# Hyperthyroid, possibly Graves



## titapwease (Aug 31, 2012)

Has anyone ever seen blood levels like this? Also, can anyone help me to better understand them? This is the first set of blood work my Endo had done; I went back yesterday and I haven't received my new results. However, my Endo called me and upped my Tapazole from 10mg 3 daily to 10mg 4 daily.

Glucose Serum: 100 High

Creatinine, Serum: 0.30 Low

BUN/Creatinine Ratio: 33 High

Alkaline Phosphates, S: 186 High

TSH: <0.006 Low
T4, Free Direct: 6.76 High

RBC: 5.39 High

Thyrotropin Receptor Ab, Serum: 18.92 High

Thyroid Peroxidase (TPO) Ab: 2812 High

Thanks for the help!


----------



## Andros (Aug 26, 2009)

titapwease said:


> Has anyone ever seen blood levels like this? Also, can anyone help me to better understand them? This is the first set of blood work my Endo had done; I went back yesterday and I haven't received my new results. However, my Endo called me and upped my Tapazole from 10mg 3 daily to 10mg 4 daily.
> 
> Glucose Serum: 100 High
> 
> ...


You are hyper; that is for sure!










Have you been on the Tapazole very long?

Did your doctor do RAIU (radioactive uptake scan) prior to your going on Tapazole?

Your high TPO is very concerning in that sometimes high titers can suggest cancer of the thyroid so hope you did get RAIU or at the very least an ultra-sound.

Anti-microsomal Antibodies- TPO Ab
Negative test is normal; you should not have any of these antibodies. And the healthy person does have a low titer of TPO.
http://www.nlm.nih.gov/medlineplus/ency/article/003556.htm

Alternative NamesThyroid antimicrosomal antibody; Antimicrosomal antibody; Microsomal antibody; Thyroid peroxidase antibody; TPOAb

Your doc ran some really good tests to get the diagnosis. I am impressed w/that.

Right now, I should imagine you don't feel too well and I am glad you got your Tapazole raised.

Here is some info and by the way, ranges would be helpful next time as different labs do use different ranges.

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

Trab
http://www.ncbi.nlm.nih.gov/pubmed/17684583

High RBC, hyper
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(76)91920-6/abstract

And here is info on the Graves' which I hope you don't have.

The criteria for Graves' is clinical. You must exhibit..........goiter, exophthalmos, pretibial myxedema and thyrotoxicosis as per Dr. Robert Graves' of the 1800 era. 3 out of the 4 qualify.

http://www.thyroidmanager.org/chapter/diagnosis-and-treatment-of-graves-disease/

Otherwise you are classified as hyperthyroid either because of Hashi's, the criteria for that being high TPO Ab and a grapelike appearance of the thyroid, both of which are "suggestive" because this is commonly seen in Hashi's with FNA (fine needle aspiration) confirming those suspicions "if" there are Hurthle Cells indigenous to Hashimoto's. Or because of cancer. We don't know which comes first, the hyperthyroid or the cancer. We just know that they are often found together.


----------



## titapwease (Aug 31, 2012)

Thanks for your quick reply. I have been diagnosed hyper for about eight years and am just now receiving the care I need. I have been on Tapazole a for about three weeks now, and Propranolol for about two months. My quest to the Endo started when I went to the ER for a dental abscess (which had my face looking like there were golf balls stuffed in it) and had the ER doc check my thyroid because I could tell it was out of whack.

They told me that my levels were high enough to admit me, but didn't because I wasn't running a temperature and was not incoherent. She prescribed Propranolol to control the symptoms until I could get to the clinic. I have been told on many occasions that I may have Graves but no absolute answer. I do have most, if not all of the clinical features of Graves.

Well, after the ER visit she called in some favors, to get me in the outpatient clinic because I had no insurance at the time. I am now insured with my local DHHR and was referred to who is now my ENDO. Both the ER and the clinic told me the same thing, "This is going to kill you". My Endo told me yesterday that I was almost into thyroid storm.

I have a substantial sized goiter, and have had for the whole eight years after diagnosis. They performed an Uptake Scan shortly before I got into the Endo's office, and I saw the scan myself which showed no nodules; but was characteristic of Graves. With that said, when I first saw my Endo, she found what I believe to be a palpable nodule close to the isthmus. From here, she scheduled an ultrasound. Of course, I was worried about the results; seeing as how it didn't show on the uptake. I called her office for two days until she finally called back and said "Nothing to worry about".

She is a good doctor; but she doesn't give me the answers I want to know. Yesterday, the visit went like this..."You were going into thyroid storm; how are you feeling?" I feel better I reply. "Remember what I told you about getting pregnant while on this drug?" Yes. "Okay, I may need to change your medicine. We will see you in three weeks. I will call you tomorrow if we need to make any changes."


