# interesting results but no diagnosis?



## bluesmom (Aug 11, 2012)

I received my lab results today from my visit to the endocrinologist last week:
Thyroperoxidase Ab: 350 (range <35)
Thyroglobulin Ab: >3000 (range <20);

My results from 8/2/2012:
TSH: 3.17 (range .5-6.0)
Free t4: 1.1 (range .8-1.5)
Total t3: 92 (range 76-181)

The nurse told me that my enlarged thyroid measured 25mg and there is a goiter on the right but she couldn't give me any other measurements. She also said that they want to start me on 50mg Synthroid and see me again in 7 weeks, so I asked if I had Hashimoto's or Graves or something else. She said neither because my TSH indicates that my thyroid is functioning normally.
I feel like they're missing something.
My questions are:
1) What might these results mean?
2) When I see my PCP on Thursday, should I ask him to do any other tests prior to starting synthroid?

Thanks for reading and I'd love any advice you all have!
Carolyn


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## joplin1975 (Jul 21, 2011)

Did you have an ultrasound?

With those results, priority #1 should be ruling out cancer, with the synthroid issue being secondary.


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## webster2 (May 19, 2011)

I think you might want to call back and ask to speak to the doctor. You have positive anitbody results. IMHO


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## bluesmom (Aug 11, 2012)

Yeah, I can't quite figure out why they bothered to do the antibody tests if they're ignoring the results. The nurse said that the doctor signed off on the results and just indicated synthroid and follow up in 7 weeks (the doctor is very young and new to the field). She did do an ultrasound and said that my thyroid was enlarged, particularly on the right, but that she didn't notice any lumps or nodules. I had also asked her to test for free t3 but she said that wasn't a good indicator of anything. New doctor, maybe?
But, in the meantime, are there any tests my PCP can order that would help move me toward a diagnosis? TSI?
I've written in another post that my mom was diagnosed with hashimoto's at age 30 (partial thyroidectomy) and my brother with graves at age 30. I'm 45 and have had 20 years of symptoms including fatigue, skin issues, random weight gain (11 years ago), random weight loss (post-partum 8 years ago), gluten and dairy intolerant for 10 years, depression, anxiety, difficulty sleeping, memory loss, irregular menstruation, loose stools nearly every day and, primarily, ongoing chronic hip, neck and shoulder pain.
Any ideas about what might be going on would be greatly appreciated as would any advice on further testing etc.
Thanks,
Carolyn


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## bluesmom (Aug 11, 2012)

Could this explain why, 4 years ago, I had a pain in the side of my neck that was so intense I literally could not move? And why I've had neck pain for 20+ years that no amount of chiropractic adjustment has helped?
Carolyn


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## Lovlkn (Dec 20, 2009)

> Thyroglobulin Ab: >3000 (range <20)


Have you ever had a FNA?

http://labtestsonline.org/understanding/analytes/thyroglobulin/tab/faq


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## joplin1975 (Jul 21, 2011)

I think my advice would be to ask for copies of the ultrasound report...and then once you have them, to post the results here.

You might also ask you PCP if he/she think a radioactive iodine uptake scan would be appropriate.

I have a herniated disk in my neck. Since my thyroid has been removed, I've been much more comfortable.


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## bluesmom (Aug 11, 2012)

I'll mention the RAI uptake to my PCP tomorrow. I haven't had an FNA but my first ultrasound was last week and the doc said she didn't notice any nodules (though the ultrasound was pretty quick).
I have a call in to the doctor to ask about diagnosis. Could I just have super high TgAb and not have Hashi's or Graves or something else?
Carolyn


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## Andros (Aug 26, 2009)

bluesmom said:


> I received my lab results today from my visit to the endocrinologist last week:
> Thyroperoxidase Ab: 350 (range <35)
> Thyroglobulin Ab: >3000 (range <20);
> 
> ...


Carolyn; you definitely need an ultra-sound. Those antibodies are "suggestive" of cancer.

Please do not accept a wait and see run around here. This is vitally important. If necessary, see an ENT about this.

cancer TPO and thyroglobulin
http://onlinelibrary.wiley.com/doi/10.1111/j.1699-0463.1994.tb04888.x/abstract
http://www.wikigenes.org/e/gene/e/7173.html

Understanding Thyroglobulin Ab.
http://www.labtestsonline.org/understanding/analytes/thyroglobulin/test.html

Thyroglobulin Ab and cancer
http://qjmed.oxfordjournals.org/content/59/2/429.full.pdf

Another Thyroglobulin and cancer
http://www.mdlinx.com/endocrinology...963/?news_id=811&newsdt=092010&subspec_id=419

This is truly nothing to put on the back burner!!


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## bluesmom (Aug 11, 2012)

I spoke with my endo doctor today (thanks to you all for advising me to call her)! She told me right away that she'd diagnosed me with Hashimoto's - so the nurse was wrong. She read the ultrasound measurements to me over the phone:
Right lobe: 4.45x1.3x1.71;
Left lobe: 3.04x1.03x1.2cm;
Isthmus: 0.56.
She said that she noted no nodules or lymphomas and that my thyroid felt very soft all over. She didn't want to do an RAI uptake because it wouldn't change the course of treatment and she felt there is nothing to biopsy as well. She wants me to take the 50mcg of Synthroid and come back in 6 months to see her. They'll also check my TSH in 7 weeks.
Does this all sound like an OK plan? Could the >3000 TgAb and the 350 TPO indicate that I've had this for many, many years (that's what I'm starting to believe)?
A part of me is just so relieved to finally have a diagnosis of some kind. I want to be hopeful that the synthroid is going to really help but with my symptoms vascillating between hypo-seeming and hyper-seeming, I'm concerned that I'm in for a long struggle figuring out the right meds.
Thanks again for listening and any advice you have.
Carolyn


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