# primary care referred me to an endocrinologist. can someone give me some advice on what is going on?



## RainyDay23 (Sep 10, 2014)

Hello! I am a 29 yr old female who is confussed on recent blood work. Ive been trying to do some internet research and because there are so many thyroid disorders i am confussed on what it could be. In september i had bood work drawn because i feel so tired all the time!

Here are the numbers:

T3 total. 3.18 and the range was .64-1.68
T3 uptake. .55 and the range was .55-1.33
T4. 17.8 and the range was 4.1-12.1
Free T4 2.99 and the range was .86-1.78
TSH less than .06 and the range was .30-5.45
Thyroglobulin antibodies 99.20 and the range is less than 60
Thyroid peroxidase antibodies 374.80 and the range was less than 60

I have my appointment on the 30th. I was very delayed trying to find an endocrinologist that took my insurance and accepted new patients.

What do you think is goin on? Obviously hyperthyroid from my research but after that is where i get confussed.


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## Lovlkn (Dec 20, 2009)

Your primary is referring you because it's out of their comfort zone. You need additional testing to confirm exactly what is happening.

I wold imagine the endo will do a ultrasound when you are in the office due to your high Thyroglobulin antibodies. Your high TPO antibodies suggests autoimmune and they will likely run a TSI test because your TSH and Free tests are low which indicates hyperthyroid. The high thyroglobulin antibodies could be skewing your labs.

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

Here is another link for other antibodies they may run on you...

http://labtestsonline.org/understanding/analytes/thyroid-antibodies/tab/sample

Make a list of questions you want answered so you do not forget - if you can - take someone with you to the appointment as 4 ears are much better than 2 in these situations.


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## joplin1975 (Jul 21, 2011)

You can be quite tired while hyper - in a sense, your body can never settle down, so you are always exhausted.

Please get an ultrasound. Those antibodies aren't good!


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## RainyDay23 (Sep 10, 2014)

would you be able to tell me why thyroglobulin antibodies or peroxidase antibodies aren't good. Ive been doing research but it isn't clear why.


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## joplin1975 (Jul 21, 2011)

Thyroid peroixdase (TPO) is often associated with Hashimoto's, an autoimmune condition of the thyroid that usually causes hypothyroid. Really, what the antibody test is saying is that your thyroid is under attack, but it does not define the nature of that attack.

Thyroglobulin (Tg) is an antibody most often associated with thyroid cancer. Elevated Tg is also found in Hashi's patients, so it's not a definitive test, but it certainly raises red flags. And, because Hashi's raises your risk of thyroid cancer, your next step really needs to be an ultrasound to make sure there are not any glaring structural abnormalities that need to be biopsied.


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## RainyDay23 (Sep 10, 2014)

Is this something the endocrinologist will do on his own? or do I have to suggest it? do antibody numbers go up ? sorry for so many questions I am just extremely confussed. The numbers scream hyper but besides a racing heartbeat often and anxiety I feel like I have more hypo symptoms. Sluggish/exhausted/gaining weight and a huge appetite. How do I determine between graves and hashi's or is there other options ?


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## Lovlkn (Dec 20, 2009)

Hypo and hyper symptoms often cross over.

You may also be low in Vit D and ferritin which also both cause fatigue


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## webster2 (May 19, 2011)

Good call on your primary. Listen to your body and rest as much as you are able. Definitely, an ultrasound is in order.


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## joplin1975 (Jul 21, 2011)

kleipalmi said:


> Is this something the endocrinologist will do on his own? or do I have to suggest it? do antibody numbers go up ? sorry for so many questions I am just extremely confussed. The numbers scream hyper but besides a racing heartbeat often and anxiety I feel like I have more hypo symptoms. Sluggish/exhausted/gaining weight and a huge appetite. How do I determine between graves and hashi's or is there other options ?


Here are links on diagnosing Grave's: http://www.endocrineweb.com/conditions/graves-disease/graves-disease-diagnosis

And, Hashi's: http://www.endocrineweb.com/conditions/hashimotos-thyroiditis/hashimotos-thyroiditis-diagnosis

Keep in mind that they can occur concurrently.

Your doctor should be doing these tests -- if you have to suggest them, think hard if you have a doctor who is servicing you well.


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