----------



## Andros (Aug 26, 2009)

titapwease said:


> Thanks for your quick reply. I have been diagnosed hyper for about eight years and am just now receiving the care I need. I have been on Tapazole a for about three weeks now, and Propranolol for about two months. My quest to the Endo started when I went to the ER for a dental abscess (which had my face looking like there were golf balls stuffed in it) and had the ER doc check my thyroid because I could tell it was out of whack.
> 
> They told me that my levels were high enough to admit me, but didn't because I wasn't running a temperature and was not incoherent. She prescribed Propranolol to control the symptoms until I could get to the clinic. I have been told on many occasions that I may have Graves but no absolute answer. I do have most, if not all of the clinical features of Graves.
> 
> ...


From what you say, you are lucky to be with us and sadly, Grave's just does a number on the dental health also.

If I could do it all over, I would go straight on to surgery and get it over w/. I tried Tapazole for 18 months and for me, it was just a different kind of sick. That was my personal experience on anti-thyroid med.

I did have RAI but I had to have it 3 times as I was in advanced state. I in fact did have thryoid storm and that is how I "finally" got a diagnoses have been fluffed off for over 20 years by a myriad of doctors.

We are here for you. Hope you start to feel better. You do need to make sure you don't have cancer.


----------



## webster2 (May 19, 2011)

I agree, it is a wonder you are still here. I had a storm after being told for years my symptoms were all attributed to menopause, so no treatment except the offer of anti-depressants. The latest endo feels I have had Graves for a long time, perhaps as far back as the original thyroidectomy. The final surgery has been a blessing, I wish I had a total 22 years ago.

I am glad you have found your way to our community. There is a lot of inof and support here. Welcome!


----------



## titapwease (Aug 31, 2012)

Thanks guys! Most of my family does not know what I am going through. It really helps to talk to people that do. :hugs: It is crazy but, before I went to the doctor I felt death near. It took every ounce of my being to get out of bed in the mornings, I was ready to rip everyone's head off around me, and I couldn't even play with my kids. I shook all over and my pulse was around 115 resting. To top all that off; I couldn't sleep yet, needed to sleep all the time (if that makes sense). Guess you could say I was extremely fatigued.

As stated, I have been like this for about 8 years that I know for sure. If you want to be honest, I think I have been suffering most of my life. I could eat a horse growing up and never gained a pound. I wish I wouldn't have waited so long; but I had no insurance and wasn't able to receive any till' Obamacare was passed. As we all all know; no specialist will see you without cash or insurance.

I am a bit perturbed that my doctor has not really discussed anything with me. When she found the nodule she mentioned FNA and ultrasound. Well, we did the ultrasound but she has not mentioned the FNA. All she said about the ultrasound was nothing to worry about I will discuss it with you on your next appointment. I however, got pushed out the door without so much as a peep about the ultrasound. She hasn't told me if it is Graves for sure and she hasn't said what the next step will be. You can bet you life though, she will tell me in three weeks.


----------



## webster2 (May 19, 2011)

I understand completely how you feel. The fatigue is unbelievable. I had grown accustomed to it, that and being a stark raving lunatic. On the last day I remember before the storm, I was trying to shower and just laid down in the tub hoping for some strength to get out.

It will get better, hopefully, soon. I am glad you are able to see a doctor now. Hang in there!


----------



## titapwease (Aug 31, 2012)

I am so glad you survived storm! Was someone there to help you? Could you walk? I am curious because, there was a time about a year back; that I could not get out of bed for five days.


----------



## webster2 (May 19, 2011)

Yes, I had help. My poor husband was there. I was really out of it and don't recall the exact details about how things happened. The day before, I got really sweaty, cranky, out of breath, was reall shaky and incoherent. I had no clue what was happening. I did have a spell just before surgery that I could not get out of bed for three days. It is pretty scary.

I am glad you are getting treatment and will be back to enjoying life soon. Graves stinks!


----------



## webster2 (May 19, 2011)

I do remember that it started as a respiratory or some tyrpe of lung infection and just spiraled out of control.


----------



## titapwease (Aug 31, 2012)

webster2 said:


> Yes, I had help. My poor husband was there. I was really out of it and don't recall the exact details about how things happened. The day before, I got really sweaty, cranky, out of breath, was reall shaky and incoherent. I had no clue what was happening. I did have a spell just before surgery that I could not get out of bed for three days. It is pretty scary.
> 
> I am glad you are getting treatment and will be back to enjoying life soon. Graves stinks!


Those symptoms sound like me on any given day lol. I am glad your husband was there, or it could have turned bad real fast! I had to miss five days of work, and had to have my bf help me with the kids. I literally could not move from the bed. I was horrible! I ultimately, lost my job because I was so grouchy; and couldn't control my outbursts. There have been mornings; I get up and feel like the life has been sucked right out of me.

