# Labs - Thyroid related? lots of different lab work included.



## Chromatic

Hi guys,

I made a post in the main section about my symptoms so I won't repeat myself too much.

But I have a laundry list of symptoms that have been going on 24/7 for the last 4 years at least. (I am 32 now, so since 26/27 yrs old).

My mother is Hypothyroid and takes Armour Thyroid IIRC. (Other family history I just don't know about).

I have seen my Primary doctor about 8 times in the last 2 years..which, for me, is ALOT. I can't stand going in to see the doctor, dentist, etc. So I am really trying to reach and answer going that much. So as you can imagine a reasonable amount of tests have been run, but looking at the records I just received, it has 90% been the same "Metabolic panel" run over and over again.

I will list the tests and results here.

The reason I am here on the thyroid forums is because my symptoms are so diverse and spread across everywhere from mind to body.. and thyroid issues would explain alot.

I had to specifically ask for the thyroid check to be done at my last visit. I asked for a comprehensive check of my thyroid to 'rule it out or in'. He agreed, yet all that was checked was my TSH.

At any rate, the Thyroid Stimulating Hormone was : 0.24 ulu/mL

out of a reference range of [0.490 - 4.670]

So low, but the nurses never mentioned it -- "All your labs are normal except low vitamin D and high cholesterol... take fish oil." I just realized today the TSH level wasn't in range.

As I asked in the other post, apparently this 0.24 is still considered normal (remember no other tests ie: t3/t4, etc were ordered so those are unknown.) ?? Seems odd that this low level wouldn't at least spike curiosity to order a few more tests to check what my actual thyroid levels were. Or is that high enough to be "A-ok". I could almost understand if it was a routine test on someone who had no complaints,.. but I have a million complaints. Thoughts?

Here are the results of other tests -- None may have anything to do with Thyroid issues, but you experts out there may find a correlation with something. (I really appreciate anyone who reads this,.. time)

[brackets will indicate reference]

*Thyroid*

TSH 0.246 ulu/mL [0.490 - 4.670] ***Abnormal*

*Lipids*

Cholesterol - (I'm assuming total) -- 247 mg/dL [100 - 199mg/dL] ***Abnormal*
DHDL - 59.0 mg/dl [40 - 60 mg/dL]
TRIG - 167 mg/dL [<150mg/dL] ***Abnormal*
CHOL/HDL RATIO - 5.0 [0.0 - 3.0] ***Abnormal*
VLDL - 33.4 mg/dL [5.0 - 40.0 mg/dL]
LDL - 147.6 [0 - 100.0] ***Abnormal*

*Note: My diet surely impacts this, I have changed it in the past few months -- and this is the worst cholesterol numbers I could find out of all the lipid panels. I'm not about to have a heart attack, I just know there is a link with thyroid and cholesterol (I think)*

*CBC ** Platelets - Auto Diff *

WBC - 5.6 k/uL [3.7 - 10.1 k/uL]
NEUTROPHILS# - 3.3 [1.6 - 7.0]
NEUTROPHILS% - 59.3 [39.3 - 73.7]
LYMPH# - 1.9K/uL [1.1 - 3.0 K/uL]
LYMPH% - 33.9% [18.0 - 48.3 %]
MONO# - 0.3% [0.2 - 0.8%]
MONO% - 5.7 [4.4 - 12.7]
EOSINOPHILS# - 0.057 [0.000 - 0.080]
EOSINPHILS% - 4.1% [0.6 - 7.3 %]
BASOPHILS# - 0.057 [0.000 - 0.0080]
BASOPHILS% - 1.0% [0.0 - 1.7 %]
RBC - 4.01 m/uL [4.06 - 5.58 m/uL] ***Abnormal*
HGB - 12.1 g/dL [12.9 - 15.9 g/dL] ***Abnormal*
HCT - 35.4% [37.7 - 53.7 %] _***Abnormal*_
MCV 0 88.3 fL [81.1 - 96.0 fL]
MCH 30.2 pg [27.0 - 31.2 pg]
MCHC 34.2 g/dL [31.8 - 35.4 g/dL]
PLT 261.7 k/M [155.0 - 366.0 kM]

*GGT GAMMA GLUTAMYLTRANSFERASE*

GGTP 45.0 U/L [15.0 -73.0 U/L]

*Metabolic Panel ** Comprehensive*

ALB - 4.7 g/dL [3.5 - 5.0 g/dL]
ALK PHOS - 86 u/L [38 - 126 u/L]
ALT - 37 u/L [21.0 - 72.0 u/L]
AST - 40.0 u/L [17.0 - 59.0 u/L]
BILI TOTAL - 0.7mg/dL [0.2 - 1.3 mg/dL]
BUN - 16mg/dL [9 - 20 mg/dL]
CALCIUM - 10.2 mg/dL [8.4 - 10.5 mg/dL]
GLOBULIN - 2.2
CHLORIDE - 102mmol/L [98 - 107 mmol/L]
CREATININE - 1.0mg/dL [0.7 - 1.2 mg/dL]
ECO2 - 28 mmol/L [22 - 30 mmol/L]
GLUCOSE - 92mg/dL [74 - 99 mg/dL]
POTASSIUM - 5.0 mmol/L [3.5 -5.1 mmol/L]
SODIUM - 141 mmol/L [137 - 145 mmol/L]
TOTAL PROTEIN - 7.8 g/dL [6.2 - 8.3 g/dL]
BUN/CREATININE - 13.3 [6 - 22]
A/G RATIO - 1.5 [1.1 - 2.5]
GFR - 75.1

*Other non *routine* testing over 2 years:*

Temperature - between 96.5 - 97.4 degrees F ***Why always low?*
Iron, Serum - 56 ug/dL [40 - 155 ug/dL]
RA LAtex Turbid - 7.0 IU/mL [0.0 - 13.9 IU/mL]
Folate Serum - 10.0 ng/mL [>3.0 ng/mL]
SED Rate - 4.0mm/hour [0.0 - 30.0 mm/hour]
HLA-B27 Antigen only - Negative
Vitamin B12 - 417pg/mL [211 - 946 pg/mL]
ANA Direct - Negative
Vitamin D - 14.6 ng/mL [32 - 100.00 ng/ML] * **Abnormal*

I honestly don't know what has any relation/correlation to thyroid disorders, I know science is discovering alot more is systemic than we ever thought, so I'm sure there is a relationship with at least a few of these items.

Most of it I'm sure can be ignored.

