# Dr. suspects Hashi's. Help with lab results?



## shouldbesleeping (Jul 22, 2011)

Hello everyone,

I posted here in July, and received a lot of kind and helpful responses about my health problems:
http://thyroidboards.com/showthread.php?t=3603
(My symptoms, story, etc. are in that post.)

My endocrinologist, upon my first visit, suspected PCOS, Hashimoto's, and potentially Cushing's. I have a family history of thyroid issues, and I know that PCOS is very common, so I wasn't as freaked out about those (and I am excited just finally have some answers), but the Cushing's scared me.

I just received my copy of the lab results, and am still waiting to hear back from my doctor. I'm having a hard time interpreting them... do antibodies signify Hashimoto's? I do have a small goiter, according to my endo, so there's definitely something thyroid related going on. I am hopeful that we can just get a definite answer soon so I can start some kind of treatment and start feeling better.

Also, I know cortisol can be tricky to test, but my labs were drawn at 8:00 in the morning, after an exceedingly stressful 24 hours, and I still tested right in the middle of the range. I am hoping this suggests NO Cushing's... does anyone have any idea?

My results were:

Comprehensive Metabolic panel w/EGFR
Sodium 139 (135-146)
Potassium 4.5 (3.5-5.3)
Chloride 104 (98-110)
Carbon Dioxide 26 (21-33)
Calcium 9.5 (8.6-10.2)
Alkaline Phosphatase 101 (33-115)
AST 18 (10-30)
ALT 30 (6-40)
Bilirubin, Total .3 (.2-1.2)
Glucose 91 (65-99)
UREA Nitrogen 13 (7-25)
Creatinine .73 (.57-1.03)
Bun/Creatinine Ratio 18.4 (6-22)
Protein, Total 6.8 (6.2-8.3)
Albumin 4.4 (3.6-5.1)
Globulin, Calculated 2.4 (2.2-3.9)
A/G Ratio 1.9 (1.0-2.1)
EGFR Non-Afr. American 115 (> or = 60)
EGFR African American 134 (> or = 60)

Lipid Panel
Cholesterol 263 (125-200) (This FREAKS ME OUT since I am only 24, and my family has a history of heart disease.)
HDL Cholesterol 47 (> or =46)
Cholesterol/HDL ratio 5.6 (< or = 5.0)
LDL Chol, Calculated 192 (<130)
Triglycerides 119 (<150)

CBC w/ DIFF and PLT
WBC 7.7 (3.8-10.8)
RBC 4.98 (3.8-5.1)
Hemoglobin 14.3 (11.7-15.5)
Hematocrit 42.4 (35.0-45.0)
MCV 85.2 (80.0-100.0)
MCH 28.6 (27.0-33.0)
MCHC 33.6 (32.0-36.0)
RDW 12.8 (11.0-15.0)
Platelet Count 321 (140-400)
Neutrophils, Absolute 4520 (1500-7800)
Lymphocytes, Absolute 2160 (850-3900)
Monocytes, Absolute 760 (200-950)
Eosinophils, Absolute 190 (15-500)
Basophils, Absolute 40 (0-200)
Total Neutrophils, % 59 (38-80)
Total Lymphocytes, % 28 (15-49)
Monocytes, % 10 (0-13)
Eosinphils, % 2 (0-8)
Basophils, % 0 (0-2)
Hemoglobin A1C 5.3 (0.0-5.6)
Insulin, Serum 16 (<17)

FSH 7.3 (Follicular 2.5-10.2; Mid-Cycle Peak 3.1-17.7; Luteal 1.5-9.1; Postmenopausal 23.0-116.3) (I have no idea where I fall in here, since I don't really get periods ever without the pill.)

LH 14.7 (Follicular 1.9-12.5; Mid-Cycle Peak 8.7-76.3; Luteal 0.5-16.9; Postmenopausal 10.0-54.7)

TSH, 3rd Generation 2.55 (0.4-4.5)

T4, Free 1.4 (0.8-1.8)

DHEA Sulfate 140 (45-320)

Prolactin 15.0 (Non-pregnant 3.0-30.0)

Thyroglobulin Antibodies <20 (<20)

Thyroid Peroxidase AB 16 (<35)

Cortisol, Free, LC/MS/MS 0.46 (8:00-10:00 .07-.93)

IGF-I, LC/MS 286 (83-456)
Z-Score (female) 0.9 (-2.0 - +2.0)

17-OH-Progesterone, LC/MS/MS 62 (Follicular </= 185; Luteal </= 285; Postmenopausal </=45)

Any help is sincerely appreciated.


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## Andros (Aug 26, 2009)

shouldbesleeping said:


> Hello everyone,
> 
> I posted here in July, and received a lot of kind and helpful responses about my health problems:
> http://thyroidboards.com/showthread.php?t=3603
> ...


