# No diagnosis - need help with labs



## ksgal (Nov 19, 2010)

Hello everyone! I am a newbie just beginning to venture into the wonderful world of thyroid issues.

I have been dealing with not feeling well for quite awhile and have been to numerous doctors in an attempt to figure out just why I feel so bad. My only official diagnosis thus far has been fibro and I always felt like that was just what they told me because I didn't fit any of their other models.

I did find one doctor to do some testing on my thyroid but he determined I did not have a problem with it at that time - a year and ½ ago. This doctor put me on cortef and vitamin D but he passed away suddenly recently and kind of left me wondering what to do. I had a new doctor move to where I live and decided to give her a try. I am currently taking the vitamin D but not cortef. This new doctor does not think I have a problem with low cortisol.

She had blood work done (although not as much as I would like) and had a sonogram of my thyroid. They found a multi nodular goiter and I am schedule to see an ENT on December 16 unless I can get in sooner. I am not really sure what that could lead to. I have listed the results from this bloodwork and testing from my last doctor that was a year and ½ ago. My sister had hashimoto's and passed away with ovarian cancer several years ago, my Dad had thyroid problems and took a pill each day but I am not sure what he had. I also had a grandma with a goiter that they had to remove part of - not sure about the official diagnosis on that one either.

I would very much appreciate your taking a look at my labs and give me some ideas as to where I should go from here. I would like to know if the ENT I am going to see will be heading me in the right direction or if I should try elsewhere.

Thanks for looking!!!

Bloodwork results (range in Parentheses):
Glucose 90. Mg/DL (65.-110.)
Urea Nitrogen 10. Mg/Dl (7.-20.)
Creatine .8 Mg/Dl (.7-1.5)
AST 16. U/L (15.-46.)
ALT 16. U/L (11.-66.)
Calcium 9.1 Mg/Dl (8.4-10.3)
Total Protien 6.9 g/dL (6.3-8.2)
Albumin 4. g/Dl (3.5-5.1)
ALKP 79. U/L (39.-126.)
Sodium 139. Mmol/L (137.-145.)
Potassium 4.1 mmol/L (3.6-5.0)
Chloride 106 mmol/L (89.-107.)
Carbon Dioxide 26. Mmol (22.-30.)

Cortisol - 4.9 mcg/dl (4.0-22) (last time tested a year and half ago it was 9.7 - same range)

Thyroid Peroxidase antibodies 516 IU/mL (<35.) (tested year and half ago)

T3, Free 292 pg/dl (230.-420.) tested year and half ago - not tested again
Vitamin d 19 ng/ml (20.-100.) was low year and half ago - not tested again
TSH now is 3.114 uIU/mL (.490-4.67)and was 2.627 year and half ago 
Free T4 is .83 ng/dL and was .96 year and half ago (.71-1.85)

They did an RA screen and it was negative.


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## Lovlkn (Dec 20, 2009)

Based on your TSH, T-3 and FT-4 a low dose of thyroid hormone replacement would be appropriate. If your current doctor will not prescribe try going to another doctor.

You are low on VitD and need to supplement that as well. Ask for a 12 week 50K IU dose then supplement daily afterward.


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## ksgal (Nov 19, 2010)

Thank you so much for the information! I will see what the doctor is willing to do.


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## Andros (Aug 26, 2009)

ksgal said:


> Hello everyone! I am a newbie just beginning to venture into the wonderful world of thyroid issues.
> 
> I have been dealing with not feeling well for quite awhile and have been to numerous doctors in an attempt to figure out just why I feel so bad. My only official diagnosis thus far has been fibro and I always felt like that was just what they told me because I didn't fit any of their other models.
> 
> ...


Holy cats, girl!!! Your TPO antibodies are sky-high. You absolutely have something autoimmune going on and I do suspect it is thyroid given the TSH and low FT4 and low FT3.

I am surprised you had the energy to type this. Albeit these labs are from over a year ago, is that right?

So glad to hear you are seeing an ENT and maybe you could get on a cancellation list and get in sooner?

No comments on the sonogram other than setting you up w/ the ENT? You don't know if you have solid nodules or the size of them or any other irregularities??

Welcome to the board. You will find plenty of help and support here.


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## ksgal (Nov 19, 2010)

I had wondered about the antibodies but wasn't really sure what they meant. As far as energy it is funny - sometimes I am barely able to go and other times not so bad. Most days I hurt so bad it is an effort to keep going.

