of all the siblings (could be stress could be thyroid)
> ...


I do believe something is afoot in the thyroid department. Therefore, getting antibodies' tests are essential. They will get to the bottom of it. Sometimes the thyroid panel does not give the complete picture.

Please don't accept anything until you rule out the thyroid as a problem. TSH is never sufficient as a stand alone for diagnosing thyroid disease.

Please let us know what you decide re futher in-depth testing. You may have to find a more amenable doctor and definitely one who does not have tunnel vision. Your current doc is rather cut and dried. Not good for you. No way.

Others will be along to give their opinions also.


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## borderlinehypermaybe (Oct 21, 2010)

Just an update. I do plan to have more testing done by an endo this coming Friday. I am concerned that my pcp is taking the high results from the TT4 a little to lightly. I will let everyone know as I find out. I have a hard time believing that the TT4 results are skewed and will be much different the next time my doctor draws blood, especially in light of the hereditary and symptom factors.


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## Andros (Aug 26, 2009)

borderlinehypermaybe said:


> Just an update. I do plan to have more testing done by an endo this coming Friday. I am concerned that my pcp is taking the high results from the TT4 a little to lightly. I will let everyone know as I find out. I have a hard time believing that the TT4 results are skewed and will be much different the next time my doctor draws blood, especially in light of the hereditary and symptom factors.


I hope you can convince the doctor to run the FREE T3 and the FREE T4.

Here is info on that.
Understanding thyroid lab tests.....http://www.amarillomed.com/howto

And TSI (thyroid stimulating immunoglobulin) for sure. This would indicate hyperthyroid or not. You should have absolutely no TSI.

Please do let us know.

How are you feeling?


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## usmc4myson (Sep 26, 2010)

Be prepared for the endo to spout the same stuff as your pcp...they all seem to be cut from the same cookie cutter...quick to dismiss any and all thyroid issues. Why are thyroid issues flatly denied in the presence of clear and unmistakable symptoms and bloodwork?? This is something I will never be comfortable with. Question your docs respectfully but firmly. Be prepared. I learned more about the thyroid gland and its function on this board than I did at my doctors office. Good Luck.


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## borderlinehypermaybe (Oct 21, 2010)

I am afraid you folks are right in terms of medical doctors pushing off the treatment of the thyroid. I find this rather surprising being that the symptoms are there and at least one of the tests was off scale from the blood test yet the pcp is not even concerned enough to look deeper at the issue.

I am quite prepared for the endo to not really care about the test results (I see the endo Friday). I will attempt to push for further testing. For the initial test I specifically asked for Free T4, Antibodies test, and Free T3 and he agreed but ran the TSH, Total T4, and I believe the Free T3 test.

Its a shame and rather frustrating.


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## Andros (Aug 26, 2009)

borderlinehypermaybe said:


> I am afraid you folks are right in terms of medical doctors pushing off the treatment of the thyroid. I find this rather surprising being that the symptoms are there and at least one of the tests was off scale from the blood test yet the pcp is not even concerned enough to look deeper at the issue.
> 
> I am quite prepared for the endo to not really care about the test results (I see the endo Friday). I will attempt to push for further testing. For the initial test I specifically asked for Free T4, Antibodies test, and Free T3 and he agreed but ran the TSH, Total T4, and I believe the Free T3 test.
> 
> Its a shame and rather frustrating.


They are a bunch of dirty rats. We must all learn to advocate for ourselves here. Bottom line.

We will help you.


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## djwillia (Nov 3, 2010)

Here are my test results - I am confused and don't know what this all means. I think that the Thyrotropin Receptor Antibody should be negative and that the value of 9 indicates the presence of antibodies for Graves Disease? I am hyper, have horrible symptoms - extreme nausea, sever heat intolerance, great difficultly breathing, diarreah, weight loss of about 30lbs over 3 months and some vision problems.

TSH (THYROID STIMULATING HORMONE) (84443) 10/20/2010 1:07:00 PM 
Profile/Panel/Test Value Unit Normal Range 
TSH, 3RD GENERATION 0.48 MIU/L 0.40-4.50 
Comment:

64821 -T4, FREE DIRECT DIALYSIS (84439) 10/20/2010 1:07:00 PM 
Profile/Panel/Test Value Unit Normal Range 
T4, FREE DIRECT DIALYSIS 2.0 ng/dL 0.8-2.7 
Comment:

64822 -TT3 (TOTAL TRIDOTHYRONINE) (84480) 10/20/2010 1:07:00 PM 
Profile/Panel/Test Value Unit Normal Range 
T-3, TOTAL 107 NG/DL 76-181 
Comment:

64824 -Thyrotropin Receptor Antibody (83519) 10/20/2010 1:07:00 PM 
Profile/Panel/Test Value Unit Normal Range 
TBII 9 SEE NOTE 
Comment:

64825 -TPO ANTIBODY (86376) 10/20/2010 1:07:00 PM 
Profile/Panel/Test Value Unit Normal Range 
THYROID PEROXIDASE AB <10.0 IU/ML <35 
Comment:

64826 -THYROGLOBULIN ANTIBODY (86800) 10/20/2010 1:07:00 PM 
Profile/Panel/Test Value Unit Normal Range 
THYROGLOBULIN AB <20.0 IU/ML <20


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## Andros (Aug 26, 2009)

djwillia said:


> Here are my test results - I am confused and don't know what this all means. I think that the Thyrotropin Receptor Antibody should be negative and that the value of 9 indicates the presence of antibodies for Graves Disease? I am hyper, have horrible symptoms - extreme nausea, sever heat intolerance, great difficultly breathing, diarreah, weight loss of about 30lbs over 3 months and some vision problems.
> 
> TSH (THYROID STIMULATING HORMONE) (84443) 10/20/2010 1:07:00 PM
> Profile/Panel/Test Value Unit Normal Range
> ...


Welcome to the board. You are correct about the TBII. It is usually present when TSI (thyroid stimulating immunoglobulin) is present and you should have none of either. TSI is responsible for the hyper.

All signs point to hyperthyroid. Wonder why the doc did not do FREE T3? Aaaaaaaaaaaaaaaargh. Especially since hyper is a suspicion!

http://jcem.endojournals.org/cgi/content/full/92/3/1058

You certainly are not confused. Your brain is working fine.

So.................what does the doctor purport as a treatment plan?


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