# Looking for help on Labs. New to all of this and looking for your expertise



## alexanderk47 (Sep 16, 2015)

Hello,

Thanks for taking the time to read this.

I had an ENT run blood tests looking deeper into the thyroid. I got to this point because my symptoms over the last 4 months have been: lump in throat, fatigue, malaise, moodiness, puffy eyes, etc.

My ENT looked at these results and referred me back to my Primary Care Doctor who has *NOT* been helpful with my symptoms and with the possible thyroid problem.

Anyways, here are the results. I'd appreciate all responses as your expertise will help me because I feel lost right now.

Free T4: *0.8* Range (0.8-1.5 ng/dL)

TSH: *3.029* Range (0.350-5.000 mcUnits/mL)

Anti Thyroglobulin: *10.8* Range (0.0-4.0 IU/mL)

Thyroid Peroxidase AB: *209 *Range (<60 Units/mL)

Any help/diagnoses/recommendations is greatly appreciated


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## joplin1975 (Jul 21, 2011)

You appear hypo.

More importantly, you should have a thyroid ultrasound as soon as possible.


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## alexanderk47 (Sep 16, 2015)

I had a thyroid ultrasound and my unhelpful PCP said that there were no problems but noted that the thyroid looked "mildly enlarged"


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## alexanderk47 (Sep 16, 2015)

Thanks for the response btw


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## joplin1975 (Jul 21, 2011)

Just for your own piece of mind, I would request hard copies of the radiologist's report on your thyroid ultrasound.

I think you would also want to have your free t3 and TPO tested.


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## alexanderk47 (Sep 16, 2015)

Is thyroid perixodase TPO?


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## alexanderk47 (Sep 16, 2015)

Anyone else?


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## Andros (Aug 26, 2009)

Understanding the Thyroid: Why You Should Check Your Free T3
http://breakingmuscle.com/health-medicine/understanding-thyroid-why-you-should-check-your-free-t3
(Copy and paste into your browser)

Dr. Mercola (FREES)
http://www.mercola.com/article/hypothyroid/diagnosis_comp.htm
(Copy and paste into your browser)

Free T3 and Free T4 are the only accurate measurement of the actual active thyroid hormone levels in the body. This is the hormone that is actually free and exerting effect on the cells. These are the thyroid hormones that count.

Substances not found in normal serum
http://www.thyroidmanager.org/Chapter6/Ch-6-6.htm
(Copy and paste into your browser)

TBII
http://www.ncbi.nlm.nih.gov/pubmed/9364248
http://en.wikipedia.org/wiki/Anti-thyroid_autoantibodies
(Copy and paste into your browser)

Blocking TRAbs (also known as Thyrotropin Binding Inhibitory Immunoglobulins (TBII)) competitively block the activity of TSH on the receptor. This can cause hypothyroidism by reducing the thyrotropic effects of TSH. They are found in Hashimoto's thyroiditis and Graves' disease and may be cause of fluctuation of thyroid function in the latter. During treatment of Graves' disease they may also become the predominant antibody, which can cause hypothyroidism.

TPO and Thyroglobulin Ab
cancer TPO and thryoglobulin Ab
http://onlinelibrary.wiley.com/doi/10.1111/j.1699-0463.1994.tb04888.x/abstract

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

As Joplin1975 has said, you do need an ultra-sound. The high titers of antibodies demand that you do.

And a lump? And there is nothing wrong? Good grief! You may have to find a better doctor. I am surprised the ENT fluffed you off like that. Is this an insurance referral?

Please read the info I have provided.

Welcome to the board!


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## alexanderk47 (Sep 16, 2015)

Thank you for the response & information. The ENT doesn't seem that comfortable treating the thyroid in my opinion which is why he sent me back to Primary Care Doc. This isn't an insurance referral.

I had a thyroid ultrasound in July and this is what the Doc wrote "The thyroid gland is considered mildly enlarged, for which laboratory

correlation is recommended. No thyroid mass lesions"

Just based on my labs--what do you all think? I have an appt. scheduled w/ an endo in early October but I am looking for some answers in the mean time because I am miserable.


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## Octavia (Aug 1, 2011)

I feel best when my Free T4 is in the upper part of the range. Yours is at the very, very bottom of the range. Any lower and you would officially be hypo. You're borderline enough to justify treatment.


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## joplin1975 (Jul 21, 2011)

Yup, what Octavia said.

T3 is your active hormone that you need for metabolism. T4 is a "storage" hormone. When your body needs energy, it converts t4 into t3. If there isn't enough t4 to convert, you'll feel crummy.

Not to mention that while your TSH is technically in range, it's a bit high. Most people feel better with a TSH around 1.0.


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## alexanderk47 (Sep 16, 2015)

Thanks Joplin and Octavia.

My ENT prescribed me Levothyroxine 0.025 mg.

Is this typically what someone with my labs should be taking?

How long does it take to begin to reverse the symptoms?


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## joplin1975 (Jul 21, 2011)

That's a pretty common starting dose for your labs. You may have to increase...you may not.

It takes six to eight weeks for the full impact of your dose to be felt. Sadly, with thyroid issues, its a slow, slow process.

Keep in mind, it's very possible that with elevated antibodies, you might still have symptoms, even if your TSH and free t4 improve.


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## alexanderk47 (Sep 16, 2015)

Thanks!

So how do you treat elevated antibodies?


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## joplin1975 (Jul 21, 2011)

You keep your TSH suppressed (so at or below 1.0).

For some people, even proactive treatment doesn't help and they go with ablation of their thyroid. Thyroid issues require a lot of patience and willingness to experiment.


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