# Help understanding labs & ultrasound



## Jslatts23 (Jul 12, 2016)

Hello,

Hopefully someone can chime in and help me understand what is going on. Basically I didn't think I could feel worse until I went gluten free. anxiety and weight hugely increased after going gluten free in November 1016. I have all the standard thyroid symptoms and they continue to get worse. Also like to mention from January 1st 2017 to January 30th 2017 I was taking 100mcg of levo and 25mcg cytomel daily that was purchased 3rd party. I have not been prescribed or treated for any thyroid condition. Here are my labs and ultra sound.

06/06/2016

CORTISOL AM

7.5 ug/dL

3.7 - 19.4 ug/dL

TSH

2.23 uIU/mL

0.20 - 4.50 uIU/mL

06/17/2016

T4, Free

1.0 ng/dL

0.7 - 1.5 ng/dL

Can't find date but these labs were sometime in the beginning of August 2016

TSH 1.77 Range 0.35-3.74

Free Thyroxine,Free T4 0.91 Range 0.76-1.46

Triiodothyronine T3 Free 3.77 Range 2.18-3.98

Thyroperoxidase Antibodies 3.4 Range <9.0

Vitamin D12 537 Range 211.0-911.0

02/3/2017

Thyroperoxidase Ab

4 IU/ml

0 - 8 IU/ml

TSH, Sensitive

0.97 uIU/ml

0.35 - 4.94 uIU/ml

T4, Free

0.8 ng/dl

0.7 - 1.5 ng/dl

T3,Free

3.1 pg/ml

1.7 - 3.7 pg/ml

Hgb A1c

4.8 %

4.3 - 5.6 %

Hemoglobin

17.2 g/dl

13.5 - 17.5 g/dl

Sex Horm Bind Glob

29 nmol/L

16 - 70 nmol/L

Testosterone

352 ng/dl

200 - 745 ng/dl

Testosterone, Free

7.6 ng/dl

3.1 - 12.8 ng/dl

Testosterone, Bioav.

178.0 ng/dl

71.7 - 300.0 ng/dl

Prostatic Spec Ag

0.5 ng/ml

0.0 - 4.0 ng/ml

ALT (SGPT)

41 U/L

0 - 55 U/L

Thyr Stim Immunoglob

<89
Reference range: <140
Unit: % baseline

03/06/2017

TSH, Sensitive

1.45 uIU/ml

0.35 - 4.94 uIU/ml

T4, Free

0.8 ng/dl

0.7 - 1.5 ng/dl

T3,Free

2.8 pg/ml

1.7 - 3.7 pg/ml

03/14/2017 Ultrasound

TECHNIQUE: Routine.
COMPARISON: None.

FINDINGS:
Right thyroid lobe measures 4.6 x 1.9 x 1.6 cm. Normal echotexture with no
focal nodule.

Left thyroid lobe measures 4.7 x 1.4 x 1.6 cm. Normal echotexture with no
focal nodule.

Isthmus measures 3 mm. No additional findings.

No cervical lymphadenopathy.

CONCLUSION:
1. Normal thyroid ultrasound.

Current doc is a complete jackass. Will continue to use him to track thyroid while shopping for a new doc. Any help with labs is appreciated.

Cheers,
John


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## Lovlkn (Dec 20, 2009)

Welcome to the forum!



> Also like to mention from January 1st 2017 to January 30th 2017 I was taking 100mcg of levo and 25mcg cytomel daily that was purchased 3rd party. I have not been prescribed or treated for any thyroid condition.


Never a good idea. Are those dates correct? You only took the medications you purchased 3rd party for one month in 2017?

That is a pretty hefty dose, it's not surprising you are experiencing anxiety. Your FT-3 is definitely in "anxiety" range and should come down a bit. Most people like to fall somewhere between 1/2-3/4 of range. How much do you weigh? Thyroid hormone replacement is prescribed by weight as well as lab results.

So to clarify - you purchased your levo and Cytomel 3rd party? A medical doctor has never prescribed any thyroid hormone replacement?



> Thyroperoxidase Antibodies 3.4 Range <9.0


Suggests something autoimmune may be happening.

What other medications or supplements do you currently take?


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## Jslatts23 (Jul 12, 2016)

I weigh about 220 up from about 170 about 4 years ago when symptoms started to happen. I do have some new test results.

4/4/17
TSH, Sensitive	1.48 uIU/ml
0.30 - 4.50 uIU/ml
T4, Free	0.8 ng/dl	0.7 - 1.5 ng/dl
T3,Free	3.3 pg/ml	1.7 - 3.7 pg/ml

4/19/17 about 2 weeks later.

TSH	2.04 uIU/mL	0.30 - 4.50 uIU/mL
T4, Free	0.9 ng/dL	0.7 - 1.5 ng/dL
T3,Free	3.6 pg/mL	1.7 - 3.7 pg/mL
THYROID PEROXIDASE (TPO) ANTIBODIES	4.9 IU/mL	0.0 - 9.0 IU/mL
THYROID STIMULATING IMMUNOGLOBULINS	85 %	<=122 %

My dads twin sister has hyperthyroidism and would guess he has the same. At the moment I have both hyper and hypo symptoms. For instance I will be extremely warm but can't feel my hands and feet because they are so cold. Others are

Fatigue 
Brain fog
Weight gain 30-40 pounds in 1 month
Constant ringing in ears
Depression
Anxiety
Along with many others

The endo I saw last week mentioned I can not have both hyper and hypo symptoms and my thyroid is fine. He said I should get a sleep study.....

It seems like my levels bounce around a lot. Is this normal? Any idea what is going on?


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## joplin1975 (Jul 21, 2011)

> THYROID STIMULATING IMMUNOGLOBULINS 85 % <=122 %


This is a big problem -- thyroid antibodies are problematic anyway but TSI is particularly insidious. You should not have any TSI. Just because its below range does not mean normal.

Your levels bouncing around a lot are very common with the presence of TSI, unfortunately. Above all, stay far, far, far away from any T3 meds if you have TSI.

I don't know much about it, but you might want to google block and replace therapy to see if you have any luck. If you had nodules, I'd advise that you complain about trouble swallowing so they'd remove your thyroid, but with a normal thyroid utlrasound, they probably won't do much.


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## Jslatts23 (Jul 12, 2016)

Figured out what was going on too early I guess. At this point I can't even get a doctor to recognize what is going on.

Any suggestions on how to continue this process? Or any suggestions on a good doc in Minneapolis?

Cheers,


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