# Help with Labs? Still feel terrible!



## Pelzergirl (May 24, 2011)

The doc resisted doing all the labs I asked for.. He said there's no reason to test for those things since I already have a grave's diagnosis. : ((

Here's the numbers I got today:

T4 Free

May 26 - 5.4
June 2 - 1.6
Range 0.6 - 1.1

T3 Total

May 26 - 278

No range listed, only shows ()??

TSH

May 26 - .013
Range 0.4 - 4.0

AST (what the heck??)

May 26 - 41
Range 1-45

I'm on 60 mg of Tapazole and 50 of betablocker..

Still feel terrible, maybe little less tremor.. Asked directly several times was there anything I could do to "flush" it out quicker, diet, other meds.. he said NOTHING, suck it up, you should feel better by next appt in a month!

I truly feel like I can not go on another week much less month like this...

I'm partly relieved that I didn't have to go in for emergency surgery to remove it today.. but also disappointed that there's no relief in sight! : ((

Advise please!!??!!


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## Andros (Aug 26, 2009)

Pelzergirl said:


> The doc resisted doing all the labs I asked for.. He said there's no reason to test for those things since I already have a grave's diagnosis. : ((
> 
> Here's the numbers I got today:
> 
> ...


You are very hyper. The Tapazole is not working and this is not unusual in advanced cases. Putting you on more Tapazole can only cause a very serious adverse reaction.

Are you opposed to knocking that thyroid out of the saddle?

And quite frankly, if I were you, I would be looking for a much better doctor.

How do you know you don't have cancer. Hyper and cancer are often bedfellows.

Have you had a sonogram or RAIU (radioactive uptake scan?)

Do you have the criteria for Graves' which is exophthalmos, goiter, pretibial mixedema and thyrotoxicosis (this one you have.) You must have 3 out of the 4 as per Dr. Robert Grave's. There is no test for Grave's. It is a visual (clinical)evaluation. There are tests for hyperthyroid. TSI (thyroid stimulating immunoglobulin.)

This cannot be flushed out. This is a chronic disease which is autoimmune.

Thyroid Storm Symptoms
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001437


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## bigfoot (May 13, 2011)

I love it. Yet another doctor who thinks "just get over it". I agree with Andros -- time to find another doctor ASAP. I think your doctor must know my doctor or something. Maybe they were roommates in medical school, LOL.

"AST" is a liver function test to see if you have liver disease or damage. Usually it is also run with an "ALT" test. Your number is getting up there in the normal range, but I've gotta believe some of that is due to the medication, such as Tapazole, that you are running through your body. I wouldn't sweat your numbers too much -- you can even take some OTC pain medication and raise your liver numbers. Stress plays a part, too.

http://en.wikipedia.org/wiki/Liver_function_tests

http://www.mayoclinic.com/health/liver-function-tests/MY00093

Hang in there!! :anim_32:


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## Pelzergirl (May 24, 2011)

Thank you so much for the responses, this is the best resourse I have found and you guys are great!!

Andros.. thanks for taking the time to comment.. tried to clarify below.. Any ideas?

I though the T4 coming down indicated the Tapazole is working??

I really don't want to have the thyroid out if possible, it seems like between the para's and going hypo it's almost as bad..? Not a candidate for the radiation (sheww would rather the surgery) because I'm too 'HOT'..??

I'm stuck with this endo group in my area, further out was one that would see me in September.. don't think I have the resources or the heart to try further away for what's likely the same attitude : ((

I asked about cancer!! I mean, it's possible, I've been Graves for 8 years.. he tut tuted me and said that he wished patients would stay off the internet and let him do his job!!! OMG

I had the uptake scan back in 04 when I first had this issue.. they said it was clearly Graves. The tech and the Dr's&#8230;

I don't have the skin issue, the eye issue or any goiter..

I understand that I can't flush out the Graves, but what about the excessive thyroid stuff.. Dr was adamant that I just had to suck it up and be miserable until it came down more.. I just want to go back to 2 months ago when I could funtion... it's been all these years fine.. now this... surely there's something to speed up the flush??


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## mixer23 (Jun 21, 2011)

Hi!
I have had terrible muscle weakness and pain off and on since jan. I was placed on methimazole in dec along with beta blocker, k+ and lasix. My recent labs are:06/16 ft4 2.73 (0.82-1.77) tsh <0.006 (0.450-4.50). Labs in May show antibodies were high. Doc wants to stop tirosint and restart methimazole(stopped on 06/08). I currently have the muscle pain and weakness and have had to call off work. Does this sound right??


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## Andros (Aug 26, 2009)

mixer23 said:


> Hi!
> I have had terrible muscle weakness and pain off and on since jan. I was placed on methimazole in dec along with beta blocker, k+ and lasix. My recent labs are:06/16 ft4 2.73 (0.82-1.77) tsh <0.006 (0.450-4.50). Labs in May show antibodies were high. Doc wants to stop tirosint and restart methimazole(stopped on 06/08). I currently have the muscle pain and weakness and have had to call off work. Does this sound right??


