# Lab results need help pls



## Megan.faith10

So doc said my tsh level isnt low enough to treat n gave me buspar.... Here are my labs

T3 up take: 61 ref range 32 to 48
Free thyroxine index: 8.1 ref range 1.5 to 4.4
T4 total: 13.2 ref range 6.1 to 12.0
Tsh: .59 ref range .34 to 5.60
T3 free: 3.2 ref range 2.3 to 4.2
T4 free:, 1.08 ref range .75 to 2.00

Ugh. Help


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## chopper

Hi Megan,

I would LOVE to see a Thyroid Stimulating Immunoglobulins (TSI) and antibodies test.

Looks like you've got something going on - probably Hashimotos or even the beginning of Graves or both.

I am particularly interested in your high TOTAL T4 yet on the low side FREE T4 - that doesn't jive and your T3 Uptake was very high, similar to mine except my T4 was low, not high.

What kind of symptoms are you dealing with?


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## Megan.faith10

He wont do an antibodies test for another month. It was an endo i saw... Im getting so down and dont know where to turn!

Symptoms:

Increased appetite
Heart palpitations
Trouble staying asleep
Fast heartbeat
Loose stools/diarrhea
Frequent urination
Some anxiety but it seems more physical if that makes sense
Feel so tired
Lost 35 lbs in 2 months
Nervousness for no good reason lol

He kept me on the beta blocker which at least helps some of my physical symptoms so i can somewhat function. By the end of the day, i cant keep my eyes open  i just dont know who to see next. I know its not anxiety... I know my body better then that! They put me on zoloft and it made me sooo crazy! Xanex/ativan did nothing. Lord help me!


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## chopper

Tired and wired. I know the feeling. Read my piece about Hashitoxicosis and see if it sounds right. I'll bet you've got the trifecta of antibodies as well and that's causing the trouble, particularly that damned TSI - that's the culprit. You need to get that test. In the end, if it's not Hashitox, it's probably your garden variety of Graves. Was this your very first set of thyroid labs?

Check it out: http://www.thyroidboards.com/hashitoxicosis/

I even made a comment to one of the other "old timers" here how your labs, barring the high Total T4 are a lot like mine. I'll bet your labs fluctuate a lot from test to test.


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## Megan.faith10

Ya thats how i feel! Ugh. Alot depends on the time of day... Morning is the worst!

How do i get that test? He wont do an antibody test for another month and has it marked on the lab paper for tpo antibody. Gosh this sucks!! Should i see an holistic doc?


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## chopper

If that doctor thinks your labs were nothing out of the ordinary than you need to see someone else. The guy probably specializes in diabetes like most endos.

You need TPO AB, TG Ab and TSI. TRUST ME.....get the TSI test now and save yourself years of mis-diagnoses.

This is what I consider a "full" thyroid test:

TSH
Free T3
Free T4
Total T3
Total T4
Thyroid Peroxidase Antibody (TPO Ab)
Thyroglobin Antibody (TG Ab)
...and in your case Thyroid Stimulating Immunoglobulin (TSI)

Next....there are a lot of other things the thyroid works its magic on and I would want it explored further:

CMP - Comprehensive Metabolic Panel
AM Cortisol
ACTH (adrenals)
Cholesterol
Prolactin
Sex hormones - Estrogen, FSH, LH

You are shaky and nervous because your Total T4 is HIGH - you are hyperthyroid in my opinion.

If you are not familiar with any of the tests above just google them. You may as well start your thyroid education now because if you have thyroid trouble, you are going to need it.

I don't see any need to wait another month. Find a doctor who will give you good labs - pre-screen them - tell them before your appointment if he isn't going to write me labs, Im not making the appointment - it's that simple. Let them know YOU are in charge.

How old are you?

Have you recently had an event to trigger this? Quit smoking, had a baby, death, divorce, etc? Many of us first fall apart with a trigger - quitting smoking is a big one along with having a baby.


