# Checking in with New Labs



## lavender (Jul 13, 2010)

I haven't been on in a while. I was tired of feeling so lousy and not knowing what to do about it and just didn't have any energy to post. Well, my doc ordered every lab test known to womankind last week to try and figure out what's going on, and I follow up on Friday. I'm posting the thyroid labs first because most of these are unrelated, but if anyone can shed some light on the rest of the labs, I would really appreciate it.

A little background on me: I'm a bit over a year post-total thyroidectomy for Graves disease. I've barely been well for the year and a half since I got sick. Most recently, I spent months on my couch barely doing anything. I was starting to feel better on some anti-depressants, until my med got changed, and I had a big crash: pain all over, so weak I could barely stand, shaky and confused. My med got changed back a week ago, and I'm starting to feel a bit better today.

I'm currently taking 137 mg Armour along with Neurontin for fibromyalgia pain, Metoprolol for heart palpitations (started with the Graves, but never stopped), and Abilify for depression. I had just stopped Tripeltal the day before I had the labs drawn, and I think it was the cause of my low sodium level. I also take Calcium, Magnesium, Ferretin, DHEA, Vitamin B-100, Vitamin D, and Fish Oil.

T UPTAKE 0.80	(0.75 - 1.23 bind index)
T4 TOTAL THYROXIN	6.2	(4.5 - 10.9 ug/dL)
FREE THYROXIN INDEX	5.0	(4.2 - 13.0 ug/dL)
TSH, HIGH-SENSITIVITY	0.976	(0.550 - 4.780 uIU/mL)
T3 FREE 2.4	(2.3 - 4.2 pg/mL)
T4 FREE 0.79	(0.89 - 1.76 ng/dL)	L

THYROGLOBULIN ANTIBODY	29.3	(<40.0 IU/mL	)
THYROGLOBULIN (NEW) <0.2	(1.6 - 59.9 ng/mL)	L
MICROSOMAL AB (ANTI-TPO AB)	<10.0	(<35.0 IU/mL)

MAGNESIUM 2.1	(1.6 - 2.6 mg/dL)
VITAMIN D 25 HYDROXY	55.2	(30 - 100 ng/mL)

WBC (WHITE BLOOD COUNT)	10.3	(4.5 - 11.0 K/uL)
RBC 4.55	(3.8 - 5.1 M/uL)
HEMOGLOBIN (HGB) 13.2	(11.7 - 15.5 g/dL)
HEMATOCRIT (HCT) 39.2	(35.0 - 45.0%)
MEAN CELL VOLUME 86.1	(81.0 - 100.0 fL)
MEAN CELL HGB CONCENTRATION	33.6	(32 - 36 g/dL)
RBC DISTRIBUTION 14.5	(11.6 - 14.8)
GRANS, ELECTRONIC 71.9	(40 - 70%)	H
LYMPHS, ELECTRONIC 22.3	(22.0 - 44.0%)	
MONOCYTES, ELECTRONIC 4.1	(0 - 7.0%)	
EOSINOPHILS, ELECTRONIC 1.3	(0 - 5.0%)	
BASOPHILS, ELECTRONIC 0.4	(0 - 2%	)
GRANS, ABSOLUTE 7.4	(1.8 - 7.7 K/uL)	
LYMPHS, ABSOLUTE 2.3	(1.0 - 4.8 K/uL)	
MONOS, ABSOLUTE 0.4	(0 - 0.8 K/uL)
EOS, ABSOLUTE 0.1	(0 - 0.5 K/uL)	
BASO, ABSOLUTE 0.0	(0 - 0.2 K/uL)	
PLATELET COUNT 304	(150 - 400 K/uL)	
MEAN PLATELET VOLUME 8.1	(7.5 - 11.2 f L)
URIC ACID 3.4	(2.3 - 6.6 mg/dL)