It seems like alot of testing, but in reality the bulk of it is routine testing, most of what isn't routine is/are the 5-6 things I included at the end, and perhaps the TSH.

Thanks for your thoughts on my labs,.. especially the abnormal values -- which I think for the most part are really unremarkable aside from the Vitamin D, and I *think* the low TSH.

Oh yeah -- These are from 2010.

I have a reference of Thyroid Labs from 1999, roughly 10 years ago which may help at least reference the TSH.

In 1999 I had these taken because I had a sudden onset of anxiety and insomnia,.. this doctor was fantastic but moved out of state since. Those labs:

*1999 - Thyroid Panel:*

Thyroxine - 7.1 MCG/DL [4.5-12.0]
T-Uptake 34.89 % [25 38]

*TSH - 1.40 UIU/ML [0.47 -5.01]*

Free T4 - 0.95 NG/DL [0.71-1.85]
Reverse T3 - 15 NG/DL [10-50]

**Again the above 5 values are from *1999* for reference**

Not sure if having a reference like this is of any value, you can tell me. But it all looked good then, even the TSH. Does TSH fluctuate I wonder from 1.4 to 0.2 normally?

Thanks for scanning over this..

Chromatic


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## Andros

Chromatic said:


> Hi guys,
> 
> I made a post in the main section about my symptoms so I won't repeat myself too much.
> 
> But I have a laundry list of symptoms that have been going on 24/7 for the last 4 years at least. (I am 32 now, so since 26/27 yrs old).
> 
> My mother is Hypothyroid and takes Armour Thyroid IIRC. (Other family history I just don't know about).
> 
> I have seen my Primary doctor about 8 times in the last 2 years..which, for me, is ALOT. I can't stand going in to see the doctor, dentist, etc. So I am really trying to reach and answer going that much. So as you can imagine a reasonable amount of tests have been run, but looking at the records I just received, it has 90% been the same "Metabolic panel" run over and over again.
> 
> I will list the tests and results here.
> 
> The reason I am here on the thyroid forums is because my symptoms are so diverse and spread across everywhere from mind to body.. and thyroid issues would explain alot.
> 
> I had to specifically ask for the thyroid check to be done at my last visit. I asked for a comprehensive check of my thyroid to 'rule it out or in'. He agreed, yet all that was checked was my TSH.
> 
> At any rate, the Thyroid Stimulating Hormone was : 0.24 ulu/mL
> 
> out of a reference range of [0.490 - 4.670]
> 
> So low, but the nurses never mentioned it -- "All your labs are normal except low vitamin D and high cholesterol... take fish oil." I just realized today the TSH level wasn't in range.
> 
> As I asked in the other post, apparently this 0.24 is still considered normal (remember no other tests ie: t3/t4, etc were ordered so those are unknown.) ?? Seems odd that this low level wouldn't at least spike curiosity to order a few more tests to check what my actual thyroid levels were. Or is that high enough to be "A-ok". I could almost understand if it was a routine test on someone who had no complaints,.. but I have a million complaints. Thoughts?
> 
> Here are the results of other tests -- None may have anything to do with Thyroid issues, but you experts out there may find a correlation with something. (I really appreciate anyone who reads this,.. time)
> 
> [brackets will indicate reference]
> 
> *Thyroid*
> 
> TSH 0.246 ulu/mL [0.490 - 4.670] ***Abnormal*
> 
> *Lipids*
> 
> Cholesterol - (I'm assuming total) -- 247 mg/dL [100 - 199mg/dL] ***Abnormal*
> DHDL - 59.0 mg/dl [40 - 60 mg/dL]
> TRIG - 167 mg/dL [<150mg/dL] ***Abnormal*
> CHOL/HDL RATIO - 5.0 [0.0 - 3.0] ***Abnormal*
> VLDL - 33.4 mg/dL [5.0 - 40.0 mg/dL]
> LDL - 147.6 [0 - 100.0] ***Abnormal*
> 
> *Note: My diet surely impacts this, I have changed it in the past few months -- and this is the worst cholesterol numbers I could find out of all the lipid panels. I'm not about to have a heart attack, I just know there is a link with thyroid and cholesterol (I think)*
> 
> *CBC ** Platelets - Auto Diff *
> 
> WBC - 5.6 k/uL [3.7 - 10.1 k/uL]
> NEUTROPHILS# - 3.3 [1.6 - 7.0]
> NEUTROPHILS% - 59.3 [39.3 - 73.7]
> LYMPH# - 1.9K/uL [1.1 - 3.0 K/uL]
> LYMPH% - 33.9% [18.0 - 48.3 %]
> MONO# - 0.3% [0.2 - 0.8%]
> MONO% - 5.7 [4.4 - 12.7]
> EOSINOPHILS# - 0.057 [0.000 - 0.080]
> EOSINPHILS% - 4.1% [0.6 - 7.3 %]
> BASOPHILS# - 0.057 [0.000 - 0.0080]
> BASOPHILS% - 1.0% [0.0 - 1.7 %]
> RBC - 4.01 m/uL [4.06 - 5.58 m/uL] ***Abnormal*
> HGB - 12.1 g/dL [12.9 - 15.9 g/dL] ***Abnormal*
> HCT - 35.4% [37.7 - 53.7 %] _***Abnormal*_
> MCV 0 88.3 fL [81.1 - 96.0 fL]
> MCH 30.2 pg [27.0 - 31.2 pg]
> MCHC 34.2 g/dL [31.8 - 35.4 g/dL]
> PLT 261.7 k/M [155.0 - 366.0 kM]
> 
> *GGT GAMMA GLUTAMYLTRANSFERASE*
> 
> GGTP 45.0 U/L [15.0 -73.0 U/L]
> 
> *Metabolic Panel ** Comprehensive*
> 
> ALB - 4.7 g/dL [3.5 - 5.0 g/dL]
> ALK PHOS - 86 u/L [38 - 126 u/L]
> ALT - 37 u/L [21.0 - 72.0 u/L]
> AST - 40.0 u/L [17.0 - 59.0 u/L]
> BILI TOTAL - 0.7mg/dL [0.2 - 1.3 mg/dL]
> BUN - 16mg/dL [9 - 20 mg/dL]
> CALCIUM - 10.2 mg/dL [8.4 - 10.5 mg/dL]
> GLOBULIN - 2.2
> CHLORIDE - 102mmol/L [98 - 107 mmol/L]
> CREATININE - 1.0mg/dL [0.7 - 1.2 mg/dL]
> ECO2 - 28 mmol/L [22 - 30 mmol/L]
> GLUCOSE - 92mg/dL [74 - 99 mg/dL]
> POTASSIUM - 5.0 mmol/L [3.5 -5.1 mmol/L]
> SODIUM - 141 mmol/L [137 - 145 mmol/L]
> TOTAL PROTEIN - 7.8 g/dL [6.2 - 8.3 g/dL]
> BUN/CREATININE - 13.3 [6 - 22]
> A/G RATIO - 1.5 [1.1 - 2.5]
> GFR - 75.1
> 
> *Other non *routine* testing over 2 years:*
> 
> Temperature - between 96.5 - 97.4 degrees F ***Why always low?*
> Iron, Serum - 56 ug/dL [40 - 155 ug/dL]
> RA LAtex Turbid - 7.0 IU/mL [0.0 - 13.9 IU/mL]
> Folate Serum - 10.0 ng/mL [>3.0 ng/mL]
> SED Rate - 4.0mm/hour [0.0 - 30.0 mm/hour]
> HLA-B27 Antigen only - Negative
> Vitamin B12 - 417pg/mL [211 - 946 pg/mL]
> ANA Direct - Negative
> Vitamin D - 14.6 ng/mL [32 - 100.00 ng/ML] * **Abnormal*
> 
> I honestly don't know what has any relation/correlation to thyroid disorders, I know science is discovering alot more is systemic than we ever thought, so I'm sure there is a relationship with at least a few of these items.
> 
> Most of it I'm sure can be ignored.
> 
> It seems like alot of testing, but in reality the bulk of it is routine testing, most of what isn't routine is/are the 5-6 things I included at the end, and perhaps the TSH.
> 
> Suspect low temp because ferritin is probably low. Maybe.
> 
> Thanks for your thoughts on my labs,.. especially the abnormal values -- which I think for the most part are really unremarkable aside from the Vitamin D, and I *think* the low TSH.
> 
> Oh yeah -- These are from 2010.
> 
> I have a reference of Thyroid Labs from 1999, roughly 10 years ago which may help at least reference the TSH.
> 
> In 1999 I had these taken because I had a sudden onset of anxiety and insomnia,.. this doctor was fantastic but moved out of state since. Those labs:
> 
> *1999 - Thyroid Panel:*
> 
> Thyroxine - 7.1 MCG/DL [4.5-12.0]
> T-Uptake 34.89 % [25 38]
> 
> *TSH - 1.40 UIU/ML [0.47 -5.01]*
> 
> Free T4 - 0.95 NG/DL [0.71-1.85]
> Reverse T3 - 15 NG/DL [10-50]
> 
> **Again the above 5 values are from *1999* for reference**
> 
> Not sure if having a reference like this is of any value, you can tell me. But it all looked good then, even the TSH. Does TSH fluctuate I wonder from 1.4 to 0.2 normally?
> 
> Thanks for scanning over this..
> 
> Chromatic