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## Megan.faith10

Okay so ill try n find a different endocrinologist.
I had a baby sept 25, 2010... I also had the iud in but got that removed when i started feeling in around march 9th.

Ill have to hope to find a better endo who specializes in thyroid issues! Ugh lol. Do you happen to be in california? Howd you finally get diagnosed?


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## lavender

You sound a lot like I was before I was hospitlaized in thyroid storm. Exhausted but couldn't sleep. This doc's refusal to do further testing or treat your thyroid is dangerous. You need to see someone else. Nasdaqphil's list of tests is good.


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## Megan.faith10

Okay so who should I go to or can I get these antibodies done myself somehow? This is [email protected]#!! Are we allowed to chat outside of this? Lord knows I need more help on this since they wont listen to me


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## chopper

You can PM a person and ask for their email if you want to chat off the boards.

The timing is perfect with your baby for all hell breaking loose. Probably half the people here either had a baby or quit smoking.

I quit smoking the same time my wife got pregnant with our first and 3 months later all hell broke loose.

As for diagnosis, get the TSI - if and when it comes out high (mine is 189 in a range of 0-125 but you should have ZERO) you'll probably need an RAIU - RadioActive Iodine Uptake scan test. You take a little shot of radioiodine and then they take pictures of your thyroid to get a really good look at what is going on. They may even ask for an FNA (fine needle aspiration, biopsy) to get a better picture as well.

Ultimately if you are hyper, they may try anti-thyroid meds but ultimately, you'll probably end up with surgery or RAI - radioactive iodine ablation - a heavier dose of radioiodine that kills the entire thyroid. After that you take thyroid replacement meds the rest of your life but at least your thyroid is controlled.


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## Andros

Megan.faith10 said:


> So doc said my tsh level isnt low enough to treat n gave me buspar.... Here are my labs
> 
> T3 up take: 61 ref range 32 to 48
> Free thyroxine index: 8.1 ref range 1.5 to 4.4
> T4 total: 13.2 ref range 6.1 to 12.0
> Tsh: .59 ref range .34 to 5.60
> T3 free: 3.2 ref range 2.3 to 4.2
> T4 free:, 1.08 ref range .75 to 2.00
> 
> Ugh. Help


Megan; I believe you are hyperthyroid!! When a patient presents with such a high T3 Resin Uptake, that points to hyperthyroid.

Because your TSH is so low, it would be reasonable to suspect hyper rather than the other things listed. But, you need to speak to a doctor about this.

Greater than normal levels may indicate:

•Kidney failure
•Overactive thyroid (hyperthyroidism)
•Nephrotic syndrome
•Protein malnutrition
http://www.nlm.nih.gov/medlineplus/ency/article/003688.htm

I sincerely hope you have not taken the Buspar which will only mask your symptoms.

Please get this test.

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

Please note: the healty person has no TSI. If you get the test, get a copy of the results because they will tell you it is in range. That is a misnomer. The range is only to detect movement. I personally need the numbers; okay?

Any doctor can order the TSI test for you. Or you can go here if they have one in your area.

HealthCheckUSA

http://www.healthcheckusa.com/


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## Megan.faith10

so i called another endos office, she took my lab values, i demanded antibody tests for a second opinion, and they are supposed to call me back.

I broke down today n cried. Thrn I realized, im not giving up no matter what it takes. Im tempyed to buy a tsi test online to be honest. Gosh im sick of crappy docs!! Anyone from california by chance? My daughter needs her mommy back!!


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## Megan.faith10

No i refuse to take anti depressants... I know anxiety is not the issue.

Im unsure of where to turn. Gosh im so young and these docs are taking a toll on mee ugh. The only thing keeping me functioning is the beta blocker sadly.


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## Megan.faith10

Question: will a tpo test be useful? Im going to order one online


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## chopper

Megan.faith10 said:


> Question: will a tpo test be useful? Im going to order one online


Yes, absolutely. If TPO is high you almost certainly have hashimotos. Normal people don't have these antibodies. Mine have been in excess of 3000 in the past.