SODIUM 135	(136 - 145 mmol/L)	L
POTASSIUM 3.9	(3.5 - 5.1 mmol/L)	
CHLORIDE 102	(98 - 107 mmol/L)	
BUN 8	(6.0 - 20.0 mg/dL)	
CREATININE SERUM 0.68	(0.60 - 1.10 mg/dL)	
GLUCOSE 84	(74 - 106 mg/dL)	
BILIRUBIN, TOTAL 0.7	(<1.5 mg/dL)	
ALBUMIN 3.6	(3.4 - 4.8 g/dL)	
PROTEIN, TOTAL 7.1	(6.4 - 8.3 g/dL)	
AST 20	(5 - 34 U/L)	
ALKALINE PHOSPHATASE	58	(38 - 126 U/L)	
CALCIUM 8.9	(8.6 - 10.0 mg/dL)	
OSMOLALITY (CALC) 280	(275 - 295 mOsm/kg)
BUN/CREA RATIO 12 
CARBON DIOXIDE (CO2)	24	(21 - 31 mmol/L)	
ALT 19	(8 - 35 U/L)

IRON 76	(50 - 170 ug/dL)	
TOTAL IRON BINDING	396	(298 - 596 ug/dL)	
IRON SATURATION	19	(20 - 55%)	L
TRANSFERRIN 266	(200 - 400 mg/dL)

CHOLESTEROL 187	(<200 mg/dL)	
TRIGLYCERIDES-TRIGE 114	(<150	mg/dL)	
HDL CHOLESTEROL 44	(>60.0	mg/dL)	L
LDL CHOLESTEROL, CALCULATED	120	(0 - 99	mg/dL)	H
CHOLESTEROL, TOTAL/HDL 4.3	(<4.5) 
NON-HDL CHOLESTEROL (CHOL-HDL)	143	(<130mg/dL)	H

C-REACTIVE PROTEIN 15.80	(0.00 - 9.99 mg/L)	H
SEDIMENTATION RATE AUTOMATED	30	(0 - 19 mm/hr)	H
RHEUMATOID FACTOR <20	(0 - 20 IU/mL)	
GLIADIN AB, IGG 8	(<11	U/mL) Negative
GLIADIN AB, IGA 4	(<11	U/mL)	Negative
IGA 288	(70 - 400 mg/dL)
IMMUNOGLOBULIN IGE <5.0	(0 - 135 IU/mL)	
ANA, IFA NEGATIVE

DHEA-SULFATE	121	(35 - 430 ug/dL)	
CORTISOL 5.87	(3.09 - 22.40 ug/dL)	
PTH INTACT	12.2	(14.0 - 72.0 pg/mL)	L
C-PEPTIDE 3.7	(0.2 - 2.7ng/mL)	H
ACTH 6.0	(9.0 - 50.0 pg/mL)	L
HEMOGLOBIN A1C 5.4	(4.7 - 5.8%)	
Estimated Average Glucose	108

TESTOSTERONE 43	(14 - 76	ng/dL)	
TESTOSTERONE, FREE 1.16	(0.10 - 1.50	pg/mL)	
TESTOSTERONE, % FREE	2.70	
ESTRONE 117 pg/mL	(Premenopausal: 17-200)
ESTRADIOL, ENHANCED	64 pg/mL	(Premenopausal: 15-350)

for the reference ranges on the following, I am only showing the Follicular Phase since I was on day 1 of my cycle when my labs were drawn:

ESTRADIOL, ENHANCED	68.8	(4.4 - 49.2pg/mL)	H
Follicular phase: 19.5-144.2
FSH 3.8 mIU/mL	
Follicular: 2.5-10.2 mIU/mL
LH 2.2 mIU/mL	
Follicular phase 1.9-12.5
PROGESTERONE 0.88 ng/mL	
Follicular phase 0.15-1.40


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## peacesells560 (Aug 9, 2011)

The only non-thyroid things I can really comment on are the C-peptide and the PTH. The C-peptide being higher than normal can be indicative of insulin resistance; and the PTH is parathyroid hormone and since you have had a TT that may mean that they could have been damaged during the TT. As far as thyroid stuff goes, I'd say you need a dose increase, but you probably already knew that.


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## lavender (Jul 13, 2010)

Yup, my parathyroids got damaged during my surgery. One is gone completely, and the others have never kicked back in fully.

And I know I need a dose increase. However, the last time I saw the doc, my Armour was decreased. It was someone who was filling in for my usual doc. She's been out on maternity leave, and Friday's appointment will be the first time I see her in months. She doesn't seem so worried when my TSH is low. So I'm hoping for an increase.