There are other medical conditions that cause some of the abnormal results listed but they also are "all" common with thyroid.

Cholesterol............................yes.

CBC......................................yes (get Ferritin test; most of us w/TD have low ferritin.
Ferritin http://www.thewayup.com/newsletters/081504.htm

Also, in men....................testosterone is usually low w/thyroid disease.


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## Chromatic

Andros said:


> There are other medical conditions that cause some of the abnormal results listed but they also are "all" common with thyroid.
> 
> Cholesterol............................yes.
> 
> CBC......................................yes (get Ferritin test; most of us w/TD have low ferritin.
> Ferritin http://www.thewayup.com/newsletters/081504.htm
> 
> Also, in men....................testosterone is usually low w/thyroid disease.


I knew cholesterol was/is -- Is the high cholesterol common with both hyper and hypo?

Also, can it be possible to be Hypo but have a low TSH test for some different reason?

I did have ferritin tested, I forgot to add it, it wasn't out of range:

Ferritin, Serum - 165 ng/mL [30 - 400 ng/mL]

*That has a huge range..

Also, if anyone else reads this -- Is 0.24 out of [.5 - 5.0] TSH .. even though it is abnormal, really something that is rarely ever a problem and is why the doctor didn't mention it?

Gracious,


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## Chromatic

Ok I had several more labs run -- and while they all fall within reference range I am rather confused especially on the antibodies.

*T4,Free*(Direct) *1.38* ng/dL 0.82-1.77

*TSH* *0.7*67 uIU/mL 0.450-4.500

*TSI* Thyroid Stim Immunoglobulin *70* % 0-139

Thyroid Peroxidase (*TPO*) Ab *7* IU/mL 0-34

*Antithyroglobulin Ab* *<20 *IU/mL 0-40 
Siemens (DPC) ICMA Methodology

*Free T3* Triiodothyronine,Free,Serum *4.3* pg/mL 2.0-4.4

From what I read here on this forum.. having any TSI is indicative of a problem. You shouldn't have it. However, it doesn't make sense if there is a 'normal reference range' if it isn't normal that have it. It should be more of a positive or negative, than give your value to judge how 'bad' or much is present. Anyhow I apparently have a level of 70 TSI.

I also have the TPO Antibodies.. at 7.

In range, but I have both TSI and TPO?

The other antibody of <20 I assume means something is there but the testing method just gives a result of less than some large number. Shrug.

The only other oddity was my Free T3 was but .1 from being out of range on the hyper side. At 4.3 out of a range of 2.0 to 4.4. This significant in relation to other labs or not?

I'm basically trying to see if these labs say, ok -- You have nothing wrong with the thyroid at all.. move on to something else.. or if there is something that is definitely not right with these group of numbers.

Remember my TSH about 5 months ago was .24 (out of a range of .5 - 5.0 ) -- So it *was* out of range, now is in range at .7 or so.

Any help figuring this out would be great.

Is it just normal to have the antibodies I do? Since my T3 is at 4.3, is that a good thing?