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## Megan.faith10

well my TPO value was .7 (0.0-9.0)
and my tsh receptor antibody test was <.90 with no reference range given.

Im confused.

Both are still present but within range.


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## Andros

Megan.faith10 said:


> well my TPO value was .7 (0.0-9.0)
> and my tsh receptor antibody test was <.90 with no reference range given.
> 
> Im confused.
> 
> Both are still present but within range.


Trab. You should not have Trab. (Thyroglobulin antibody) You do have a smattering of it.

http://www.liebertonline.com/doi/abs/10.1089/105072504323030951?journalCode=thy

TRAb can act as blocking antibodies; This indicates a need for paired determinations of both TSH-binding inhibitory immunoglobulin (TBII) and thyroid-stimulating immunoglobulin (TSI) for accurate clinical correlations. Cloning the TSH-receptor gene has clarified its structure and function. .....
http://www.ncbi.nlm.nih.gov/pubmed/1633635

http://www.mayomedicallaboratories.com/test-catalog/Overview/81797

This also means that you probably have TSI (thyroid stimulating immunoglobulin) as well.


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## Megan.faith10

Thank you for responding Andros as Im going nuts LOLOL!

*sigh of relief*

Could this all be a goiter problem? I found a hard lump (feels like bone) underneath my adams apple and its very uncomfortable. I will get a TSI ASAP! Right when I can afford it. My tsh rose from .59 to 1.57 in a month so Im even more confused.


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## Andros

Megan.faith10 said:


> Thank you for responding Andros as Im going nuts LOLOL!
> 
> *sigh of relief*
> 
> Could this all be a goiter problem? I found a hard lump (feels like bone) underneath my adams apple and its very uncomfortable. I will get a TSI ASAP! Right when I can afford it. My tsh rose from .59 to 1.57 in a month so Im even more confused.


Your TSH is not reflecting your true status due to blocking and binding of the TSH receptor site.

You also need the FREE T3 and FREE T4. And yes, it sounds like a goiter is developing. Sometimes they will take the path of least resistance and grow inward rather than outward. I would suggest you talk to your doctor more about this.

Is your doctor taking a back seat on this? If so, I urge you to find one that is proactive on your behalf.


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## Megan.faith10

Ok Andros.

06/09/2011

t3 free: 3.1 (2.3-4.2)
t4 free: .97 (.75-2.00)
tsh 1.57 (.34-5.60)
Microsomal AB (Thyroid Peroxidase) .7 (0.0-9.0)
Tsh Receptor Antibody *<.90 (no reference range)

Thats my latest labs from about a week and a half ago. This bump on my neck is noticable when I tilt my head back and moves when I swallow... Its so odd.


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## Andros

Megan.faith10 said:


> Ok Andros.
> 
> 06/09/2011
> 
> t3 free: 3.1 (2.3-4.2)
> t4 free: .97 (.75-2.00)
> tsh 1.57 (.34-5.60)
> Microsomal AB (Thyroid Peroxidase) .7 (0.0-9.0)
> Tsh Receptor Antibody *<.90 (no reference range)
> 
> Thats my latest labs from about a week and a half ago. This bump on my neck is noticable when I tilt my head back and moves when I swallow... Its so odd.


As you can see, your FT4 is in the basement and the FT3 is below mid-range.

What concerns me is this.

T3 up take: 61 ref range 32 to 48
Because it is so high, that indicates possible hyperthyroid.

Please read this.
http://www.nlm.nih.gov/medlineplus/ency/article/003688.htm

I know your thyroid panel does not reflect the "typical" hyper numbers but I suspect that is because of antibodies, autoantibodies and immunoglobulins are at "play" here.

Yes, if you take a mouthful of water, tilt your head back in front of a mirror and swallow, you should be able to see the goiter.


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## Megan.faith10

My endo told me my t3 uptake, total t4, and free thyroxine index is all high because I have extra estrogen which is a good thing... LOL!