Not much of an expert on the other stuff but you may wish to read this re the Monocytes etc..
http://labtestsonline.org/understanding/analytes/differential/tab/test

I would say that your TSH is probably too high; most of feel best with TSH @ 1.0 or less and the FREE T4 is just barely above the mid-range. Too bad your doc did not run FREE T3 as that would have told us a lot. The FREE T3 is your active hormone.

Anyway, you do have low titers of TPO and Thyroglobulin Ab which does mean something is going on with the thyroid but it has not really taken hold yet.

Surprised also that your doc did not run a ferritin test.

Ferritin http://www.thewayup.com/newsletters/081504.htm
(should be 50 to 100; the closer to 100, the better)

I personally would request a sonogram or an ultra-sound of the thyroid. And there are other antibodies which are binding, blocking and stimulating which would make some of your lab tests come in so that they look okay but in reality, they may not be.

This is not good that you are not feeling well and I sure hope the doctor can get to the bottom of all of this.

Has your doctor commented on your lab report? I will say that cholesterol is typically out of control when hypothyroid. It drives it right up but this is in no way a stand alone diagnosis.


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## lainey (Aug 26, 2010)

Just be ready.

There really isn't anything glaringly off in your lab results--hormones, cortisol, glucose.

Cholesterol is high, yes, but triglycerides are not. This would probably respond well to lifestyle changes such as diet and exercise.

You have a smattering of thyroid antibodies (and a percentage of the healthy population does), but your TSH and FT4 are pretty normal.

So, just be ready in case the doctor says that they don't see anything obvious.


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## bigfoot (May 13, 2011)

I agree -- unless your doc is pretty knowledgable about this stuff (and may well be), you should be prepared for the "your labs look normal" answer. In that case, I'd be ready with a laundry list of signs & symptoms and your side of things. Sounds like you already have a great handle on this, and probably have already covered this with the doc. Maybe you can convince him/her to let you do a brief trial with a low dose of levothyroxine to see if it helps.

As a fellow newbie, here are a few things I have been doing, many of which have been recommended by the fine folks here on the boards:

* Carlson's liquid fish oil at mealtime (can find this at Whole Foods type stores, etc.)
* Selenium supplement (also Whole Foods or similar):
NIH Link 
Dr. Weil Link
* A good, well-rounded daily multivitamin (again, Whole Foods type stores)
* Consistent, light exercise (daily walks or bike) -- not hard workouts
* Plenty of rest and good night's sleep if possible
* Eating more fruits, veggies, whole grains, oatmeal, and fiber
* Stay away from soy products and cruciferous veggies Link
* Avoid excess fats, alcohol, caffeine, sugars, soda, fast food, etc.
* Avoid lots of carbs & gluten (this is a tough one, I love bread!)
* Use sea salt instead of iodized table salt
* Drink lots of water

None of this is a "magic cure" but should help give your body a good head start. I would run all of this by your doc, too, just to keep him/her in the loop.

hugs3


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## shouldbesleeping (Jul 22, 2011)

Thank you SO MUCH for all of the information. My endo did what many of you predicted, and said she doesn't think it's the thyroid causing all of these symptoms. I trust her, but I am genuinely confused, since I have a small goiter and all of these awful symptoms.

My new PCP wanted to run a few tests again, and I just got the results. I think everything looks normal, according to the ranges, but can anyone tell me why my TSH went down a little? Is that normal? I was steadily rising (the past few times it was checked), so I'm confused. But I don't want to read too much anything. I just want to get to the bottom of this and FEEL BETTER.

Levels (taken around the same time of morning as the last panel):

TSH 1.205 (.03-5.0)
Thyroxine/ T4 9.7 (5.0-12.0)
Thyroid Horm.(T3UP)Bind.Ratio .98 (.8-1.2)
Free Thyroxine Index 9.5 (5-12)

Thank you all again for being such a kind and wonderful resource for those of us still getting these things figured out.

If it isn't my thyroid, I'm worried about what it might be...


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## Jya1124 (Oct 1, 2011)

What symptoms are you having? Your antibody tests look very low which is good. Mine we 309 whereas normal is below or at 60. I happened to be in a current "thyroid attack" though when they tested me meaning that my immune system was currently attacking my thyroid. However, if you've had hypO aymptoms like extreme fatigue, hair loss, dry skin etc you may be experiencing that while your body is not attacking the thyroid. Hashis goes in and out with attacking so when you are in an "attack" your thyrogloubin levels would be typically high and you would actually most likely be having hyPER symptoms as well. What exactly is prompting your doctor to believe you have hashis? Your thyroid levels are pretty "normal" as well. Were all different but mine for example was a 27 with .84-4.84 being normal. You have to be VERY proactive with doctors. Hashis is very often undetected for years and can me a lving hell while waiting for the right doctor to come along...good luck! I agree with previous posters about cutting put gluten and adding multivitamins and working out a bit. I just started my journey "knowing" that I have the disease, so I am learning too, but I've been reading the most informative helpful book by one of the most prestigious people in endocrine medicine that has taught me a ton! If you do have hashis I strongly recommend you buying it!!!! http://www.thyroidbook.com/


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