Thanks for the reply! It gives me hope that they will be able to find something and help me out! Course I realize just because they find something doesn't mean that it won't be a long road to feeling better but at least I will know what is going on. Thanks again!


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## ksgal (Nov 19, 2010)

Realized I forgot some of the questions - that is a symptom I am having too! The antibodies test was from a year and 1/2 ago - I couldn't get this dr. convinced to run another this time. I am on the cancellation list so hopefully will get in soon. I don't know about the goiter other than it was multinodular and the doctor said it was very enlarged.


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## Andros (Aug 26, 2009)

ksgal said:


> I had wondered about the antibodies but wasn't really sure what they meant. As far as energy it is funny - sometimes I am barely able to go and other times not so bad. Most days I hurt so bad it is an effort to keep going.
> 
> Thanks for the reply! It gives me hope that they will be able to find something and help me out! Course I realize just because they find something doesn't mean that it won't be a long road to feeling better but at least I will know what is going on. Thanks again!


I think that you should consider having these tests run.

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

Antibodies usually cause inflammation (pain.)

Once you get good medical intervention, it does not take that long to feel better.


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## ksgal (Nov 19, 2010)

I will do some research on those tests and try and convinve the ENT to run them for me - unless (hopefully) he already suggests it! I am all for anything that will help me feel better!! Thanks!


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## Andros (Aug 26, 2009)

ksgal said:


> I will do some research on those tests and try and convinve the ENT to run them for me - unless (hopefully) he already suggests it! I am all for anything that will help me feel better!! Thanks!


We are here for you so keep us in the loop.


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## ksgal (Nov 19, 2010)

I am not always by a computer but will check back in when I can. Thanks!


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## Debbie from Milwaukee (Apr 18, 2010)

Hi--welcome to the board! Here is one thought: I wonder why your new primary doc put in a referral for an ENT doc rather than and endocrinologist. I know the specialties sometimes overlap, but I would think the ENT doc would only be interested in the goiter. When you do ask questions, be sure to communicate the family history with thyroid problems.

It is my understanding that the majority of thyroid disease is caused by autoimmune factors (thus the reason Andros advised you to be tested for all antibodies that affect the thyroid). Many people on this board have commented how either times of hormonal change and/or physical events (i.e., surgery, female hormone changes, immunizations, even stopping smoking) seem to kick-start a myriad of thyroid problems throughout life. It might be revealing to you to think back to when you remember your symptoms became worse and see if you had some sort of physical event going on.


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## ksgal (Nov 19, 2010)

I don't think my current doctor was concerned about the cortisol levels - mostly worried about the goiter right now. I thought they should send me to an endo also but I guess this will be a start.

I did have a problem with an ovarian cyst around the time I first had the problem - within a few months. There is a strong history of ovarian and other cancers in my family and I think I read that that can give you a higher chance of thyroid cancer. I will do some thinking and look at some dates.Thanks for idea - it seems that a lot of this "stuff" is connected and can be difficult to figure out.


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## lavender (Jul 13, 2010)

ksgal said:


> Hello everyone! I am a newbie just beginning to venture into the wonderful world of thyroid issues.
> 
> I have been dealing with not feeling well for quite awhile and have been to numerous doctors in an attempt to figure out just why I feel so bad. My only official diagnosis thus far has been fibro and I always felt like that was just what they told me because I didn't fit any of their other models.


Hi and welcome! I first had my thyroid issues identified 5 years ago, then nearly no follow up until I developed thyroid storm this past April. In the meantime, I was told that I have fibro as well. I felt much as you did, that I was just given a diagnosis that included very few treatment models because I didn't fit anything else and it gave the docs a reason to stop looking. It was as if I was given this diagnosis, told it was a real disease, and then when I bought anything to the attention of my docs, I was told it was the fibro, and basically dismissed without treatment or further testing.

I am particularly interested in some info I have seen about the link between fibromyalgia and thyroid hormone levels, particularly T3. When I looked at your labs, I saw that your Free T3 and Free T4, although "in range" were on the low side. I have a hunch that you would feel better with some replacement thyroid hormone.


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## ksgal (Nov 19, 2010)

Thanks Lavender! Do you have adrenal issues as well? It seems like it is very difficult to find a doctor that is willing to help deal with issues like this. I am surprised at the lack of understanding about thyroid problems. I look forward to being able to visit with those on this board and hope I will be able to get some help from the ENT I am going to see soon - although not soon enough!


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