Im gonna get the TSI test done as well asap. Yes i drink water and I can see that bump move. I can feel it moving when I swallow as well. Gosh, why cant doctors just know what they are doing? GRRRRRRRR!!!!!!!

Could my t4 be dropping cause im on a beta blocker or no? Thanks hun so much!


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## Megan.faith10

Since you guys are alot more knowledablge, here is a pic of my throat and the bump. Its below my adams apple which you obviously cant see lol any advice? Comments?

http://img.photobucket.com/albums/v167/cheerleading05/2011-06-18150451.jpg


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## Megan.faith10

Can anyone take a look at my picture? Could this be a possible goiter? Im so tired of being sick 

Any answers would put my mind at ease. Ive looked alot up online and most say its a goiter that could be producing thyroid hormone. Guess Im just holding onto hope that their is a way to fix me


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## McKenna

Goiter really just means enlargement or swelling of the thyroid. When I had my thyroid, it would swell, go down, and swell again. It's hard to tell from a pic, you should have your neck palpated by a doctor.

From reading your last few posts, the most important thing you can get right now is the TSI test. Is there a reason why you haven't had it yet? Take it from someone who was Hashitoxic....you need that test to get a complete picture. But get the full panel done at the same time too, b/c levels can flutuate.



> Could my t4 be dropping cause im on a beta blocker or no?


Nope. Your t4 could be dropping b/c you're on the down swing of a Hashi's attack and going hypo.


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## Andros

Megan.faith10 said:


> Since you guys are alot more knowledablge, here is a pic of my throat and the bump. Its below my adams apple which you obviously cant see lol any advice? Comments?
> 
> http://img.photobucket.com/albums/v167/cheerleading05/2011-06-18150451.jpg


Absolutely it'a a goiter. OMG!! And a doctor does not "see" this? Are you kidding me? Outrageous!


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## Andros

Megan.faith10 said:


> My endo told me my t3 uptake, total t4, and free thyroxine index is all high because I have extra estrogen which is a good thing... LOL!
> 
> Im gonna get the TSI test done as well asap. Yes i drink water and I can see that bump move. I can feel it moving when I swallow as well. Gosh, why cant doctors just know what they are doing? GRRRRRRRR!!!!!!!
> 
> Could my t4 be dropping cause im on a beta blocker or no? Thanks hun so much!


Beta-blockers: Beta-blocker drugs, such as atenolol, do not block the production of thyroid hormone. Instead, they control many troubling symptoms of this hormone imbalance, especially rapid heart rate, trembling, anxiety, and the high amount of heat the body produces with this condition

http://www.hormone.org/Thyroid/hyperthyroidism.cfm


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## Megan.faith10

Andros thank you so much for the info. I just noticed the bump last Friday. Its growing. I think its been there just been gradually growing. I go Thursday to a different doctor who maybe will give a flying *@&$! Sorry Im just really upset. How can doctors be so blind and stupid? Its so frustrating.

I havent had the TSI cause no doctor will get it! They are stingy and rude here. I havent had help for 3 months... Just antibiotics (obviously dont help the lump in the throat and tightness feeling), and antidepressants. Gosh I wanna cry. Im so glad Im stubborn and persistent. Im gonna upload another picture.


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## Megan.faith10

http://img.photobucket.com/albums/v167/cheerleading05/2011-06-21075355.jpg

This pic was taken today. My whole neck looks funny to me.


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## lavender

It looks a bit swollen to me, but I didn't comment because I NEVER had a goitre. Despite many exams over the course of my thyroid storm, my doc could not find one. I even had a doc dismiss me years back because she could not find a goitre. Ridiculous. There are many docs who are simply ignorant about thyroid disease, which can lead to dangerous results for us patients. I hope you can find a better doc.