The insulin resistance info is helpful. I've tried looking up the abnormal tests on-line, and can't make heads or tails of much of it. Diabetes runs in my family. So, I will be sure to ask my doc about it.

I do know that C-Reactive Protein and Sedimentation Rate mean I have some sort of inflammation going on, which is no surprise when I look at my swollen fingers. They look like sausages. I'm just not sure what is causing the inflammation.


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## webster2 (May 19, 2011)

Hi Lavender,
I can't shed any light on your labs, but it is nice to "see" you again. I am sorry you are still not feeling well. Hopefully, that will change soon.


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## Octavia (Aug 1, 2011)

Hi Lavender...glad your back, not glad that you're feeling this bad.

Just one comment to add to the others - I thought Abilify was a "supplement" to antidepressants, not an antidepressant in and of itself??? My understanding is that you take an antidepressant, then you take Abilify on top of the antidepressant to help the antidepressant work better. Were you on a different antidepressant before?


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## Andros (Aug 26, 2009)

lavender said:


> I haven't been on in a while. I was tired of feeling so lousy and not knowing what to do about it and just didn't have any energy to post. Well, my doc ordered every lab test known to womankind last week to try and figure out what's going on, and I follow up on Friday. I'm posting the thyroid labs first because most of these are unrelated, but if anyone can shed some light on the rest of the labs, I would really appreciate it.
> 
> A little background on me: I'm a bit over a year post-total thyroidectomy for Graves disease. I've barely been well for the year and a half since I got sick. Most recently, I spent months on my couch barely doing anything. I was starting to feel better on some anti-depressants, until my med got changed, and I had a big crash: pain all over, so weak I could barely stand, shaky and confused. My med got changed back a week ago, and I'm starting to feel a bit better today.
> 
> ...


Lavender!! Hugs to you!

You are very very undermedicated in the Armour department. As you know, your Free T3 should be above the mid-range of the range given by your lab and at about 75% of that range seems to be about right for most of us.

I am on 225 mgs. and I am 68 for crying out loud. Yes, I am active but not like a young lady would be. LOL!!

I believe this is why you are in so much pain; CRP is high. I also believe being under medicated can cause heart palps and arrhythmnia. I have read this many times in various places.

Unfortunately, I am not the whiz kid w/other hormones and cortisol.


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## lavender (Jul 13, 2010)

Octavia said:


> Hi Lavender...glad your back, not glad that you're feeling this bad.
> 
> Just one comment to add to the others - I thought Abilify was a "supplement" to antidepressants, not an antidepressant in and of itself??? My understanding is that you take an antidepressant, then you take Abilify on top of the antidepressant to help the antidepressant work better. Were you on a different antidepressant before?


I have been on a variety of anti-depressants in the past and usually end up with side effects and no benefit. I tried a couple in the past months and only ended up in worse shape. I'm seeing a psychiatrist now who decided to try me on Abilify alone, and it seems to be helping like nothing else has. I can't say why. I'm just grateful that it's helping.


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## lavender (Jul 13, 2010)

webster2 said:


> Hi Lavender,
> I can't shed any light on your labs, but it is nice to "see" you again. I am sorry you are still not feeling well. Hopefully, that will change soon.


Hi!

It is nice to be seen! and yes, I hope things will improve soon.


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## lavender (Jul 13, 2010)

Andros said:


> Lavender!! Hugs to you!
> 
> You are very very undermedicated in the Armour department. As you know, your Free T3 should be above the mid-range of the range given by your lab and at about 75% of that range seems to be about right for most of us.
> 
> ...


Thanks for the Hugs.

I may be under medicated, but unless I can convince a doctor of that, I'm stuck. I was sent on to a cardiologist when my BP skyrocketed in my family doc's office this spring, and when she saw my last labs, she cried out that my Armour dose needed to be lowered. My BP was not high at that time. I was having heart palps, but no more severe than I have had for months when I was severely hypothyroid. At this point, my BP is so low that they're afraid to keep me on the beta-blocker except at a very low dose. Fighting my family doc for a dose increase is one thing. Fighting her plus the Caridiologist is another.

These are my last thyroid labs from 9/8/11 when I was on 150 mg Armour:
TSH, HIGH-SENSITIVITY	0.044	(0.550 - 4.780)	L
T3 FREE	3.0	(2.3 - 4.2)	
T4 FREE	1.08	(0.89 - 1.76)

Both of these labs were taken in the morning, fasting and armour before the test.