Thanks,


----------



## Andros

Chromatic said:


> Ok I had several more labs run -- and while they all fall within reference range I am rather confused especially on the antibodies.
> 
> *T4,Free*(Direct) *1.38* ng/dL 0.82-1.77
> 
> *TSH* *0.7*67 uIU/mL 0.450-4.500
> 
> *TSI* Thyroid Stim Immunoglobulin *70* % 0-139
> 
> Thyroid Peroxidase (*TPO*) Ab *7* IU/mL 0-34
> 
> *Antithyroglobulin Ab* *<20 *IU/mL 0-40
> Siemens (DPC) ICMA Methodology
> 
> *Free T3* Triiodothyronine,Free,Serum *4.3* pg/mL 2.0-4.4
> 
> From what I read here on this forum.. having any TSI is indicative of a problem. You shouldn't have it. However, it doesn't make sense if there is a 'normal reference range' if it isn't normal that have it. It should be more of a positive or negative, than give your value to judge how 'bad' or much is present. Anyhow I apparently have a level of 70 TSI.
> 
> I also have the TPO Antibodies.. at 7.
> 
> In range, but I have both TSI and TPO?
> 
> The other antibody of <20 I assume means something is there but the testing method just gives a result of less than some large number. Shrug.
> 
> The only other oddity was my Free T3 was but .1 from being out of range on the hyper side. At 4.3 out of a range of 2.0 to 4.4. This significant in relation to other labs or not?
> 
> I'm basically trying to see if these labs say, ok -- You have nothing wrong with the thyroid at all.. move on to something else.. or if there is something that is definitely not right with these group of numbers.
> 
> Remember my TSH about 5 months ago was .24 (out of a range of .5 - 5.0 ) -- So it *was* out of range, now is in range at .7 or so.
> 
> Any help figuring this out would be great.
> 
> Is it just normal to have the antibodies I do? Since my T3 is at 4.3, is that a good thing?
> 
> Thanks,


It makes sense to have a range because that is the only way to detect movement. Otherwise, there is no use for the range for the person should not have any TSI.

As you know, I am not surprised. Your TSH and FREE T3 also reflect hyper state.

Just because your FT3 is slightly below the top of the range does not mean you are not hyper. FT3 as well as the other hormones fluctuate on an hourly basis. I am sure FT3 has been over the top a time or two.

My next recommendation to you is to get RAIU. You need to know the rate of uptake and also to rule out cancer. Sadly, men are more prone to have thyroid cancer and also cancer and hyperthyroid are often found as bedmates.

men more likely to have cancer than women
http://www.umm.edu/endocrin/thytum.htm

Thyroid cancer, cold nodules, men, uptake etc.
http://www.aafp.org/afp/2003/0201/p559.html

Thyrotoxicosis and cancer
http://lib.bioinfo.pl/pmid:2261908

Graves' and Hashi's cancer
http://www.thyroidmanager.org/Chapter18/18-cancothr.htm

You only have a "smattering" of Thyroglobulin Ab which is a good thing but still..................

A negative test is normal. A negative test means no antibodies to thyroglobulin are found in your blood.

Normal value ranges may vary slightly among different laboratories. Talk to your doctor about the meaning of your specific test results.

http://www.nlm.nih.gov/medlineplus/ency/article/003557.htm

Let me know what you think of my comments. I like to err on the side of caution. Better to be safe than sorry.


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## Chromatic

Andros said:


> It makes sense to have a range because that is the only way to detect movement. Otherwise, there is no use for the range for the person should not have any TSI.


Well I would surmise that previous lab tests based on new lab tests over time detect movement.. BUT, it makes sense to have a range because labs are all a little different..

I just am confused .. so I am abosolutely not supposed to have any TSI ,.. and my 70 definitely points to something wrong right?

Cause you know how ranges are.. in 'range' doctors tend to ignore of course.



> As you know, I am not surprised. Your TSH and FREE T3 also reflect hyper state.
> 
> Just because your FT3 is slightly below the top of the range does not mean you are not hyper. FT3 as well as the other hormones fluctuate on an hourly basis. I am sure FT3 has been over the top a time or two.


Yeah.. I thought that was logical, anything that is near low or high is very logically gone over it.. and perhaps a considerable amount. My TSH moved quite a bit in two months.. relatively.. but still only .5 tenths of a point.

Dose the T4 number bring any thoughts to mind in regards to the rest of results? Or is there just nothing remarkable about it.. looks pretty bland to me. Isn't a hyperthyroid trending state both high T4 and T3 (free).. ? When untreated.



> My next recommendation to you is to get RAIU. You need to know the rate of uptake and also to rule out cancer. Sadly, men are more prone to have thyroid cancer and also cancer and hyperthyroid are often found as bedmates.


I will look into this.. I Need to get a doctor on board who is as convinced as you and I are. I need to psyche myself up and hear from you guys as to whether this is something that I can be forceful that there is a problem given results.. going in on the fence just doesn't cut it with doctors I've found, for obvious reasons.



> You only have a "smattering" of Thyroglobulin Ab which is a good thing but still..................
> 
> A negative test is normal. A negative test means no antibodies to thyroglobulin are found in your blood.


Yeah, it is low. I have read that elevated TSI and low TPO is traditional Hyper..

As for thyroglobulin and the <20 for a range.. Does that mean it is above zero but just unable to zero in in where it is between 1 and 20?



> Normal value ranges may vary slightly among different laboratories. Talk to your doctor about the meaning of your specific test results.


This I know, but you know I need to go in educated.. Wouldn't most endo's and doctors in general throw these results with little regard because they look normal? I need to be able to say this is why I've learned/researched it is abnormal (besides my symptoms).



> Let me know what you think of my comments. I like to err on the side of caution. Better to be safe than sorry.


SOmetimes I can't tell if you have some macro's or copy and paste at the end of your posts.. but I like your comments,.. of course, you do a great service. And I do realize you do tend to err on the side of caution -- a trait many doctors do not.

I just don't want to try to make a big deal out of something that isn't a problem is all.. so need information and some relative backing is all. 

Thanks of course.


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## lainey

Chromatic said:


> Ok I had several more labs run -- and while they all fall within reference range I am rather confused especially on the antibodies.
> 
> *T4,Free*(Direct) *1.38* ng/dL 0.82-1.77
> 
> *TSH* *0.7*67 uIU/mL 0.450-4.500
> 
> *TSI* Thyroid Stim Immunoglobulin *70* % 0-139
> 
> Thyroid Peroxidase (*TPO*) Ab *7* IU/mL 0-34
> 
> *Antithyroglobulin Ab* *<20 *IU/mL 0-40
> Siemens (DPC) ICMA Methodology
> 
> *Free T3* Triiodothyronine,Free,Serum *4.3* pg/mL 2.0-4.4


Was it the GP that you got to run these tests?

The combination of TSI and high free T3 means hyper. You may not be clearly there yet, there is no telling if or when you will become more clearly clinically hyper. What you must do is repeat the blood testing until things move in one direction or another.

