# Labs-Even Endo is perplexed



## BeachMom01 (Sep 2, 2013)

Hi Everyone,

I am a 41 year old female.

I went to my primary care in the beginning of August complaining of extreme fatigue, heart racing, sore throat/occasional hoarseness, heat intolerance, loss of weight, & major irritability, brain fog, insomnia x 1 month ..just to name a few of the symptoms I am having. He ran some labs:

Aug 7 th TSH came back at .34 (.4-4.5)
Vit D was low, B12 and Folate were low normal.

Put me on vit D.

He sent me for an ultrasound, 3 nodules...one of which 1.7cm, they are all solid.

So end of August, off to an endo I go...she orders a bunch of labs plus an uptake scan:

TSH- 0.13 (0.3-3.5)
Free T3- 2.5 (1.5-4.1)
Free T4- 1.54 (0.8-2.00)
Anti-TPO Abs- <10.00 (0.00-35.00) 
Anti-TG Abs- <20.00 (<20.00=undetectable)
Prolactin- 14.6 (3.8-23.2)
TRab- <1.00 (<1.0 negative, >2.00 positive)

RAIU results- 4 hour uptake- 4% and no hot or cold nodules, in fact they don't show up at all, looks like thyroiditis.

She was perplexed because she thought for sure it was Graves and it ends up a really low uptake.

Basically said well, not sure, but looks like maybe thryoiditis from a viral infection.

She diagnoses thyroiditis from a viral infection, says all your labs are perfectly normal except TSH, gives me a beta-blocker because I am having so many symptoms of hyper, and says see you in a month for an ultrasound, she doesn't think those nodules are even nodules, she just thinks the thyroid is inflamed and it will all go away in a month.

I'm really unsure. I'm going to see my ob-gyn to make sure this isn't ovarian in nature (I know in rare ovarian tumors TSH can be low), it has been 8 weeks of pure hell. Is thyroiditis from a viral infection common? I have not been sick at all...not even a sniffle in over a year or more until all of these weird symtoms started.

Are there any other labs I should have run?


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## Lovlkn (Dec 20, 2009)

I would lab in 6 weeks TSH, FT-4 and FT-3.

Giving you a beta blocker was a good decision, since your labs are quite normal.

The goal in running another lab is to try and see if there is a pattern or possibly be able to catch the hormone surge causing your issues.

How much Vit D are you not taking and what was your starting number? Low D causes some wicked fatigue. I suffered post TT and can really notice a difference now that I am in the 70's.


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## Velcro (Jul 26, 2013)

My labs came back low in Vit D also a couple of years ago (24), so I was started on 5,000 a day. It has come up and although I still have fatigue due to other autoimmune diseases, I can tell a difference since taking the Vit D.


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## BeachMom01 (Sep 2, 2013)

My Vit D was 19 and I'm taking 5,000 units a day. I'm feeling better. Still waiting to get into see the Gyn doc to make sure it isn't a sneaky ovarian tumor causing the whacky TSH. My symptoms seem to be abating a little so hopefully that is a good sign.

Thanks for the input, going to re-do the labs in 6 weeks and see what they look like.


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## Lovlkn (Dec 20, 2009)

Beach,

Are you feeling better since adding the D? When I started D I was on 50KIU daily for 6 weeks. If you D does not increase quickly enough you might ask your doctor for a prescription of D.

MIne was in the 27 range and up to 70 7 wks later. I now have to supplement with 5KIU daily to maintain around 70 (30-100)


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## BeachMom01 (Sep 2, 2013)

I feel a little better since starting the Vit D, but I still have days where I am just hit with this awful fatigue. I thought about increasing the dose of Vit D to see if it would help more. Maybe I will give that a shot. I'm just so frustrated.


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## Lovlkn (Dec 20, 2009)

I checked my records and was actually taking 50KIU weekly for 12 weeks to get into the 70's. You are only taking 35KIU by taking the 5KIU daily. Check with your doctor - and be sure to do a follow up lab.

What amazes me the most is I still have to take 5KIU 6 days a week to maintain. I think the 50KIU boosts it up then gives you a fighting chance to keep it up with daily supplementation.


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## BeachMom01 (Sep 2, 2013)

A little update on my situation. In october all labs were normal and a repeat ultrasound showed the nodules, but endo wanted to just watch. Repeat labs in January and ultrasound in 6 months.

January labs on 1/14/14:

TSH- 0.44 (0.3-3.5)
Free T3- 6.0 (1.5-4.1)
Free T4-1.32 (0.8-2.00)

I was feeling much better, only weird symptom was extreme hair loss (it has been going on since November). However, I have been on a beta-blocker since September to relieve my other symptoms.

So they said I am hyper...again. No change in treatment, just observation with repeat ultrasound and follow-up appt in April.

Follow-up with OB/GYN and pelvic ultrasound was normal so that was not the cause of the original low tsh.

It seems so strange to me that a viral thyroiditis would last this long. It has been 6 months since this all started.

Hopefully Appt in April will yield more answers.


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