# Labs for the cranky one....



## Squirrel (Oct 4, 2012)

Hi everyone, 
After complaining about being cold at inappropriate times, losing a lot of hair and having weight loss difficulties in 2008, my GP began treating me as hypothyroid. Labs were done and I was borderline/sub-clinical, took 25mcg levothyroxine. I was also on birth control and very moody, no matter what brand they tried. 
Other than irritability, most other symptoms gone, but I had a bit of joint pain I chalked up to being physically demanding on my body (I WAS a nationally competitive tennis player). I still feel fatigued when I sleep 12 hours. 
Fast forward to this spring. I decided to see a doc about my knee & hip pains. The only remarkable thing he could find were two cysts on my rt ovary. Ok, off to the gyno, who not one but two docs, said it is probably nothing and are repeating ultrasounds to monitor growth (5x3x3cm). Still waiting on last week's results. 
GP begins inquiring about possibility of rheumatoid arthritis because I also have bouts of a sensation of swelling (not visible) in hands and ankles during periods of inactivity. Labs negative, follow up with rheumatologist indicates arthritis from unknown origin. So a trial on Celebrex is only mildly responsive - hands ankles still hurt, but joint ache gone. I hate taking meds. So I thought about it, and concluded that I never had a baseline study of my hormone levels before I went on birth control. Lets try to cease all medication and test from there. Bingo!
Here are some results:
July results (still taking oral contraceptives)...
Chloride 107 (98-107)
CO2 25 (21-32)
Potassium 4.2 (3.5-5.1)
Sodium 140 (136-145)
Bld urea nitrogen 13 (7-18)
Fasting glucose 83 (70-99)
Anion gap 12 (10-20)
Total protein 6.8 (6.4-8.2)
Albumin 3.5 (3.4-5.0)
Calcium 3.5 (3.4-5.0)
Creatine 0.9 (0.6-1.3)
Bilirubin, total 0.4 (0.2-1.0)
Alk phos 30 (33-136) *
SGOT (AST) 7 (10-37) *
SGPT (ALT) 13 (12-78)
Globulin (calculated) 3.3 (2.5-4.0)
A:G ratio 1.1
BUN: creat ratio 14.4
GFR/age ref 107
GFR est <60
Rheumatoid factor <10 (<15)
CPK 47 (26-192)
WBC 7.1 (4.3-10.7)
RBC 4.05 (3.7-5.3)
Hemoglobin 13 (12-15)
Hematocrit 37.8 (36-46)
MCV 93.5 (80-100)
MCH 32 (27-33)
MCHC 34.3 (32-36)
RDW 12.3 (11.7-13.7)
Plt cnt 282 (135-435)
MPV 9.4 (7.4-10.4)
Neutrophils pct 52.3 (42.2-75.2)
Lymph pct 38.5 (15-44)
Mono pct 5.6 (1.7-9.3)
EOS pct 3.2 (0.0-6.5)
Baso pct 0.4 (0.0-0.8)
Neutrophils number 3.7 (1.4-6.5)
Lymph number 2.7 (1.0-3.0)
Mono number 0.4 (0.1-0.6)
EOS number 0.2 (0.0-0.7)
Baso number 0.0 (0.0-0.2)
Westergren sed rate 11 (0-20)
Free t4 1.12 (0.76-1.46)
TSH 3rd gen 1.7 (0.3-3.74)
ANA negative 
Whew!!!! Now, as a side note, in August I was hospitalized w severe dehydration from a stomach virus and with massive headache and 102.8* fever. Reason I was admitted was because I nearly fainted and have a history of fainting when hungry and overheated from heavy exercise (three times). Also noteworthy is family history of unknown hormone issues. Maternal grandmother had digestive issues, led to removal of stomach, later adrenal glands (went from Cushings to Addison's - or vice versa?); potassium and calcium never in proper balance. Paternal grandmother and aunt severe hypothyroid. 
Going forward, I visited an endo Monday, and here are the partial results... (I am off all meds)
TSH 2.17 (0.4-5.5)
T4 free 1.0 (0.7-1.8)
Microsomal ab 1.9 (<5.6)
PTH intact ?
Vit D 25 hydroxy 14.4 (31-80) *
Gastrin ?
Prolactin 5.3 (2-17.4)
Pancreatic polypept ?
I will report back to fill the remaining. In the meanwhile, what-the-bleep is up with my vit d? I just want to feel normal. I am not depressed just constantly having short explosions of crankiness.