If you have not seen an endo with these results, now is the time to do so. Yes, they are in range, but you are also symptomatic and wish to set up a followup schedule.



Chromatic said:


> I also have the TPO Antibodies.. at 7.
> 
> In range, but I have both TSI and TPO?
> 
> The other antibody of <20 I assume means something is there but the testing method just gives a result of less than some large number. Shrug.


Yes, there are blocking and stimulating antibodies, and it is not uncommon to have both. Which one is dominant influences the thyroid function--at the moment for you the stimulating seem to be dominant. Some people produce enough of both to stay stable, some have levels that swing dramatically. The point of the follow up is to measure all of these, to see which direction you seem to be headed.



Chromatic said:


> Is it just normal to have the antibodies I do? Since my T3 is at 4.3, is that a good thing?


The TPO and thyroblobulin can occur naturally in a person who has not developed a thyroid condition--they can indicate the potential for a problem, but not necessarily that there is one. Generally, the antibodies work as part of the autoimmune process to attack--in this case they thyroid--but it does not always pan out that way, or work in predictable manner--people may have antibodies and not much evidence for damage to their thyroid based on their testable levels.

As for THYCA and men, keep in mind that in general terms, the percentages are skewed because women are about 8 times more likely than men to have a thyroid problem to start with, and thyroid problems generally increase your risk of cancer. The primary reason for having the uptake is to see if your thyroid is behaving as if it is hyper, and to see if there are nodules, if any.

No, the high Free T3, in combination with the TSI is not a good thing. Free T3 over the range means hyperthyroid.


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## Chromatic

lainey said:


> Was it the GP that you got to run these tests?


No. I ordered the labs myself and paid out of pocket to avoid the hassle of whether the GP would run the tests I 'dictated" or not. I wanted to get a better picture.



> The combination of TSI and high free T3 means hyper. You may not be clearly there yet, there is no telling if or when you will become more clearly clinically hyper. What you must do is repeat the blood testing until things move in one direction or another.


Indeed -- well TSH is the only thing I know that has moved,.. but testing is expensive either way -- what has to be done has to be done. As we chatted, I have to find a doctor who is willing to treat and investigate.



> If you have not seen an endo with these results, now is the time to do so. Yes, they are in range, but you are also symptomatic and wish to set up a followup schedule.


Even without my confidence my thyroid is creating any problems I suppose I still need to investigate this. This is my main question, and I was hoping these labs I paid for would sort of 'settle the score' on yes big problem. .or no, no problem. Seems I'm stuck in the same position before I had them done .



> Yes, there are blocking and stimulating antibodies, and it is not uncommon to have both. Which one is dominant influences the thyroid function--at the moment for you the stimulating seem to be dominant. Some people produce enough of both to stay stable, some have levels that swing dramatically. The point of the follow up is to measure all of these, to see which direction you seem to be headed.


But I shouldn't have these antibodies to start with, (so some say and others not so much) -- So my thyroid is having some level of moderate issues regardless. IE: "Subclinical Hyperthyroidism or similar". Shrug.

My symptoms are so severe if lab results are directly proportionate to how much you are suffering then this seems a little unlikely to be the cause.



> The TPO and thyroblobulin can occur naturally in a person who has not developed a thyroid condition--they can indicate the potential for a problem, but not necessarily that there is one. Generally, the antibodies work as part of the autoimmune process to attack--in this case they thyroid--but it does not always pan out that way, or work in predictable manner--people may have antibodies and not much evidence for damage to their thyroid based on their testable levels.


These both were relatively low -- The TSI smack dab in the middle of the reference range which is in percent..

But it is pounded out that any level of TSI = not normal. But when I ask around, people agree that a doctor very well could see the antibodies present and all the labs and shrug it off as no thyroid issue because my TSI isn't say, 450, and my TSH isn't say.. 0.00001 and my FT3 isn't 32 or some equally just obvious diagnosis.



> As for THYCA and men, keep in mind that in general terms, the percentages are skewed because women are about 8 times more likely than men to have a thyroid problem to start with, and thyroid problems generally increase your risk of cancer. The primary reason for having the uptake is to see if your thyroid is behaving as if it is hyper, and to see if there are nodules, if any.


That is a good point. Women, with most disease tend to be 5-10x more common. Not sure why,.. but it works in reverse as well. When diseases are predominately found in women, a man with the symptoms gets blown off as it isn't 'typically' seen on a regular basis.

But, I certainly hope I don't have cancer. But it just irks me that doctors will likely just ignore my results, and you guys say it may be indicative of possible cancer. I mean, come on! I suppose this is just the difference in opinion/experience of those here vs. the mainstream of physicians.

Most people say ask your doctor, trust your doctor and so on.. but I am first hand witness that not only do they get it wrong sometimes.. the are very fallible, and some I've seen are just morons. I literally explained things to them that they didn't know about basic anatomy. (This is just unexcusable) -- But I digress..



> No, the high Free T3, in combination with the TSI is not a good thing. Free T3 over the range means hyperthyroid.


At best my results so far would indicate subclinical Hyperthyroidism. With TSH at one reading being abnormally low.. and the TSI existing, with my T3 being 'high' (although just squeezing into range this test).

IE: subclinical hypothyroidism would be something like a TSH of 3.5 - 4.9 or so . With FT4/FT3 on the low end of normal.

The treatment for hyper is anti thyroid medication,.. which I assume would not be good to just try on the basis of symptoms alone -- and then beyond that there is the chemical destruction of the thyroid or removal which of course I wouldnt' think would be prudent on symptoms and borderline labs.

With hypo thyroidism in a subclinical range, I think the use of minimal dosages of T4/T3 may be quite a bit safer and even recommended just to see what effect and how labs adjust based on such treatment. In other words if it is titrated slowly and monitored going hyper would be less likely and it wouldn't stand to really hurt anything long term for a trial.

So much grey area in this specialty.

Thanks for the thorough reply.


