# Need a second opinion on lab results/diagnosis



## lijame85 (May 22, 2017)

I'm going to assume that none of you are doctors however most of you have lived with a thyroid condition for years and have experience reading lab results and making basic obversations. Right? 
So, to give you a brief review, I've had hormonal problems (mood swings and irregular to absent perdiods) for the past couple years that my previous gyno told me was normal because I was taking birth control. Fastforward to 6 months ago, I see a new gyno because I'm currently living in Mexico for work. I tell her my history and she runs some tests, including a thyroid panel. She diagnosed me with hyperthyroid. I was shocked to hear this because, for starters, I weigh around 240lb, and have symptoms of hypo not hyper. She put me on Tapazol 2.5mg, and based on other blood work results, she has changed my dosage a little but never higher than 2.5mg.

Here are my lab results:

November 2016:
T4 TOTAL: 15.50 (5.53-11.0ug/dL)
227.8 (71.1-141.6nmol/L)

T3 TOTAL: 1.95 (.97-1.7ng/mL)
4.08 (1.49-2.60nmol/L)

TSH: 9.10 (.465-4.68mUI/L)

FREE T3: 3.59 (2.71-6.16pg/mL)
29.41 (4.17-9.46pmol/L)

FREE T4: 1.12 (.64-1.79ng/dL)
78.30 (8.27-23.1pmol/L)

IODINE PROTEIN: 10.85 (4-8mUI/L)
(There are more but I think these are the most imporatant)

She told me there was a problem, said I had hyperthyrodism and put me on 2.5 mg of Tapazol.

January 2017, I do another round of blood work and all of my numbers are in the normal range but she doesn't believe the numbers, says I couldn't have reach normal levels in such a short period of time. She cut my dose of Tapazol to 1.75mg.

March 2017, I do yet another round of blood work.
all using the same variable above)

T4 TOTAL: 8.5
T3 TOTAL: 1.12
TSH: 6.26
IODINE PROTEIN: 5.23

She had me raise my Tapazol to 2.5mg.

Last week, I did yet another round of blood work, and here are the shocking results!

TSH 9.51
T3 Total: 1.24
T3 Free: 2.99

My TSH is now higher than when I first started this process. I go to the doctor tomorrow afternoon to read the results with her.

I have done some research online and with these numbers it sounds to me like I have subclinical hyporthyroidism or maybe an auto-immune thyroid (auto-immune gene runs in my family). I also have very low progesterone hormone. I have been off birth control since November 2016.

Any advice would be very much appreciated as I am lost lost lost and obviously no signs of getting better. Help!


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## joplin1975 (Jul 21, 2011)

Hello and welcome.

Just for clarification, are the second numbers you listed from subsequent tests? Or are they the same tests and you were just converting the measurement value? (See below in red)



> FREE T3: 3.59 (2.71-6.16pg/mL)
> 29.41 (4.17-9.46pmol/L) <-is this another test or the same value converted into a different measurement?
> 
> FREE T4: 1.12 (.64-1.79ng/dL)
> 78.30 (8.27-23.1pmol/L)


Has you doctor ordered a thyroid ultrasound?


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## Lovlkn (Dec 20, 2009)

I would also ask that antibodies tests be run - to include TPO, TSI and thyroglobulin.


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## lijame85 (May 22, 2017)

joplin1975 said:


> Hello and welcome.
> 
> Just for clarification, are the second numbers you listed from subsequent tests? Or are they the same tests and you were just converting the measurement value? (See below in red)
> 
> Has you doctor ordered a thyroid ultrasound?


They are the same tests, just measured differently. I have since gone to another lab and they do not do the same measurements. If it confuses anyone, just ignore the second measurements for November. The doctor has not ordered any thyroid ultrasound, and if I remember correctly, hasn't even touched my neck/thyroid.

I go see her today at 4pm. I'm nervous to see what she says.


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## joplin1975 (Jul 21, 2011)

Gotcha.

Well, two things stand out. The first, as I previously mentioned, is that I would ask for a thyroid ultrasound. (I also agree about getting your antibodies tested, by they way.)

But the second and more pressing issues is that I believe she is diagnosing you based upon your total t4 and total t3 numbers.

Total t or t3 measures the total amount of bound and unbound hormone in your blood. The trick is that your body can't use the bound -- that hormone is attached to proteins that prevent the hormones from being used by or absorbed by bodily tissues. Meanwhile, free t4 or free t3 measures only the unbound or "ready to use" hormone. It's a pretty significant difference. If you look at your total numbers, you look hyper...but if you look at your free numbers, you are actually trending hypo. Not OMG HOW ARE YOU FUNCTIONING hypo, but you are trending that way. Which is why your TSH is creeping up.

I'm not a doctor and I do not have personal experiences with hyper or meds used for hyperthyroid, but I do not think you need to be on Tapazol.


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## lijame85 (May 22, 2017)

The doctor took me off Tapazol and now I'm taking levothyroxine 1/2 50mcg. She felt like the Free T3 and T3 Total were in a good place and now wanted to work more on the TSH, as she also noted that my number is higher than when we first started this process. She now says I have subclinical hypothyroidism and not hyperthyroidism (as I noted in my first post!).

I'm on a 2 week trial to see how the new med works on me and then have to do bloodwork again only for TSH this time. She told me this med will work faster than the other, that I will start feeling better soon, headaches will go away, might lose some weight, etc.

We'll see how it goes....


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## joplin1975 (Jul 21, 2011)

Well...

A) I don't think focusing on TSH makes any sense...and,...
B) I don't think doing blood work in 2 weeks makes any sense either. Wait at least 4 weeks. Thyroxine works slowly and TSH is the last thyroid lab to change.


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## lijame85 (May 22, 2017)

I have to do it in two weeks because I'm going out of the country and there is no way for me to get my bloodwork done while away, so we decided that I'd get it done the day before I leave to check the level, then again once I get back a month afterwards, so 6-8 weeks from now, before I physcially see her again to see how I'm doing. Sorry, maybe should have clarified that part. She wanted to do it 4 weeks from now, but because I will be away, we agreed to do it this way. :/


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