I was finally starting to experience slight delirium, when I went to the ER. I couldn't concentrate and was confused. I'm guessing, the thyroid coupled with the abscess. My vision has changed as well. I cannot see at night very well and I see flashes of light sometimes. They have even said it is working on my liver.


----------



## titapwease (Aug 31, 2012)

Andros said:


> From what you say, you are lucky to be with us and sadly, Grave's just does a number on the dental health also.
> 
> If I could do it all over, I would go straight on to surgery and get it over w/. I tried Tapazole for 18 months and for me, it was just a different kind of sick. That was my personal experience on anti-thyroid med.
> 
> ...


Your concern means a lot to me. It is definitely a struggle to function everyday.

I would love to opt for the surgery! I would do it in a New York minute. I can't understand why my nodule did not show up on the uptake. It is either hyper-functioning at the same level as my thyroid or it is a different type of cell. When she felt it, she mumbled...Why didn't they find this; and then left the room a few minutes to go look at my scan. :sad0049: I still think there is more than she is telling me!

My diagnosis was made when I had to have emergency surgery. I went into hospital with severe stomach cramps. Turns out, I had a ruptured right fallopian tube and a grapefruit sized cyst on my left ovary. When I woke from surgery; the nurse came in and told me that they had trouble getting the respirator in, and when they finally did get it in a goiter came to the surface.


----------



## Andros (Aug 26, 2009)

titapwease said:


> Thanks guys! Most of my family does not know what I am going through. It really helps to talk to people that do. :hugs: It is crazy but, before I went to the doctor I felt death near. It took every ounce of my being to get out of bed in the mornings, I was ready to rip everyone's head off around me, and I couldn't even play with my kids. I shook all over and my pulse was around 115 resting. To top all that off; I couldn't sleep yet, needed to sleep all the time (if that makes sense). Guess you could say I was extremely fatigued.
> 
> As stated, I have been like this for about 8 years that I know for sure. If you want to be honest, I think I have been suffering most of my life. I could eat a horse growing up and never gained a pound. I wish I wouldn't have waited so long; but I had no insurance and wasn't able to receive any till' Obamacare was passed. As we all all know; no specialist will see you without cash or insurance.
> 
> I am a bit perturbed that my doctor has not really discussed anything with me. When she found the nodule she mentioned FNA and ultrasound. Well, we did the ultrasound but she has not mentioned the FNA. All she said about the ultrasound was nothing to worry about I will discuss it with you on your next appointment. I however, got pushed out the door without so much as a peep about the ultrasound. She hasn't told me if it is Graves for sure and she hasn't said what the next step will be. You can bet you life though, she will tell me in three weeks.


Yes; garner all the info you can from what we have to offer here. Lots of very very good stuff that will help you advocate for yourself.

Push the FNA thing and if you have to scream cancer, do so. You will get someone's attention this way. I hate to take these tactics but sometimes it is necessary.

From what you told me, you have Graves'.

You may be interested in this; I am pretty sure you will be.

http://www.thyroidmanager.org/

Go armed and ready is my motto!


----------



## titapwease (Aug 31, 2012)

Wow, thanks! Great site; lots of info! Something tells me I will be on there all day.

I am not sure if you had a goiter, but if you did, did you ever have a metallic taste in your mouth? Also, I can feel mine grow larger and then shrink. When it shrinks, is when I usually get the weird tastes.


----------



## titapwease (Aug 31, 2012)

Also, reading the site you directed me to...my nodule is non-palpable. Which to me means, all the more reason to do the FNA.


----------



## webster2 (May 19, 2011)

You sure have been through the wringer. I hope you will get some attention very soon.

I nearly lost my job and my marriage because of my mood swings and outbursts.

It is really good to go to your appointment and be able to speak their language as well as be informed about Graves. Andros has given you a great link. She helped me so much with info, I was able to be an informed patient.

I'd pull out the cancer card to get the FNA, even if the results aren't cancer, it does seem like your thyroid needs to be dealt with ASAP.


----------



## titapwease (Aug 31, 2012)

I was wrong...my nodule is definitely palpable. It can be felt, but did not show up on RAIU.

I hope to get the ball rolling soon as well.

Kind of off topic; but still relevant, about 10 years ago I had an abnormal pap. They proceeded to do a colposcopy which came back showing HPV with mild to moderate dysplasia. I had to have a cone biopsy for removal of the pre-cancerous cells. I have had a few abnormal paps come back but are never bad enough to warrant any further testing. My last pap came back normal, and they say I don't need a pap till next year. So, I guess my question is; do you think that because I have had abnormal cell growth in the past, albeit, in the southern region, that my body would be more apt to develop abnormal thyroid tissue?


----------