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## Andros

Chromatic said:


> Well I would surmise that previous lab tests based on new lab tests over time detect movement.. BUT, it makes sense to have a range because labs are all a little different..
> 
> I just am confused .. so I am abosolutely not supposed to have any TSI ,.. and my 70 definitely points to something wrong right?
> 
> Cause you know how ranges are.. in 'range' doctors tend to ignore of course.
> 
> Yeah.. I thought that was logical, anything that is near low or high is very logically gone over it.. and perhaps a considerable amount. My TSH moved quite a bit in two months.. relatively.. but still only .5 tenths of a point.
> 
> Dose the T4 number bring any thoughts to mind in regards to the rest of results? Or is there just nothing remarkable about it.. looks pretty bland to me. Isn't a hyperthyroid trending state both high T4 and T3 (free).. ? When untreated.
> 
> I will look into this.. I Need to get a doctor on board who is as convinced as you and I are. I need to psyche myself up and hear from you guys as to whether this is something that I can be forceful that there is a problem given results.. going in on the fence just doesn't cut it with doctors I've found, for obvious reasons.
> 
> Yeah, it is low. I have read that elevated TSI and low TPO is traditional Hyper..
> 
> As for thyroglobulin and the <20 for a range.. Does that mean it is above zero but just unable to zero in in where it is between 1 and 20?
> 
> This I know, but you know I need to go in educated.. Wouldn't most endo's and doctors in general throw these results with little regard because they look normal? I need to be able to say this is why I've learned/researched it is abnormal (besides my symptoms).
> 
> SOmetimes I can't tell if you have some macro's or copy and paste at the end of your posts.. but I like your comments,.. of course, you do a great service. And I do realize you do tend to err on the side of caution -- a trait many doctors do not.
> 
> I just don't want to try to make a big deal out of something that isn't a problem is all.. so need information and some relative backing is all.
> 
> Thanks of course.


Your FT4 seems to be in a good place but I attribute that to the fact that "probably" a binding or blocking antibody is binding it to the receptor site so that it cannot convert to FT3. You see, the body is a fighter and will try really hard to "right" it's self.

Would not be surprised to see that you have Trab. Blocking antibodies.
http://www.ncbi.nlm.nih.gov/pubmed/1633635

Thyroglobulin Ab is "detectable" but below 0. See what I mean about the ranges? This is another one you should not have at all if things were going right.

When I see a "smattering", I worry. Like others things such as TSH, this stuff waxes and wanes on a daily basis. Hard to catch these "critters!"

Ranges are mean averages of cohorts. That should tell you something. 
Anybody's guess.


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## Chromatic

Andros said:


> Your FT3 seems to be in a good place but I attribute that to the fact that "probably" a binding or blocking antibody is binding it to the receptor site so that it cannot convert to FT3. You see, the body is a fighter and will try really hard to "right" it's self.


So you are saying an Antibody is keying in.. or plugging itself into a slot where T3 should be, thus allowing for a higher level of it to be 'unbound' so to speak?

If not, clarify?

Also, T3 at, in this case, 99.9% of the reference range is good? So basically the higher the better as long as it falls in range with FT3?



> Would not be surprised to see that you have Trab. Blocking antibodies.
> http://www.ncbi.nlm.nih.gov/pubmed/1633635


I tried to order the most comprehensive labs I could do ... did I miss one? heh.



> Thyroglobulin Ab is "detectable" but below 0. See what I mean about the ranges? This is another one you should not have at all if things were going right.


Well, I wish someone could explain the <20 value. Less than 20 could be zero, but it also shows range of 0 - 40. So Wouldn't it say 0 if it wasn't there.. or does the <20 means it might not exist?



> When I see a "smattering", I worry. Like others things such as TSH, this stuff waxes and wanes on a daily basis. Hard to catch these "critters!"
> 
> Ranges are mean averages of cohorts. That should tell you something.
> Anybody's guess.


Explain/clarify your meaning of smattering. 

Yes, I see it waxes and wanes.. and the TSH I've had 3 times now.

1999 -- TSH = 1.40

Oct 2010 - TSH = 0.2

April 2011 - TSH = 0.7

That is quite the spread .. but still.

Likewise now my Free T4 has been measured twice.

1999 - Free T4 - 0.95

2011 - Free T4 - 1.38

FWIW.

Yes, it is hard to 'catch those critters' because it so expensive. Even with copays it wouldn't be cheap to run a proper range of tests every few weeks until you could find it. But you have to do what you have to do.. IE: In some serious cases it has to be done. In my case,.. regardless of severity of symptoms it looks like it needs to be monitored but will the next set of labs lead to any clues.. shrug.

Also, yes, I anticipated ranges were the means of an average 'healthy' test subject X (a big number). Looking at some other Free T3 ranges online I would be a bit out of range on the high side with T3.. and I think that sometimes ranges definitely are due to lab procedure and equipment, but I also think they are due to sometimes to the accepted reference range by that particular lab. When another lab may run an exact same test (assay) and have a slightly different range .. ie: a few tenths plus or minus.


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## Andros

Chromatic said:


> So you are saying an Antibody is keying in.. or plugging itself into a slot where T3 should be, thus allowing for a higher level of it to be 'unbound' so to speak?
> 
> If not, clarify?
> 
> Also, T3 at, in this case, 99.9% of the reference range is good? So basically the higher the better as long as it falls in range with FT3?
> 
> I tried to order the most comprehensive labs I could do ... did I miss one? heh.
> 
> Well, I wish someone could explain the <20 value. Less than 20 could be zero, but it also shows range of 0 - 40. So Wouldn't it say 0 if it wasn't there.. or does the <20 means it might not exist?
> 
> Explain/clarify your meaning of smattering.
> 
> Yes, I see it waxes and wanes.. and the TSH I've had 3 times now.
> 
> 1999 -- TSH = 1.40
> 
> Oct 2010 - TSH = 0.2
> 
> April 2011 - TSH = 0.7
> 
> That is quite the spread .. but still.
> 
> Likewise now my Free T4 has been measured twice.
> 
> 1999 - Free T4 - 0.95
> 
> 2011 - Free T4 - 1.38
> 
> FWIW.
> 
> Yes, it is hard to 'catch those critters' because it so expensive. Even with copays it wouldn't be cheap to run a proper range of tests every few weeks until you could find it. But you have to do what you have to do.. IE: In some serious cases it has to be done. In my case,.. regardless of severity of symptoms it looks like it needs to be monitored but will the next set of labs lead to any clues.. shrug.
> 
> Also, yes, I anticipated ranges were the means of an average 'healthy' test subject X (a big number). Looking at some other Free T3 ranges online I would be a bit out of range on the high side with T3.. and I think that sometimes ranges definitely are due to lab procedure and equipment, but I also think they are due to sometimes to the accepted reference range by that particular lab. When another lab may run an exact same test (assay) and have a slightly different range .. ie: a few tenths plus or minus.


