# I'm confused...



## Elegant_Phoenix (Feb 26, 2011)

I have my RAIU tomorrow and Tuesday.

I have tested positive for Thyroid AB (Result: 92, Range:<61) and they are suspecting Hashimoto's.

How is the RAIU useful for diagnosing Hashi's or are they just ruling out cancer? The PA did mention something about the cycle that the thyroid takes - hypo, then hyper then hypo and they wanted to figure out if I'm at the first hypo or the second or something like that.

Don't I need to have a FNA to get an correct Hashi's diagnosis? I do not have one of these scheduled as of yet.

I don't have the actulal numbers, but my ESR (sed rate) was normal, my cortisol was normal (whew!) and my iron and ferritin are low.


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## McKenna (Jun 23, 2010)

The RAIU will show if you have any nodules, if they are "hot" or "cold" (producing or not producing hormone), and if your thyoid is hyper or hypo. 
If you have any nodules they should be biopsied and if you have certain cells, they would confirm a Hashi's diagnosis.

Are your labs reflecting hyper or hypo? Did you have a TPO level done?

Good luck with your test.


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## Elegant_Phoenix (Feb 26, 2011)

I had an ultrasound and it showed "increased vascularization", but no nodules. I have a goiter that is visible at a glance. Swelling and buring pain. Difficult to swallow. That has been going on for years and only after my badgering did they run the antibodies which came up positive.

I'm testing out "normal" with all my labs, but there is clearly something wrong and the endo agrees. All my symptoms are hypo.

I do not see that I have had a TPO level done. Would it be called something else?


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## lainey (Aug 26, 2010)

You did have TPO (copied from an earlier post):

TSH: 1.060, Range: .358-3.8
Thyroxine, Free: .92, Range: .76-1.46
Free T3: 2.85, Range: 2.18-3.98
Thyroid Peroxidase Ab: 4.9, Range: 0.0 to 9.0
Thyroglobulin: 7.0, Range: 0.0-55.0
Anti-Thyroglobulin: 92, Range: <62

It is the thyroid peroxidase Ab.

If you had no nodules on the sonogram, than the purpose of the test is to see if your uptake is normal, low (hypo) or high (hyper).

It will not diagnose Hashi's per se. That's typically assumed via lab work, or determined via a FNA.

Keep in mind that you can be diagnosed with Hashi's, but not necessarily treated for it. Thyroid levels via blood work generally need to warrant thyroid replacement medication, and that is not always the case even though antibodies may be present.


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## Elegant_Phoenix (Feb 26, 2011)

lainey said:


> You did have TPO (copied from an earlier post):
> 
> TSH: 1.060, Range: .358-3.8
> Thyroxine, Free: .92, Range: .76-1.46
> ...


Thank you for copying that - but which one is the TPO and what does that mean?

(OK, found it. Thyroid Ab: mildly positive. Meaning that there may be thyroid disease due to an autoimmune disorder. Am I correct? There is a note to the doc about that and it being sent to the endo asap.)

Another question: Can the RAIU show either hypo or hyper even when the labs look normal?

That last bit... So even if I do have Hashi's, and if my other labs are normal, even with all of my debilitating symptoms, there may be nothing they can do??? Even for the goiter? For the kidney stones, the fatigue, the weight gain? I'm seriously at the end of my rope.


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## McKenna (Jun 23, 2010)

> So even if I do have Hashi's, and if my other labs are normal, even with all of my debilitating symptoms, there may be nothing they can do??? Even for the goiter? For the kidney stones, the fatigue, the weight gain? I'm seriously at the end of my rope.


Your labs are reflecting that you're hypo. Both your Free T's are below the mid range mark, which would explain your symptoms. Your TSH is at a level where most endos would be comfortable with and probably not treat you. BUT, you will need to be proactive and ask for a trial of replacement meds.



> Another question: Can the RAIU show either hypo or hyper even when the labs look normal?


 Yep. With Hashi's you can swing up and down as your gland is being being attacked.


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## Andros (Aug 26, 2009)

Elegant_Phoenix said:


> I have my RAIU tomorrow and Tuesday.
> 
> I have tested positive for Thyroid AB (Result: 92, Range:<61) and they are suspecting Hashimoto's.
> 
> ...


Your thyroid on the RAIU could look "suggestive" of Hashimoto's just as high titers of TPO are "suggestive" of Hashimoto's. I am one person that feels that FNA is the true definitive diagnosis for Hashimoto's as clearly outlined by the presence of Hurthle Cells indigenous to Hashimoto's. I am in the minority on this thinking.

They are primarily concerned w/ the rate of uptake, solid or hot nodules and vascularity as well as other irregularities. I am so glad you are doing this; so very glad.

Ferritin needs to be 50 to 100; the closer to 100, the better so I hope you are working on that. Liquid Floradix is good as it is fast absorbing. And flavored. LOL!!

Cast iron cookware is a must.

I am with you in spirit today and tomorrow and cannot wait to hear.


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## Elegant_Phoenix (Feb 26, 2011)

Thank you for these last two posts. I read them when I was waiting in admissions to take my iodine pill. I nearly cried. I've been a mess for so long and to think that I would go through all of this only to be told that there is nothing they can do? I cry BS. If anything, I am my own best advocate. I learned the hard way with my baby, and I'm going to do it again for myself. (He was born with severe GERD and other genetic abnormalities - had a fundoplication and a g-tube placed at 7 months old - had the g-tube for 3 years. He would have died if I didn't do my research and questioned and pushed the docs and gotten him help he needed. He weighed less then 10 pounds at 7 months because of all of the vomiting.)

But I digress...

I took a look back at my Ferritin results - it's a 33. No mention has been made about the Floradix. I'll ask when I see my Endo next time. Is it consitpating? I have enough trouble with that already! lol

Would this test show nodules if the ultrasound didn't see any?

How long does it take to get the results back?

Thanks again.


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## Andros (Aug 26, 2009)

Elegant_Phoenix said:


> Thank you for these last two posts. I read them when I was waiting in admissions to take my iodine pill. I nearly cried. I've been a mess for so long and to think that I would go through all of this only to be told that there is nothing they can do? I cry BS. If anything, I am my own best advocate. I learned the hard way with my baby, and I'm going to do it again for myself. (He was born with severe GERD and other genetic abnormalities - had a fundoplication and a g-tube placed at 7 months old - had the g-tube for 3 years. He would have died if I didn't do my research and questioned and pushed the docs and gotten him help he needed. He weighed less then 10 pounds at 7 months because of all of the vomiting.)
> 
> But I digress...
> 
> ...


Oh yes; ultrasound is a good tool but it does have it's limitations.
Ultra-sound limitations http://www.radiologyinfo.org/en/info.cfm?pg=us-thyroid

With many supplemental iron products there is a strong likelihood of developing constipation. This is one of the main reasons that so many people have tried to avoid products that contain extra iron. Floradix liquid iron is a gentle, effective and non-constipating formula that will not create problems for your digestive and elimination systems.

http://floradixliquidiron.com/

You should be able to get this product at any reputable Vitamin/Health Food Store.

God bless you and your little boy. I could not imagine that; you are the "best" mom in the whole wide world.


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