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## Andros

Megan.faith10 said:


> Andros thank you so much for the info. I just noticed the bump last Friday. Its growing. I think its been there just been gradually growing. I go Thursday to a different doctor who maybe will give a flying *@&$! Sorry Im just really upset. How can doctors be so blind and stupid? Its so frustrating.
> 
> I havent had the TSI cause no doctor will get it! They are stingy and rude here. I havent had help for 3 months... Just antibiotics (obviously dont help the lump in the throat and tightness feeling), and antidepressants. Gosh I wanna cry. Im so glad Im stubborn and persistent. Im gonna upload another picture.


I'll tell you what to do. Start talking about cancer. That will get their attention. I hate to resort to such tactics but I don't like "their" tactics any better.

Giving patients the brush-off seems to be the only thing they are good at. Oh yeah; and writing comments on the patient's chart that they are psychosomatic, suffering from depression etc.. Once that is on your record, you are shot down.

"There outta' be a law!"


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## lavender

I've had the depression it's all in your head brush off from docs, even after I had a diagnosis. I had to start over with a new doc. I took her copies of all the labs I already had done, but never transferred my chart. She looks at my labs and my symptoms and not once has she suggested it's all in my head. I know I have mental issues. I see a therapist and they are under control. I know the difference between physical symptoms and my mental health symptoms. I know that anti-depressants don't help me. I also know that being really sick for a long time and not getting help from docs makes me depressed and feel crazy. The solution is not drugs, but to actually find someone to address my physical symptoms.


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## Megan.faith10

hugs1

Thanks guys!

I have an appointment in an hour for the lump on my throat with a new doc. Wish me luck. All I know is my charts from the emergency room say "Severe Anxiety" LMAO! I know what anxiety alone is... my symptoms are PHYSICAL not MENTAL! And hell yea im gonna stay stressed when I feel like crap everyday... who wouldnt?

Thanks for the hope! Im hopeing for an ultrasound at least of my throat... This bump is bothersome. I will update after my appointment.


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## webster2

I am wishing you the best of luck, buckets and buckets of luck! Hang in there, be an advocate for yourself! I was able to use some of the things I've learned here to insist on treatment. And, it worked! I will keep you in my thoughts! Best Wishes!


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## Andros

Megan.faith10 said:


> hugs1
> 
> Thanks guys!
> 
> I have an appointment in an hour for the lump on my throat with a new doc. Wish me luck. All I know is my charts from the emergency room say "Severe Anxiety" LMAO! I know what anxiety alone is... my symptoms are PHYSICAL not MENTAL! And hell yea im gonna stay stressed when I feel like crap everyday... who wouldnt?
> 
> Thanks for the hope! Im hopeing for an ultrasound at least of my throat... This bump is bothersome. I will update after my appointment.


Good luck today, Honey Bunny and please let us know. We will be with you in spirit when you see the doc today.

Ditto what you said. Yes, indeed! Sick = stress


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## Megan.faith10

So I met with the new doctor. He said my thyroid tests are negative (idk how that is considering there is a number for my antibody tests) BUT said the lump on my neck is not normal.

Therefore, I have a scheduled thyroid ultrasound for the 28th! OMG Im sure you have an idea of how excited I am lol. Best thing Ive had happen in months!!!!!!!!

Now to see what they say. Lord only knows. I just want to feel better!

Thanks for all your kind words. Im still wondering if I should get the TSI antibody tests as Ive only had TPO and TRAb done. Thanks a bunch hugs1


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## Andros

Megan.faith10 said:


> So I met with the new doctor. He said my thyroid tests are negative (idk how that is considering there is a number for my antibody tests) BUT said the lump on my neck is not normal.
> 
> Therefore, I have a scheduled thyroid ultrasound for the 28th! OMG Im sure you have an idea of how excited I am lol. Best thing Ive had happen in months!!!!!!!!
> 
> Now to see what they say. Lord only knows. I just want to feel better!
> 
> Thanks for all your kind words. Im still wondering if I should get the TSI antibody tests as Ive only had TPO and TRAb done. Thanks a bunch hugs1


I would say that "probably" you do have TSI if Trab is present.

http://www.liebertonline.com/doi/abs/10.1089/105072504323030951?journalCode=thy

Boy, am I happy about the ultra-sound. And very happy the doctor did seem to pay attention to the fact that you have a swollen thyroid. That is impressive because so many get disregarded on this one single issue.