Good grief! I made a typo. And here I thought I was perfect. Here is the edited version. ( I said FT3 and meant FT4)

edited
Your FT4 seems to be in a good place but I attribute that to the fact that "probably" a binding or blocking antibody is binding it to the receptor site so that it cannot convert to FT3. You see, the body is a fighter and will try really hard to "right" it's self.

As if things are not confusing enough.

< is smaller than
value on right (I believe this is called a negative integer)

My definition of smattering is a "hint of."

I hear you loud and clear on this "ranges" stuff and on the expense of it all as well.

How are you feeling today? Also, what about your mom? Has she spoken to her doctor?


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## Chromatic

Andros said:


> Good grief! I made a typo. And here I thought I was perfect. Here is the edited version. ( I said FT3 and meant FT4)






> edited
> Your FT4 seems to be in a good place but I attribute that to the fact that "probably" a binding or blocking antibody is binding it to the receptor site so that it cannot convert to FT3. You see, the body is a fighter and will try really hard to "right" it's self.
> 
> As if things are not confusing enough.


No doubt. I agree, the labs, for the 'most part' look fairly good to me. The T3 is a hair from over range, and I don't know if T3 in that ballpark would be symptomatic anyhow.

The TSI, I don't know what to make of. It is in 'normal range'.. despite how some say having 70 in TSI is abnormal and indicative itself. Doctors won't, not that I know of. So it is essentially useless.



> < is smaller than
> value on right (I believe this is called a negative integer)
> 
> My definition of smattering is a "hint of."
> 
> I hear you loud and clear on this "ranges" stuff and on the expense of it all as well.
> 
> How are you feeling today? Also, what about your mom? Has she spoken to her doctor?


I am feeling my normal (for the past few years) suffering self and potentially writing another thing off as a 'possibility'.

With these labs, I just don't think I should put the blame on my thyroid -- I haven't gotten any clear cut answer thus far, I can't throw more money at it so am sort of still 'looking' at the moment. Really don't know where to turn to even investigate next aside from psychiatric help, but that road is one I do not like and doesn't produce any good results (for me).

In the mean time I'm trying to work on the vitamin D, and sooner or later I'll try another doctor just don't know who or what kind to be honest. I need a RL Doctor 'house' that deals with mystery symptoms of a chronic nature.. know anyone. ? 

The mother is doing the same, bit irritable , tired, but no worse for the wear at the moment. Her situation is not anything that is 'dire' so to speak. As aforementioned in another post she will see her doctor at the regularly scheduled visit in a few months.

With my thyroid situation (or lack thereof?) should I just let it go basically? I mean what doctor is realistically going to take these lab values and do anything with them? Would it be best to just assume things are normal?

Thanks,


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## lainey

I wouldn't leave it go--chances are, in the future your levels will change such that they are more "distinct".

You may wish to repeat the labs in 4 to 6 months, or sooner if you have more "hyper" symptoms--but these are deceptive, as a lot of them are similar to "hypo"--so, more symptoms.

A consult with an endo or rheumatologist might be constructive. You won't know that unless you try.


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## Andros

Chromatic said:


> No doubt. I agree, the labs, for the 'most part' look fairly good to me. The T3 is a hair from over range, and I don't know if T3 in that ballpark would be symptomatic anyhow.
> 
> The TSI, I don't know what to make of. It is in 'normal range'.. despite how some say having 70 in TSI is abnormal and indicative itself. Doctors won't, not that I know of. So it is essentially useless.
> 
> I am feeling my normal (for the past few years) suffering self and potentially writing another thing off as a 'possibility'.
> 
> With these labs, I just don't think I should put the blame on my thyroid -- I haven't gotten any clear cut answer thus far, I can't throw more money at it so am sort of still 'looking' at the moment. Really don't know where to turn to even investigate next aside from psychiatric help, but that road is one I do not like and doesn't produce any good results (for me).
> 
> In the mean time I'm trying to work on the vitamin D, and sooner or later I'll try another doctor just don't know who or what kind to be honest. I need a RL Doctor 'house' that deals with mystery symptoms of a chronic nature.. know anyone. ?
> 
> The mother is doing the same, bit irritable , tired, but no worse for the wear at the moment. Her situation is not anything that is 'dire' so to speak. As aforementioned in another post she will see her doctor at the regularly scheduled visit in a few months.
> 
> With my thyroid situation (or lack thereof?) should I just let it go basically? I mean what doctor is realistically going to take these lab values and do anything with them? Would it be best to just assume things are normal?
> 
> Thanks,


Well, I do hope you urge your mom to speak to her doctor about tweaking her thyroxine replacement a bit to see if she does better.

As for you, things could not be clearer. You have TSI. You should not have TSI. TSI is indigenous to hyperthyroid disease. Sorry your doctors do not concur but for your own health's sake, I urge you to find one that does.

You need RAIU for reasons and link provided in other posts. Men are prone to cancer. Cancer and hyper are bed mates.

I have no agenda other than I honestly genuinely care about you and your health. W/o treatment, permanent damage can take place.


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## Chromatic

lainey said:


> I wouldn't leave it go--chances are, in the future your levels will change such that they are more "distinct".
> 
> You may wish to repeat the labs in 4 to 6 months, or sooner if you have more "hyper" symptoms--but these are deceptive, as a lot of them are similar to "hypo"--so, more symptoms.
> 
> A consult with an endo or rheumatologist might be constructive. You won't know that unless you try.


Thanks,.. any ideas on how to find a doctor? IE: is there a really good review sight anywhere on the web? The two I've seen were very limited and weren't incredibly helpful.


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## Chromatic

Andros said:


> Well, I do hope you urge your mom to speak to her doctor about tweaking her thyroxine replacement a bit to see if she does better.


Oh that is done, she listens to me on medical issues.. luckily 



> As for you, things could not be clearer. You have TSI. You should not have TSI. TSI is indigenous to hyperthyroid disease. Sorry your doctors do not concur but for your own health's sake, I urge you to find one that does.


It isn't so much my 'doctors' don't concur,.. but doctors in general. The evidence I get from Endocrinologists across the web and patients are that if TSI falls in range, it is 'normal'. If it were abnormal then the reference range would be something like Normal = <10 or some sort and not <130.

Make sense? Why would the medical community and science go with normal = less than 130, if my 70 is a problem or 'abnormal'.