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## Andros (Aug 26, 2009)

Squirrel said:


> Hi everyone,
> After complaining about being cold at inappropriate times, losing a lot of hair and having weight loss difficulties in 2008, my GP began treating me as hypothyroid. Labs were done and I was borderline/sub-clinical, took 25mcg levothyroxine. I was also on birth control and very moody, no matter what brand they tried.
> Other than irritability, most other symptoms gone, but I had a bit of joint pain I chalked up to being physically demanding on my body (I WAS a nationally competitive tennis player). I still feel fatigued when I sleep 12 hours.
> Fast forward to this spring. I decided to see a doc about my knee & hip pains. The only remarkable thing he could find were two cysts on my rt ovary. Ok, off to the gyno, who not one but two docs, said it is probably nothing and are repeating ultrasounds to monitor growth (5x3x3cm). Still waiting on last week's results.
> ...












You definitely have something autoimmune going on because you have microsomal Ab (TPO.)

Anti-microsomal Antibodies- TPO Ab
Negative test is normal; you should not have any of these antibodies. And the healthy person does have a low titer of TPO.
http://www.nlm.nih.gov/medlineplus/ency/article/003556.htm

Alternative NamesThyroid antimicrosomal antibody; Antimicrosomal antibody; Microsomal antibody; Thyroid peroxidase antibody; TPOAb

This may be of interest.

Vitamin D
http://www.eurekalert.org/pub_releases/2009-04/arf-vdm040809.php

In refence to the AST/ALT; you will find that low is good.
http://labtestsonline.org/understanding/analytes/ast/tab/test

Also, wondering if you have been tested for hypoglycemia.

Wondering as well if you have an electrolyte depletion. Your Chloride is high which suggests the other electrolytes might be out of balance and that can cause pain.

http://labtestsonline.org/understanding/analytes/chloride/tab/test

Getting back on board w/the thyroid; I do suggest that you have an ultra-sound of the thyroid.

And see if you can get some testing. I have not made up my mind if you are hypo, hyper or flipping back and forth.

The latter is entirely possible.

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

Trab
http://www.ncbi.nlm.nih.gov/pubmed/17684583

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/

When you say ANA was negative, does that mean none or below the range?

Thank you sooooooooooooooooooooo much for adding the ranges. W/o them we would have been little lost lambs.


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## Squirrel (Oct 4, 2012)

I had my last thyroid US about 18mos ago. 
I will get the ANA to you when I get home. 
I would suspect hypoglycemia, as I am esp grouchy around mealtime and do get shaky. Although, it is only recently, after I stopped levothyroxin, that I am once again feeling hypoglycemic. 
BP jumps all over the place, from 110/70 to 140/80. Very inconsistent. 
Last years cholesterol numbers were all borderline bad.


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## Squirrel (Oct 4, 2012)

Antinuclear antibodies by ifla - negative (NEG)
ANA ab titer - n/a (NAPL)

Now I'm wondering if this "swollen" sensation is more like general numbness. Best I can describe is that I know my hands are "there", but they feel like giant balloons. There is no consistent pattern to this. Some days are fantastic, no pain. Other days not so good, but I can't say "bad" - just really annoying. I tried keeping a food log, and noticed that after high sodium foods (I.e. Indian, Asian, ham, etc) I have that sensation, sometimes immediately, sometimes the next day). Glutens don't seem to bother, but I haven't been too actively reducing them, either. I cannot get any docs to look into dietary correlations.

Menstruation is especially irregular, and two gynocologists and GP don't care. Last two months I had miserable cramps that stopped me in my tracks like a little schoolgirl. Flow was stronger than normal and lasted longer (10 days vs usual 6). I have been spotting very heavily a week before scheduled (almost like a full period). This has happened both on and off the pill. All docs wanted me to try a different birth control. I was already on Sprintec (monophasic, with 7 inert). They wanted to move to a 28-active schedule instead of 21 days of hormone. Something is definitely wrong here. As far as usage of oral contraceptives to regulate hormone imbalance, I think I was at the max. Emotionally, I could not use the Yaz-type pill, where I would have no period. All I could worry about was that the "missed" period wasn't from pill use, but a pregnancy which I was damaging.


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## Squirrel (Oct 4, 2012)

Still waiting on pancreatic polypeptide.

Gastrin 65 (18-47)*
PRH intact 22 (10-60)

Endo indicated that gastrin levels need to reach 500 to be indicative of a tumor. He suggested I begin 2000 units Vit D daily.


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