Why in the world are you on Tirosint when you are so hyper? Is doc doing block and replace?

Have you had RAIU (radioactive uptake scan?) What antibodies' test did you have that was so high?

Why are you on Lasix? That is one strong and dangerous diuretic and is not potassium sparing.

Have you had any of these antibodies' tests?

TSI (thyroid stimulating immunoglobulin),TPO (antimicrosomal antibodies) TBII (thyrotropin-binding inhibitory immunoglobulin), Thyroglobulin Ab, ANA (antinuclear antibodies), (thyroid hormone panel) TSH, Free T3, Free T4.

You can look this stuff up here and more.........
http://www.labtestsonline.org/

TSI
Normally, there is no TSI in the blood. If TSI is found in the blood, this indicates that the thyroid stimulating immunoglobulin is the cause of the of a person's hyperthyroidism.

http://www.medicineonline.com/topics/t/2/Thyroid-Stimulating-Immunoglobulin/TSI.html

Do you have a goiter, swollen lymph nodes in your neck/clavicle area?


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## mixer23 (Jun 21, 2011)

May 17, 2011 (endocrinologist)

thyroglobulin,Qn=2192.0 (0.5-55.0)
antithyroglobulin Ab=<20 (0-40)
TPO ab =220 (0-34)
tsh=2.220 (0.450-4.500)
Ft4 direct =0.67 (0.82-1.77
total ck= 209 (24-173)
sed (westergren) 27 (0-20)

started Tirosint 75mcg daily, stopped methimazole, lasix and potassium. Still had muscle pain, weakness and had to call off work.

June 16, 2011

Ft4 2.73 (0.82-1.77)
tsh <0.006 (0.450-4.500)
ck 54 (24-173)
sed (westergren) 63 (0-20)
vit d <22 low

Started 2,000iu vit d daily, stop tirosint, start cytomel 25mcg(pcp) and got a shot of kenolog (pcp). Still feel like crap.

Thank you for your reply!


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## Andros (Aug 26, 2009)

mixer23 said:


> May 17, 2011 (endocrinologist)
> 
> thyroglobulin,Qn=2192.0 (0.5-55.0)
> antithyroglobulin Ab=<20 (0-40)
> ...


Thank you for furnishing your labs and ranges. Do not believe I have ever seen a Thyroglobulin that high.

It would be in your best interest to get RAIU (radioactive uptake scan) as high thyroglobulin is suggestive of cancer. Especially in combination w/high TPO.

Sadly, you have not answered my questions.

Here is info on thyroglobulin as related to the possibility of cancer.

http://www.labtestsonline.org/understanding/analytes/thyroglobulin/test.html

cancer TPO and thyroglobulin
http://onlinelibrary.wiley.com/doi/10.1111/j.1699-0463.1994.tb04888.x/abstract

Understanding Thyroglobulin Ab.
http://www.labtestsonline.org/understanding/analytes/thyroglobulin/test.html

Why would the doctor give you Kenalog? I do need you to have some input here re the questions I ask.

Either you are over medicated or you are hyperthyroid or both. (as of the June labs)


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## mixer23 (Jun 21, 2011)

May 17, 2011 (endocrinologist)

thyroglobulin,Qn=2192.0 (0.5-55.0)
antithyroglobulin Ab=<20 (0-40)
TPO ab =220 (0-34)
tsh=2.220 (0.450-4.500)
Ft4 direct =0.67 (0.82-1.77
total ck= 209 (24-173)
sed (westergren) 27 (0-20)

started Tirosint 75mcg daily, stopped methimazole, lasix and potassium. Still had muscle pain, weakness and had to call off work.

June 16, 2011

Ft4 2.73 (0.82-1.77)
tsh <0.006 (0.450-4.500)
ck 54 (24-173)
sed (westergren) 63 (0-20)
vit d <22 low

Started 2,000iu vit d daily, stop tirosint, start cytomel 25mcg(pcp) and got a shot of kenolog (pcp). Still feel like crap.

Thank you for your reply!


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## mixer23 (Jun 21, 2011)

I'm sorry!

I was diagnosed in 1996 with hyperthyroidism. Was told I my thryroid "was hot" I had a raiu done. In 2008 I had a FNA biopsy done-negative. In nov 2010 I got short of breath and went to the ER. Was told I had chf and was given lasix. I stayed for 3 days. Went back to pcp and he placed me on lasix, beta blocker, methimazole, potassium. As I gradually went hypo the meds were decreased and now finally stopped. 
The 2 labs shown are 1 month apart. Endo wants me to stop Tirosint and restart methimazole at 5mg daily. I just found out a few minutes ago that on june 16 he also ordered a ft3 ed. I called the lab to find out what that was and was told it stands for ft3 equilibrium dialysis. The "gold standard" for ft3 testing. A test to check for thyroiditis. It takes about 9 days to complete the test so I still have a couple of days before results. And yes i have a multinodular goiter. These are the only antibody tests I have had. I was given the kenolog shot to see if it would help with the muscle pains.

Thank You!


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