I am not disagreeing with you , don't get me wrong. But what is this presence of TSI equals a problem (at my level) ? The research I've done points mainly to using it as a tool to gauge treatment levels and effectiveness of therapy but nothing that conclusively says "If you have some moderate amount of TSI you have a problem that needs to be looked into seriously".

Please link me some references to information that makes that crystal clear.. would really help.



> You need RAIU for reasons and link provided in other posts. Men are prone to cancer. Cancer and hyper are bed mates.
> 
> I have no agenda other than I honestly genuinely care about you and your health. W/o treatment, permanent damage can take place.


I believe you have no other agenda.. never thought you did. Am certainly not assuming that at all. Just I have what you say, then all the information I research that either contradicts it or moreso just doesn't really give any relevance or importance to moderate amounts of TSI that don't exceed the "130" threshold.

I don't want a thyroid problem, I just want my symptoms to get some treatment.. and thyroid fits 'fairly' well with many of them. But you would think with my severity of symptoms I would have labs that were very 'distinctive'.

Thanks for caring,


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## Andros

Chromatic said:


> Oh that is done, she listens to me on medical issues.. luckily
> 
> It isn't so much my 'doctors' don't concur,.. but doctors in general. The evidence I get from Endocrinologists across the web and patients are that if TSI falls in range, it is 'normal'. If it were abnormal then the reference range would be something like Normal = <10 or some sort and not <130.
> 
> Make sense? Why would the medical community and science go with normal = less than 130, if my 70 is a problem or 'abnormal'.
> 
> I am not disagreeing with you , don't get me wrong. But what is this presence of TSI equals a problem (at my level) ? The research I've done points mainly to using it as a tool to gauge treatment levels and effectiveness of therapy but nothing that conclusively says "If you have some moderate amount of TSI you have a problem that needs to be looked into seriously".
> 
> Please link me some references to information that makes that crystal clear.. would really help.
> 
> I believe you have no other agenda.. never thought you did. Am certainly not assuming that at all. Just I have what you say, then all the information I research that either contradicts it or moreso just doesn't really give any relevance or importance to moderate amounts of TSI that don't exceed the "130" threshold.
> 
> I don't want a thyroid problem, I just want my symptoms to get some treatment.. and thyroid fits 'fairly' well with many of them. But you would think with my severity of symptoms I would have labs that were very 'distinctive'.
> 
> Thanks for caring,


Please note the title of this chapter.

Measurement of Substances Absent in Normal Serum

Scroll down to TSI.
http://www.thyroidmanager.org/Chapter6/Ch-6-6.htm


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## lainey

>>Thanks,.. any ideas on how to find a doctor? IE: is there a really good review sight anywhere on the web? The two I've seen were very limited and weren't incredibly helpful.<<

You can do Vitals, or Ucomparehealthcare, or some other site where people write reviews, Mary Shamon has a top docs directory--if she is recommending them, they likely have more liberal views than being by the book.

I found my doc by word of mouth--I asked around, using the idea someone had told me, "ask a nurse who they see". Nurses don't generally tolerate BS for themselves, because they know stupid docs when they come across them, and likewise the smart ones.

I know parents who interview pediatricians. It's not unreasonable to do a little of that, if your insurance will tolerate several office visits.

It's not easy, I admit, but sometimes you do get lucky--


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## Chromatic

Andros said:


> Please note the title of this chapter.
> 
> Measurement of Substances Absent in Normal Serum
> 
> Scroll down to TSI.
> http://www.thyroidmanager.org/Chapter6/Ch-6-6.htm


Thanks, but this logic would also conclude that my minimal level of TPO Ab is abnormal as well. I'm not quite certain this was intended to give the impression that a TSI or any other antibody considered in 'normal range' was abnormal.

Again, not to argue, just looking for some direct, conclusive evidence. If this were so, it shouldn't be hard to find that diagnostic criteria would include the presence of something such as TSI. Instead of where it is now, which is the present of TSI that is of abnormal range (ie: in my test greater than 130).

I know that sounds argumentative or at least in disbelief, it is not meant this way -- just not very 'solid' evidence in regards to the question at hand.

I guess I need to be asking an endocrinologist this, but the whole reason for this is to establish absolute credibility instead of blindly following the thoughts of doctor A vs doctor B or C, etc.

Thanks -- and If I'm missing something that is very black and white, it wouldn't be the first time..


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## Chromatic

lainey said:


> >>Thanks,.. any ideas on how to find a doctor? IE: is there a really good review sight anywhere on the web? The two I've seen were very limited and weren't incredibly helpful.<<
> 
> You can do Vitals, or Ucomparehealthcare, or some other site where people write reviews, Mary Shamon has a top docs directory--if she is recommending them, they likely have more liberal views than being by the book.
> 
> I found my doc by word of mouth--I asked around, using the idea someone had told me, "ask a nurse who they see". Nurses don't generally tolerate BS for themselves, because they know stupid docs when they come across them, and likewise the smart ones.
> 
> I know parents who interview pediatricians. It's not unreasonable to do a little of that, if your insurance will tolerate several office visits.
> 
> It's not easy, I admit, but sometimes you do get lucky--


Good advice, thanks.


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## Chromatic

I didn't mean to offend before. I just am really eager for any and all proof, excerpts, articles.. or just self explanations (the way you see it/make it out in your own head(s)) of the whole TSI existing at pretty healthy levels (in a bad way) at 70 and the correlation with it being indicative of Hyperthyroiditic disease/process.

Anything you can provide I will definitely look at.

Any explanation beyond what you have done, if anymore exists in your minds.. I will read.

And,.. in you guys opinion, could I be symptomatic at 70 TSI?

Also, would this likely be pretty certain that 70 TSI is going to fluctuate and since it is attacking as it is an autoimmune process things will likely progress to some point being at the 'over 130' range?

I have some unexplained eye problems.. and they have existed for years now. So far the eye doctor has no real explanation, and if TSI related TED (but without bulge for whatever reason) could likely explain it.. that would be great cause then I could treat by working to lower TSI , steroid drops/immunosuppressants or whatever the doctors recommended. Having my vision improve would be a god send.

In the mean time I have elected to go ahead and just do as my GP suggested months ago and start this trial of Cymbalta. The anxiety/depression and pain are just eating my spirit away -- as much as I hate to take such a medication I want to give it a chance to at least help put me in a better place to figure out my situation.

Again, no offense meant in earlier replies -- just curiosity is all.

Thanks for taking the time to bother with my over analytical , curious self.


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