# Why'd my doctor order me all these tests when I asked for a thyroid panel?



## AgentChupa (Nov 12, 2014)

Posting again here because I found work and I want to get back on track with my thyroid meds. No insurance, but having some kind of an income will help.

Not much has changed since my last topic (which was my intro topic). I asked my doctor (a gynecologist) if she'd order me a thyroid test and she insisted on seeing me first for my routine exam. I've had pretty constant uterine bleeding ever since I went off my thyroid meds two years ago (with the occasional dry days here and there), which my doctor says is due to my thyroid messing my hormones up.

I thought she would just be ordering me a TSH test, but she also ordered an HCG/pregnancy test, a blood glucose test, FSH and LH. The pregnancy test baffles; I told her I wasn't particularly worried about being pregnant because I use protection consistently and she didn't do a urine test. Plus, constant bleeding usually indicates a reproductive system that will not sustain pregnancy anyway. I guess she's concerned I'm diabetic because I'm fat, hence the blood sugar test. I was tested for diabetes a couple years ago and my glucose was normal, but I've gained a lot of weight since then too. And I was just told the FSH and LH tests are hormone tests, but from what I gather, they're related to fertility. (As a small and very TMI aside, I don't know what she did to me during the exam, but I've been cramping a lot, bleeding heavier than normal and feeling nauseous ever since).

I've specifically told her I do not want children (and would also like normal periods) and would very much like to be on birth control again (the only reason I stopped is because of the cost + no insurance), so why she's doing fertility tests is beyond me. My only guess is maybe she wants to see if something other than my thyroid is causing the bleeding problems.

Is it normal to have all these tests done for thyroid disease? Because before, I only got the TSH test. I can't get an insurance quote until next January, so I probably won't be able to see a specialist until then, so here's hoping my doctor actually listens to me when I say the meds she's prescribing me aren't working. She's intending to start me on 25 mcg again.


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## Lovlkn (Dec 20, 2009)

TSH is the first test run usually to determine if there is thyroid involvement. Your TSH level should come back somewhere around 1 if all is normal.

Sounds like your doc is betting that peri- menopause is messing with your period levels.

http://www.healthonelabs.com/pub/tests/test/pid/167

You can order your own more in depth thyroid labs here - $59.75. This package gives you the FT-4 and FT-3 along with TSH. In my opinion , you should have this run prior to beginning any replacement so you know exactly where you are. 3/4 of range for FT-4 and FT-3 is your goal.


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## AgentChupa (Nov 12, 2014)

I don't know, I'm not even 30 yet, so I don't think it'd be perimenopause. My TSH was 5.80 when it was first tested (middle of the day, no fasting), and then 14.50 after a night of fasting and first thing in the morning. I haven't been on my thyroid meds, so I wouldn't be surprised if it's higher now than before.


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## Lovlkn (Dec 20, 2009)

Why did you stop thyroid replacement med's a few years ago?

Your current labs indicate your need for replacement med's. Call your last doctor and ask to be put on some replacement medication.

Starting with the last dose would probably be a good start - unless your labs were not good then.


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## AgentChupa (Nov 12, 2014)

I went off levothyroxine before because my doctor refused to increase my dosage (said my TSH of 5.08 was "close enough to normal"). I wasn't about to spend money on pills that didn't make me feel any better, and then my insurance ran out, so I couldn't see a specialist.

So at the time I was on my old starting dose, my labs still showed an abnormal result, but getting my TSH levels almost to what she felt was normal was good enough for her. She didn't seem too concerned about whether or not my symptoms had improved because she just cared about the numbers.

I'm hoping that I'll get my results back this coming week, and I'm hoping my doctor will at least entertain the possibility of increasing my dosage if I don't feel any better after 4-6 weeks on 25 mcg. I can't afford to doctor shop.


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## Lovlkn (Dec 20, 2009)

> 25 mcg


That is a very small dose.

Do you have FT-4 and FT-3 tests? Have they ever done an ultrasound on your gland?


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## AgentChupa (Nov 12, 2014)

Nope and nope. I'm going to try and apply for Obamacare in January so that I can possibly see an endocrinologist, so maybe I can get the free T3 and T4 tests and/or an ultrasound then. For now, I just want to get something in my system. I suppose, for the time being, something is better than nothing.

And I know 25 mcg is too small. I think average dose is something like 0.50 mcg per pound of body weight, but since I weigh so much and my thyroid isn't extremely broken, an average dose might actually be too high for me. I'm not sure.


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## Lovlkn (Dec 20, 2009)

You should order a lab draw sheet from the link I posted above. At least for $59.75 you can have the proper tests run prior to beginning any replacement. The FT-4 and FT-3 are absolutely needed to properly dose replacement.


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## AgentChupa (Nov 12, 2014)

Other folks here suggested getting my own lab work done when I posted my story the first time around. I checked it out, but the nearest facility to me where I could do all this is about an hour away. I don't have any way to get out to the locations listed.

Are the FSH, LH and glucose tests a normal part of thyroid testing? I know thyroid disease screws with hormones (and everything else), but I don't know if follicle stimulating hormones and luteinizing hormones are affected by hypothyroidism. From what I've tried to find out on my own, those tests are often done to determine the cause of infertility and a thyroid panel may be done secondary to FSH and LH in the search for an underlying cause of infertility or menstrual problems.

What about blood sugar? Is that in some way also affected by thyroid disease? Or is my doctor just trying to rule out diabetes for some other reason?


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## Lovlkn (Dec 20, 2009)

> Are the FSH, LH


These are to see if you are menopausal I believe

Glucose is a fairly standard test - not really something that determines if thyroid is the issue, although glucose can be raised in thyroid dysfunction.


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