# high sedimentation rate



## sochs

I recently had some labs done:

sed rate: 34 (0-15) high
CRP <.5 (<.5)
TSH 1.63 (.4-4.1)
FT4 1.0 (.9-1.8)
FT3 3.4 (1.8-4.2)
DHEA 5.3 (<13)
Rheumatoid Factor <5 (0-14)
Thyroid ultrasound - right lobe enlarged

I've been screened in the past for cancer and everything was ok. I'm a 30 yr old white male.

My questions is: Can the high sedimentation rate be caused by the thryoiditis or is the thyroiditis caused by the high sedimentation rate?

My thyroid antibodies, once very minimally elevated (anti-microsomal) have been normal for quite some time.

What's the next step? What could be the cause(s)?

Thanks


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## sochs

Help anybody?


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## Andros

sochs said:


> I recently had some labs done:
> 
> sed rate: 34 (0-15) high
> CRP <.5 (<.5)
> TSH 1.63 (.4-4.1)
> FT4 1.0 (.9-1.8)
> FT3 3.4 (1.8-4.2)
> DHEA 5.3 (<13)
> Rheumatoid Factor <5 (0-14)
> Thyroid ultrasound - right lobe enlarged
> 
> I've been screened in the past for cancer and everything was ok. I'm a 30 yr old white male.
> 
> My questions is: Can the high sedimentation rate be caused by the thryoiditis or is the thyroiditis caused by the high sedimentation rate?
> 
> My thyroid antibodies, once very minimally elevated (anti-microsomal) have been normal for quite some time.
> 
> What's the next step? What could be the cause(s)?
> 
> Thanks


A high sed rate usually indicates a major inflammatory process going on. So,you would not have a high sed rate causing the inflamation.

Therefore, if the only thing going on with you at the time of your labs was an inflamed thryoid, yes .................that could be the cause. Did you have any other thing going on at the time such as a sore throat, kidney infection...........anything like that?

Diabetes, heart disease and anemia can also cause a high sed rate.

What did your doctor comment about this?

What kind of cancer screening did you have?


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## sochs

Thanks for the reponse, andros. I had nothing going on at the time of the lab and plan to have it re-checked soon. No diabetes, heart disease, etc. All the docs just say that sed rate is a very general marker for inflammation. One commented that since the crp was fine, no worries. I had cancer work ups several years ago because had several low white blood cell counts. The hematologist even went as far as a bone marrow biopsy (sucked). 
Here's an interesting question as well: I got copies of my last two thyroid sono's. My thyroid is mildly enlarged, but more interesting is that the endo who performed the second sono noted that the thyroid showed several areas of hypoechogenecity. Can you comment on the effectiveness of that as an onjective diagnostic determination? Hypoechogenecity that is? Thanks


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## Andros

sochs said:


> Thanks for the reponse, andros. I had nothing going on at the time of the lab and plan to have it re-checked soon. No diabetes, heart disease, etc. All the docs just say that sed rate is a very general marker for inflammation. One commented that since the crp was fine, no worries. I had cancer work ups several years ago because had several low white blood cell counts. The hematologist even went as far as a bone marrow biopsy (sucked).
> Here's an interesting question as well: I got copies of my last two thyroid sono's. My thyroid is mildly enlarged, but more interesting is that the endo who performed the second sono noted that the thyroid showed several areas of hypoechogenecity. Can you comment on the effectiveness of that as an onjective diagnostic determination? Hypoechogenecity that is? Thanks


Hypoechogenecity would indicate something is afoot as per.........

We demonstrated an association between hypoechogenicity at thyroid US and higher levels of serum TSH even in subjects without overt thyroid disease, suggesting decreased echogenicity as an early sign of thyroid dysfunction. Irregular echo pattern, whether accompanied by hypoechogenicity or not, was another possible marker of thyroid failure. This indicates a possible use of thyroid US in detecting early and subclinical thyroid dysfunction.

Entire abstract here...........
http://www.eje-online.org/cgi/content/abstract/155/4/547

And I always like to look things up for our readers so everyone knows what we are talking about............

According to the Merriam-Webster online Medical dictionary (http://www.merriam-webster.com/medical/echogenicity), if you break the work down to its root "echogenic", that definition is:

reflecting ultrasound waves <the normal thyroid gland is uniformly echogenic - Catherine Cole-Beuglet>

- echo·ge·nic·i·ty, noun, plural echo·ge·nic·i·ties.

Now, the nice thing about medical terminology is that when you know what the prefixes and suffixes mean, you can usually get a good idea what the whole word means. In this case, hypo means less than, below, or under. Therefore, hypoechogenicity could refer to something that does not reflect ultrasound waves well (or uniformly).

That makes me wonder if you have any solid (cold) or calcified nodules. Has the doctor commented? What is your take on it?


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## sochs

Yeah, that's my take on it as well. It seems like there's not an overabundance of support for the hypoechogenecity claim. However, I did find the stud you referenced. Consequently, the mean TSH of those with some hypoechogenecity was 1.63; my exact lab value as of the last TSH test...interesting.

I don't think it's referring specifically to cold nodules. One small nodule was noted seperately on the report.

I'll try to attach a couple of pics of the sono and get your opinion.


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## Andros

sochs said:


> Yeah, that's my take on it as well. It seems like there's not an overabundance of support for the hypoechogenecity claim. However, I did find the stud you referenced. Consequently, the mean TSH of those with some hypoechogenecity was 1.63; my exact lab value as of the last TSH test...interesting.
> 
> I don't think it's referring specifically to cold nodules. One small nodule was noted seperately on the report.
> 
> I'll try to attach a couple of pics of the sono and get your opinion.


No claim to fame here but if you can upload it, I will take a look.

And I must be honest with you, sonograms do not always pick up on everything. Radioactive uptake scan is better.

What are the limitations of an Ultrasound of the Thyroid?
If a lump is detected on ultrasound within the thyroid gland, it is common that the radiologist cannot distinguish between benign and malignant lumps with complete certainty. A fine needle biopsy and review of tissue under a microscope is often necessary, while in some cases surveillance and a repeat sonogram after a few months looking for stability may suffice.

It is not possible to determine thyroid function-that is, whether the thyroid gland is underactive, overactive, or normal-with ultrasound. For that determination, your doctor may order a blood test or a radioactive iodine uptake test.

http://www.radiologyinfo.org/en/info.cfm?pg=us-thyroid


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