But, doc.....................my thyroid is swollen! Your thyroid does not look swollen to me! Yeah, right. It's not his/her thyroid so how would he/she know?


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## webster2

I am so happy that you are having an ultrasound soon!


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## Megan.faith10

Thanks you two!

I still plan on getting the TSI cause at this point, I have to take matters in my own hand as they think I have no thyroid issue...

Ill update on Tuesday when I get the ultrasound hugs8


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## Joolzy

Hi Megan!

Finally someone i listening to you, well done!! Sadly most of us have to really kick up a fuss to get a doctor to believe us. Only 3 days ago I watched in horror as my doctor wrote out my scan form with 'psychocomatic' on. I'm planning to go up today and politely tell them to ERASE that hehe 

Best wishes with the ultrasound! I've got my next one on the 7th 

:hugs:


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## Andros

Megan.faith10 said:


> Thanks you two!
> 
> I still plan on getting the TSI cause at this point, I have to take matters in my own hand as they think I have no thyroid issue...
> 
> Ill update on Tuesday when I get the ultrasound hugs8


Will be looking forward to the results of that. It will be a relief to get to the bottom of this.

All will be well; take a deep breath.

We are here for you!


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## Megan.faith10

The thing that bothers me the best, is how much doctors are not willing to listen. They see numbers and dont care about your symptoms. So far ive been told I have severe anxiety, irritable bowel syndrome, depression, gastritis, and GERD LMAO! Been put on Zoloft, given an rx for Buspar and Effexor, Ativan, Xanex, and Carafate. I really cant put my life in a doctors hands and its sad.

Here is a pic I took about 20 mins ago. Anyone ever experienced this? It seems the bump is directly below the "adams apple" (im a female), very hard, moves when I swallow or hiccup, but doesnt seem to be attached to the skin or anything.

http://img.photobucket.com/albums/v167/cheerleading05/2011-06-24160921.jpg


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## ScaredAJ

It's going to be okay! you have their attention! Good luck!


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## Megan.faith10

aw ty hun!

Im just so tired and worn out and its becoming more and more "difficult" to swallow. I can feel the lump and just swallowing saliva seems like a task. Tuesday cant come soon enough.

Not to mention I just started a new job and my health is s$#%ty! LOL

I want to say thanks to all of you who have supported me throughout this. Its amazing how people you don't know really care and have been through the same exact issues! So thanks again!!!!!!!!!!!

And if anyone else can comment on my pic i posted, please lemme know. I dont wanna go in there thinking something is abnormal when indeed, its not.

hugs8


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## Andros

Megan.faith10 said:


> aw ty hun!
> 
> Im just so tired and worn out and its becoming more and more "difficult" to swallow. I can feel the lump and just swallowing saliva seems like a task. Tuesday cant come soon enough.
> 
> Not to mention I just started a new job and my health is s$#%ty! LOL
> 
> I want to say thanks to all of you who have supported me throughout this. Its amazing how people you don't know really care and have been through the same exact issues! So thanks again!!!!!!!!!!!
> 
> And if anyone else can comment on my pic i posted, please lemme know. I dont wanna go in there thinking something is abnormal when indeed, its not.
> 
> hugs8


Keep us in the loop here. Worried about you!


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## Megan.faith10

Well, just finished my ultrasound and of course, I dont know what anything reads he did LOL wont have results for a few days most likely.

There was measurements of 27 mm, 17 mm, 13 mm, 12 mm, and my isthmus was 1.3... Boy am I ever confused. I looked for the hot/cold and there was a a bit of red and a little bit of blue... But of course that can be blood flow and water fluid. *sigh*


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## Megan.faith10

My moms been going through the same stuff as me for years.

Her SED was positive (not sure of numbers as she hasnt received a copy yet)

What is SED?


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