# Newbie here trying to decifer lab/ultrasound results



## HypoBrittany (Feb 21, 2013)

I just got a chance to review my lab results and ultrasound report that my doctor assured me was normal yesterday. I am left with some confusion and questions and even after calling the doctor today her nurse still says its normal. I have been diagnosed with a goiter and experiencing hypo symptoms. My mom, dad, paternal grandma, and older sister are all hypo! Here are my lab results:

TSH = 2.8 (0.450 - 4.500)
T4, Free (Direct) = 1.11 (0.82 - 1.77)
Thyrotropin Receptor Ab, Serum (TSHR) = <0.51 (0.00 - 1.75)
Triiodothyronine (T3) = 136 (71 - 180)
Thyroid Peroxidase (TPO) = 303 (0 - 34)

My ultrasound found my right lobe to be 5.0 x 1.5 x 1.8 cm with 6.7mL volume. Left lobe is 4.8 x 1.3 x 1.8 with 5.1 mL volume. Hospital dr. that performed ultrasound says volume is normal but echotexture is very heterogeneous. After research, the heterogeneous echotexture and high TPO seem to point to Hashimoto's but doctor says its all normal. I still feel very down, tired, trouble concentrating, difficulty sleeping, and gaining weight with no change in diet or activity. I am almost 30 and have been around 120 my whole late teen/early adult life. Over the past 2 years I have gained significant weight and am now at 165. The doctor I am seeing is a D.O. Hopefully someone with more experience in this can help me figure out whats going on and what to do...or even just help give me a sense of calmness :sad0049:


----------



## Andros (Aug 26, 2009)

HypoBrittany said:


> I just got a chance to review my lab results and ultrasound report that my doctor assured me was normal yesterday. I am left with some confusion and questions and even after calling the doctor today her nurse still says its normal. I have been diagnosed with a goiter and experiencing hypo symptoms. My mom, dad, paternal grandma, and older sister are all hypo! Here are my lab results:
> 
> TSH = 2.8
> T4, Free (Direct) = 1.11
> ...












Your TSH is higher than most of us would tolerate. And the definitive proof that something indeed is going on with your thyroid is the presence of Trab. While it is below range, you should not have any Trab. You have a bit which in fact should raise a question mark.
Also, you should not have a goiter.

Because you do have a smattering of Trab, it could be possible that you are hyper, not hypo.

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.

Negative test results means that the autoantibodies are not present in the blood at the time of testing and may indicate that symptoms are due to a cause other than autoimmune. However, a certain percentage of people who have autoimmune thyroid disease do not have autoantibodies. If it is suspected that the autoantibodies may develop over time, as may happen with some autoimmune disorders, then repeat testing may be done at a later date.
http://labtestsonline.org/understanding/analytes/thyroid-antibodies/tab/test

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

Symptoms can and do cross over. I gained a lot of weight w/hyper. Thankfully, I lost it all.

You can also be very very tired w/hyper.

Further testing would be a good thing; maybe find a new doctor if this one is not up to snuff?

Different labs use different ranges so maybe in the future you can also include the ranges w/your results. Any other comments would only be a guess and I don't find that to be a good thing when a person's health is at stake.


----------



## HypoBrittany (Feb 21, 2013)

Thank you Andros! Through my research I have often found many of your comments and they are always so informative! I am going to read those links you provided! I probably do need a new doctor. The sad thing is that she diagnosed me with a goiter the first time I saw her only 4 weeks ago. In that time I have done the labs, ultrasound, and RAI uptake and scan. I am still waiting on my own copy of the scan report but doctor says "its normal" but this seems to be a common saying for her  After only 2 visits I am already feeling as though she is not going to work for me. Thanks for the information! At least now I have the reassurance that something is not right and I am not just imagining these symptoms


----------



## jenny v (May 6, 2012)

Your results are very similar to mine. I also have a smidge of TrAb in my system (<0.51 is my reading, too!) and my TPO antibodies are down to 93, range of 0-34. My ultrasound showed "diffuse abnormality" with multiple nodules under 1cm and an overall heterogeneous echotexture.

I was diagnosed with Hashi's based on all of that (the endo said I could do an FNA to be 100% sure, but she was 99% sure with my labs and ultrasound and that was good enough for me). I'm not sure why your doctor would say your results are normal!


----------



## Andros (Aug 26, 2009)

HypoBrittany said:


> Thank you Andros! Through my research I have often found many of your comments and they are always so informative! I am going to read those links you provided! I probably do need a new doctor. The sad thing is that she diagnosed me with a goiter the first time I saw her only 4 weeks ago. In that time I have done the labs, ultrasound, and RAI uptake and scan. I am still waiting on my own copy of the scan report but doctor says "its normal" but this seems to be a common saying for her  After only 2 visits I am already feeling as though she is not going to work for me. Thanks for the information! At least now I have the reassurance that something is not right and I am not just imagining these symptoms


I will be very interested in the results of your RAIU. Very interested. And what about the ultra-sound. Do you know the results of that?

Oh, you "are" validated, my dear. Very much so.


----------



## HypoBrittany (Feb 21, 2013)

Thank you both! I am picking up my copy of the uptake on Monday so as soon I get those results I will send some more info. I am going to have my husband talk with his doctor next time he goes since they are very close and see if his doctor would give his opinion. Maybe I might just change over to him myself


----------



## Andros (Aug 26, 2009)

HypoBrittany said:


> Thank you Andros! Through my research I have often found many of your comments and they are always so informative! I am going to read those links you provided! I probably do need a new doctor. The sad thing is that she diagnosed me with a goiter the first time I saw her only 4 weeks ago. In that time I have done the labs, ultrasound, and RAI uptake and scan. I am still waiting on my own copy of the scan report but doctor says "its normal" but this seems to be a common saying for her  After only 2 visits I am already feeling as though she is not going to work for me. Thanks for the information! At least now I have the reassurance that something is not right and I am not just imagining these symptoms


Thank you for filling in the ranges. This leads to further clues. Your Total 3 which comprised of bound, unbound and rT3 (reverse) hormone is above the mid-range which does lead me to believe that you are maybe hyper and/or converting the T4 to rT3. This can happen because of antibodies to the receptor sites.

The only way to clear the air here is to insist on a FREE T3 test which is unbound hormone only available for cellular uptake. You could have an rT3 test but I would put my money on the FREE T3 test firstly and foremost!

Your FREE T4 is below the mid-range (1.29) of the range given by your lab so something is going on.

It gets very complicated when antibodies are running amok. It can skew the numbers big time. Meanwhile, you feel like you are on death's door.

We all know the feeling.


----------