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## miguel (Jul 18, 2011)

Are you taking calcitriol and calcium supplements?


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## lavender (Jul 13, 2010)

I just need to vent for a moment.

I go to an alternative medicine center, and while I like the idea of using alternative practices, I'm just tired. The guy I saw last week is known for being a bit unusual, but seriously! His suggestion for all my labs is to stop eating nuts and plant oil, to take more fish oil, vitamin B, Calcium, Magnesium and Vitamin D. I am already taking so many supplements I can't keep them straight or afford them! UGH! I am just so frustrated and sick of being sick!

I am glad he ordered the labs, and I hope my doctor can shed a little bit more light and a sensible medical opinion on them!


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## lavender (Jul 13, 2010)

miguel said:


> Are you taking calcitriol and calcium supplements?


Calcium, yes, in large quantities. 
Calcitriol, no. Can't get a doc to prescribe it, and my insurance won't cover it. I was told to take OTC Vitamin D.


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## Andros (Aug 26, 2009)

lavender said:


> Yup, my parathyroids got damaged during my surgery. One is gone completely, and the others have never kicked back in fully.
> 
> And I know I need a dose increase. However, the last time I saw the doc, my Armour was decreased. It was someone who was filling in for my usual doc. She's been out on maternity leave, and Friday's appointment will be the first time I see her in months. She doesn't seem so worried when my TSH is low. So I'm hoping for an increase.
> 
> ...


Undermedication is one possible cause of the inflammatory response in the body!

GRANS, ABSOLUTE is high and that is indicative of inflammation as well.

Oh.......................I am thrilled to hear your doc is back from maternity leave. Best news I ever heard!! I know you feel the same!!!

You have to convince her. Here is some info.

Free T3 and Free T4 are the only accurate measurement of the actual active thyroid hormone levels in the body. This is the hormone that is actually free and exerting effect on the cells. These are the thyroid hormones that count.

http://www.drlam.com/articles/hypothyroidism.asp?page=3


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## lavender (Jul 13, 2010)

Good News! My doc increased my Armour dose! She's concerned about me having more heart palpitations, and wants me to break a 15 mg tablet in half to go up by basically 7.5 mg to a whopping....144.5 mg/day for 2 weeks, and then to go all the way to 150 as long as I don't have any heart palpitations!

She wants me to decrease my metorpolol to 1/2 tablet twice a day or a full tablet at night and 1/2 in the morning instead of a whole 25 mg twice a day to decrease some of my fatigue. I'm a bit nervous about that because it seems to be keeping what I was having of heart palps in check, and it almost seems like a set up for having increased heart palps on my new Armour dose. I may try it very slowly. I do see my cardiologist before I see her again. So I have someone else to bounce the idea off of.

She's also having me increase my fish oil to 4 per day. Hello Fish Oil burps!

She didn't have a lot to say about the other labs. I think she seemed a bit overwhelmed by the list ordered by the other doc. She didn't want me to increase anything else for now. She said I could try increasing my vitamin B in a month or so depending on how my Armour increase goes.


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## Andros (Aug 26, 2009)

lavender said:


> Good News! My doc increased my Armour dose! She's concerned about me having more heart palpitations, and wants me to break a 15 mg tablet in half to go up by basically 7.5 mg to a whopping....144.5 mg/day for 2 weeks, and then to go all the way to 150 as long as I don't have any heart palpitations!
> 
> She wants me to decrease my metorpolol to 1/2 tablet twice a day or a full tablet at night and 1/2 in the morning instead of a whole 25 mg twice a day to decrease some of my fatigue. I'm a bit nervous about that because it seems to be keeping what I was having of heart palps in check, and it almost seems like a set up for having increased heart palps on my new Armour dose. I may try it very slowly. I do see my cardiologist before I see her again. So I have someone else to bounce the idea off of.
> 
> ...


Thank you dear Lord!!! I am so glad your beloved and very smart doc is back. You are going to get on track now. Stick w/her; she knows what she is doing!

I am so happy for you, Lavender!!! Truly! Plus, we need you back. I am not the only one who has missed our future counselor extraordinaire!!


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