# Help Understand Crazy Lab Work?



## Endo20 (Nov 16, 2014)

So I'm 20 (male) and I had some blood work done due to a few issues I'm experiencing. My family has a history of Thyroid issues (usually overactive) and diabetes. I went to my primary and they did some blood work but said to see an endocrinologist. He did 2 sets of lab work. I got all 3 lab results back but my last one still has to be discussed with the endocrinologist next week. Do these numbers seem good, bad, etc.

All tests were done fasting.

1st Round: 
TSH - 1.00
T4, Free - 1.3 
TSH W/ REFL Free T4 TSH - 1.00
T3 Uptake - 33 
T3, Total 83

2nd Round (2 weeks after 1st round): 
Glucose - 105
TSH - 1.9
T4, Free - 1.5 
Cortisol - 23.4 (after 4 hours of sleep)

3rd Round (4-5 weeks after 1st round): 
Glucose - 87
Thyroid peroxidase ab <1 range <9 IU/mL
Thyroglobulin Antibodies <1 range < or = 1 IU/mL
TSI 24 and the range is <140% baseline
TBII <5.0 rangeis <=16%
Z-Score -0.1 and the range is -2.0 - +2.0
Epinephrine - 135 Less than 50-95 
Norepinephrine - 400 110-650
Metanephrines Free - 83 range is <=56 
Cortisol - 12.0 (after 7 hours of sleep)

I know metanephrines being high would indicate an adrenal tumor. I'm just not sure if that is a significant level or is the test really reliable. My cortisol levels seem to be backwards as it is lower with more sleep. I can't find easy to read info on the Z-score (I'm still unsure of what it tests for, TBII, TSI, etc. So I'm not sure if they are on the low side, high side, what this all would mean, etc. I'm mainly stuck on if any of the thyroid numbers show anything questionable or is it more of an adrenal gland issue. Any help would be appreciated.


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## Andros (Aug 26, 2009)

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://labtestsonline.org/understanding/analytes/thyroid-antibodies/tab/test
(Copy and paste into your browser)

Trab
http://www.ncbi.nlm.nih.gov/pubmed/17684583
(Copy and paste into your browser)

TBG (thyroxine binding globulin) up, hypo............down, hyper
http://www.nlm.nih.gov/medlineplus/ency/article/003374.htm
(Copy and paste into your browser)

TBII
http://www.ncbi.nlm.nih.gov/pubmed/9364248
http://en.wikipedia.org/wiki/Anti-thyroid_autoantibodies

Substances not found in normal serum (scroll down to autoantibodies)
http://www.thyroidmanager.org/chapter/evaluation

Welcome to the board. I cannot answer all of your questions but I do know that the healthy person should not have any of the antibodies that are in your lab results; even if they are below the range.

It would appear that you are leaning in the direction of hyperthyroid and it would be very much in your best interest to have an ultra-sound of the thyroid if you have not had one.

You may find the info above helpful.


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## Endo20 (Nov 16, 2014)

Thanks for the welcome and response Andros. I never had a thyroid ultrasound so I'll be sure to ask the doctor next week. Thanks for the links as well.


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## Endo20 (Nov 16, 2014)

Well, I had my appointment with my doctor. He sent me for a TSH test and said he doesn't see a need for an ultrasound. I was quite surprised to see him re-run a test for a 3rd time after it keeps showing up as "in range" I'm not sure why part of the thyroid seems to be producing hormone but not significant enough to throw other levels out of balance enough for a diagnosis. I know I feel horrible but they still can't decided which part is causing the most issue.


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## RGRN (Nov 29, 2014)

I don't understand why endocrinologist just say the labs are in range and dismiss signs and symptoms of disorders? I'm having that issue too.


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## Andros (Aug 26, 2009)

It would appear you are being placated and I would like to recommend that you go doctor shopping. A Naturopathic Doc or a D.O. might be more "into" this. Many here are very pleased w/theirs.

You do need an ultra-sound to make sure you don't have cancer. I cannot fathom that your doctor told you what he did.

Sending hugs your way,


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