# Please help!!



## a2bc2 (Jul 22, 2014)

These are my latest labs. Still very very anxious ???? thanks!
Tsh 1.84
Ft4 1.2
Ft3 3.3
Thyroglobulin 146.2
Tg ab <1
Tsi 467


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## Andros (Aug 26, 2009)

What is your medical history? Have you been diagnosed as hyper and if so, are you on any medication?

Also, do you have the ranges for these results?

Because of the high Thyroglobulin, cancer is a significant risk. Have you had an ultra-sound or RAIU (radioactive uptake?)


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## a2bc2 (Jul 22, 2014)

Hashimoto's since 2005-ish. Currently 3 months post partum. Just saw an ENT who said he would not biopsy bc of the Hashimoto's the results would be inconclusive and he would recommend TT anyways. On the ultrasound he said he saw "pseudo nodules" and a nodules. I don't have the report and can't show him this blood work bc he said if I get bloodwork someone else then I just need to let that dr manage my thyroid. 


TSH on 07/31/2014

Details


TSH - 1.84 Range: - mIU/L


TSI (THYROID STIMULATING IMMUNOGLOBULIN) on 07/31/2014

Details


TSI - 467 Range: <140 - % baseline Flag: H


THYROGLOBULIN PANEL on 07/31/2014

Details


THYROGLOBULIN ANTIBODIES - <1 Range: < or = 1 - IU/mL


THYROGLOBULIN - 146.2 Range: 2.8-40.9 - ng/mL Flag: H


T4, FREE on 07/31/2014

Details


T4, FREE - 1.2 Range: 0.8-1.8 - ng/dL


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## a2bc2 (Jul 22, 2014)

My pcp said I have graves & hashi's bc the tsi and tpo, ent said no. Not taking any thyroid meds no per my endo (who scheduled to see me in oct) and my pcp.


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## joplin1975 (Jul 21, 2011)

Well, I had/have Hashi's and had/have antibodies related to Grave's and my biopsy was 100% conclusive. Just sayin'. Still, I would (again) absolutely advise total thyroid removal. Yes, postpartum stuff can exacerbate the issues, but with high thyroglobulin, TSI, and TPO, I think the idea that you'll ever be normal (in terms of thyroid issues, that is) is not realistic.


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## a2bc2 (Jul 22, 2014)

Thanks again Joplin ???? I was waiting for these labs to see if there was a trend of some sorts. Should I have a biopsy? Obviously if it showed cancer I would remove my thyroid immediately.


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## joplin1975 (Jul 21, 2011)

I think that depends how heavily you are leaning toward surgery. If you are more inclined than not to have surgery, then the biopsy is kinda pointless. The "gold standard" of pathology is full examination of the thyroid in a post-op setting. But, if you aren't sure about surgery and feel like you need more information, then a biopsy might be a good next step. Granted, inconclusive results are common with pesky thyroids, so your doctor is right that is a real possibility. But, if you have well-developed cancer that's easy to "find" with a needle, you'd get the results you need to conclusively know your next steps.


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## a2bc2 (Jul 22, 2014)

Should I seek a different ENT for biopsy? I'm confused Abt the difference of thyroglobulin and tg ab. I thought the tgab was indicative of cancer? I truly appreciate all of your input.


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## joplin1975 (Jul 21, 2011)

The presence of TgAb is measured to make sure the thyrogloublin test is accurate. If you have TgAB, you can't trust the results of your Tg test. It skews the results. But, Tg is the actual "tumor marker." A little Tg is normal, but high Tg is very often found in thyroid cancer patients. It gets confusing because it can also be found in people with advanced cases of Grave's and Hashi's, but....generally speaking, when you see normal TgAB and high Tg, you really, really want to make sure you aren't dealing with cancer. It sends up all kinds of proverbial red flags.

I think second opinions are always good. I also think that any doctor who would discharge you from his or her care because you got blood work elsewhere is a sign that he or she is a real jerk. So, perhaps consulting with someone else is a good idea. What we don't know if how big your nodules are...if they aren't 1cm or larger, then theyusually won't biopsy them. So, that's another (frustrating!) factor that has to be sorted out.


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## a2bc2 (Jul 22, 2014)

Since my tgab were <1 it would likely make my Tg results more accurate then? I will call and ask if they have the size of the nodule documented.


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## joplin1975 (Jul 21, 2011)

Yes, that is the assumption.


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## a2bc2 (Jul 22, 2014)

Waiting on a call back. They wouldn't tell me dimensions without checking with the dr. He is very very set in his ways it seems.


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## joplin1975 (Jul 21, 2011)

Just remember (said assuming you are in the States), HIPPA requires them to give you all your records. You might have to show up in person, but you do have a right to everything, even with a stodgy doctor.


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## jenny v (May 6, 2012)

> I also think that any doctor who would discharge you from his or her care because you got blood work elsewhere is a sign that he or she is a real jerk


I'll second this! Any doctor worth his or her salt is always fine when a patient wants a second opinion. If he's giving you any hassle over it, I would definitely start looking for another doctor.

And ditto to everything joplin said--you're probably going to have a real hard time stabilizing because you've got antibodies for both Graves and Hashi's. It's a never ending rollercoaster most of the time, unfortunately.


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## a2bc2 (Jul 22, 2014)

Call back from ENT's office said there isn't any "true" nodules they are different shapes and sizes. They are "pseudo" nodules do to the hashimoto's disease so he will keep doing sonograms when I come in and comparing them so there aren't any measurements. Ooookayyyy...


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## a2bc2 (Jul 22, 2014)

Due*


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## Andros (Aug 26, 2009)

I agree w/Joplin1975. Just get that bad boy outta' there. No point in going through all the formalities when the end result in most likelihood will be the same.

Then they will send the gland to pathology and you will know what you need to know. Bottom line!!!

And thank you so much for repeating your history and going to the trouble to add in the ranges. We really appreciate that as it gives a much clearer picture. Different labs use different ranges and that is because the methology differs from lab to lab.

Hugs,


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## joplin1975 (Jul 21, 2011)

Go through the trouble of getting a copy of the ultrasound report. I think it will be worth it. (And, remember, you are legally entitled to it.)

And, yes, get a second opinion. This guy sounds like a class a jerk.


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