# Lab results



## RachelF (Aug 17, 2011)

Ok so I had hyperthyroidism and had RAI administered in 2005. Last year I started to have unbearable symptoms again. These include hot flashes, panic attacks, nausea, sweating, generalized anxiety, a feeling of detachment, increased heart rate and blood sugar. I wen to the doctor and I turned out to be very hypo. He adjusted my medicine accordingly. My symptoms have lessened but I am still not able to go back to work or function normally. He just wanted to treat me solely for anxiety after that because my numbers have stabilized but I told him that that wasn't the problem it was a symptom. I went to a specialist recently for a second opinion. They ran full thyroid labs and everything came back normal. They did an ultrasound and I do have 2 nodules on my left lobe the largest of which is 1.6 cm. They want to a biopsy which I had done in 2005 and it came back benign. Is it common to have nodules six years after RAI? Why are all of my blood tests coming back normal when I feel just like I did when my thyroid was screwed up before. Any help would be greatly appreciated. Thanks.


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## Andros (Aug 26, 2009)

RachelF said:


> Ok so I had hyperthyroidism and had RAI administered in 2005. Last year I started to have unbearable symptoms again. These include hot flashes, panic attacks, nausea, sweating, generalized anxiety, a feeling of detachment, increased heart rate and blood sugar. I wen to the doctor and I turned out to be very hypo. He adjusted my medicine accordingly. My symptoms have lessened but I am still not able to go back to work or function normally. He just wanted to treat me solely for anxiety after that because my numbers have stabilized but I told him that that wasn't the problem it was a symptom. I went to a specialist recently for a second opinion. They ran full thyroid labs and everything came back normal. They did an ultrasound and I do have 2 nodules on my left lobe the largest of which is 1.6 cm. They want to a biopsy which I had done in 2005 and it came back benign. Is it common to have nodules six years after RAI? Why are all of my blood tests coming back normal when I feel just like I did when my thyroid was screwed up before. Any help would be greatly appreciated. Thanks.


Sure would like to see your test results with the ranges. I am not fond of the word normal.

I do know that I had RAI 3 times due to advanced hyperthyroid. When it gets like that, it is hard to knock that critter out of the gate.

So, what has happened to you is not a surprise to me. If any living tissue is left behind either by ablation or RAI, the thyroid can survive and grow back.

Have you been on thyroxine replacement all this time? If so, what and how much?

Your symptoms sound hyper to me.


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## RachelF (Aug 17, 2011)

Ok I will give you all that I have so please bear with me. 24.0 mCi of iodine -131 was administered in Febuary of 2005.TSH at that time was 0.03 range .49-4.67. Ranges were then monitored to intercept hypothyroidism. Febuary 2006 TSH jumped to 7.62 (range .35-5.50). I was then put on 50 MCG Levothyroxin. Symtoms were better from here on out and in Septmeber 2006 symptoms had stopped and I was able to finally go back to work. Blood tests were taken regularly after this, results are as follows;
August 2006 TSH 4.49 (range .35-5.50)
Febuary 2007 TSH 4.99 (range .35-5.50)
Febuary 2008 TSH 4.05 (range .35-5.50)
March 2009 TSH 1.76 (range .35-5.50)
September 2010 TSH 9.059 (range .550-4.780)

Symptoms came back in September 2010 when my TSH hit 9.059. I was then upped to 75 MCG levothyroxin. SYmptoms became better but have still been persistent and severe enough that I am unable to go back to work. I had further blood work done.
December 2010 TSH 1.421 (range .550-4.780)
May 2011 TSH 0.477 (range .350-5.500)

At this point my doctor chalked it up to just anxiety despite my protests. I chose to then go to a specialist who ran the full blood panel. Results of that are as follows;
ACTH BLD 36 (range 8-42)
Cortisol BLD 21.5 (range 3.4-26.9)
TSH 1.360 (range .40-5.50)
T3 Free 3.1 (range 1.8-4.6)
T4 Free 1.3 (range 0.7-1.8)
TSH Receptor AB-
TSI 89 (range <150 -)
TBI <1.0 (range <1.0 -)
Microsomal Antibody <1.0 (range <5.6 -)
Vitamin D 44.2 (range 31.0 - 80.0)

The doctor told me that given my results, she is currently unable to explain my symptoms and does not know if it is connected to my thyroid. I am confused because the symptoms are the same as what I went through before with the addition of depression (which could be due to frustration). She then sent me to get an ultrasound because of previous nodules and that's' where we are now. It also seems weird to me that my TSH levels started jumping around a bit since March of 2009. Is this normal? I know that this is a lot to read. Thanks for taking the time to help me, I really appreciate it.


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## Andros (Aug 26, 2009)

RachelF said:


> Ok I will give you all that I have so please bear with me. 24.0 mCi of iodine -131 was administered in Febuary of 2005.TSH at that time was 0.03 range .49-4.67. Ranges were then monitored to intercept hypothyroidism. Febuary 2006 TSH jumped to 7.62 (range .35-5.50). I was then put on 50 MCG Levothyroxin. Symtoms were better from here on out and in Septmeber 2006 symptoms had stopped and I was able to finally go back to work. Blood tests were taken regularly after this, results are as follows;
> August 2006 TSH 4.49 (range .35-5.50)
> Febuary 2007 TSH 4.99 (range .35-5.50)
> Febuary 2008 TSH 4.05 (range .35-5.50)
> ...


You have "active" TSI (thyroid stimulating immunoglobulin) as well as TBII.

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

TBII (Thyrotrophin Binding Inhibiting Immunoglobulin)
http://www.ncbi.nlm.nih.gov/pubmed/1969138 (good test for TSHR)

The binding immunoglobulin is keeping the TSI down. They are in a boxing match you might say. This activity skews the numbers on the thyroid panel. That is because the thyroid is getting mixed signals. Very mixed. Speed up, slow down. TSI vs TBII

Neither would be present if you were not hyperthyroid. I find it sad that your doctor does not understand this stuff .

Considering all you have told us, I do believe your best bet is to get that thyroid out. Cancer is a concern; especially since you had a failed RAI.

Humble opinion.

Thank you for posting your labs and ranges. They are most helpful.


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