# New here -- Lab results



## aceandmee (Nov 2, 2011)

I would love to hear opinions about my lab results.

My gp noticed my thyroid looked enlarged. I have had bloodwork, ultrasound and thyroid uptake. I go to the endocrinologist on Friday.

Here are the results:

Test: Results (Lab Range)
TSH, 3rd Generation: 1.53 (0.40-4.50)
T4, Free: 1.0 (0.8-1.8)
T3, Total: 89 (76-181)
Thyroglobulin Antibodies: <20 (<20)
Thyroid Peroxidase Antibodies: <10 (<35)

Ultrasound:
"Thyroid gland is enlarged and contains several small cysts. Most likely a simple goiter with a few colloid cysts."

Thyroid Uptake:
"Thyroid is enlarged. No hypofunctioning or hyperfunctioning nodules."

Time: Results (Lab Range)
5 hours: 17.2% (Max of 15%)
24 hours: 30% (Max of 30%)

"Per results, this can be consistent with mild Grave's disease."

I was just curious about the bloodwork being within "normal" ranges, which doesn't seem consistent with the other test results. What do ya'll think?


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## Octavia (Aug 1, 2011)

Welcome to the forum. It's not uncommon for labwork to be in range, even when the gland itself is a little out of whack.

Are you having symptoms, or did your doctor just happen to notice it during a routine exam?


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## lainey (Aug 26, 2010)

Based on the uptake, you really need a little bit more blood work. A free T3 should be run, along with TSI--thyroid stimulating immunoglobin.

This would give a more complete picture of your situation.

It could be that your GP caught this early--there does tend to be a lag between the build up of antibodies and the shifting of the lab results.

It is not uncommon to have a "normal" TSH and free T4 in the presence of TSI and TPO antibodies--they are both blocking and stimulating, and can cancel each other out, resulting in fairly normal thyroid hormone production. It is when one set becomes dominant over the other that the levels begin to change.

Let's see what the endo suggests.


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## Andros (Aug 26, 2009)

aceandmee said:


> I would love to hear opinions about my lab results.
> 
> My gp noticed my thyroid looked enlarged. I have had bloodwork, ultrasound and thyroid uptake. I go to the endocrinologist on Friday.
> 
> ...


Hi and welcome. Yes; the uptake is rather definitive actually. Hyper side.

Here is another test that would be good to have.

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

And you see; there are stimulating, binding and blocking antibodies and immunoglobulins to the receptor sites. This has a tendency to skew the labs. The body is trying hard to make things right and in doing so, the numbers are not true in that there is a lag time between "yes, we are going to be good and no, we are going to be bad!" It's like taking a bungee jump and not really landing.

By the way; thank you for including the ranges.

Please let us know what the endo has to say this Friday!


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## aceandmee (Nov 2, 2011)

Thanks for all the responses!

Once the doctor discovered the thyroid was enlarged, I spoke with several family members. Both grandmothers have/had thyroid issues. My aunt just had surgery on hers. My paternal grandmother said her mom and siblings had thyroid issues as well. So a family history.

Here are some symptoms I've had (I thought these were all just normal for me) : 
Tired all the time, occasional heart palpitations, feel hot (when others are not), tremors in hands, some insomnia, very light periods, acne, anxiety, and easily irritable. My thyroid is palpable, with the left side larger than the right. I can occasionally feel a lump in my throat when I swallow, which is really annoying. I've also noticed that I am more sensitive to light than I used to be (don't know if this is related or not).

So I went to the endocrinologist. Initially saw the PA, she was great. Asked about all my symptoms, etc. She told me she felt my symptoms and test results showed mild Graves and explained a couple of options for treatment. I'm thinking wow I came to the right place for help!

Then the doctor came in. Complete turn around.

Per the endocrinologist:
"My GP should not have done the ultrasound and uptake based on my TSH (My GP did the testing based on my enlarged thyroid, did not wait for blood test results). The TSH is the only important test that was done and is normal, therefore, I don't have any thyroid issues. Also, she felt the uptake test only indicates cold nodules, other information it provides is not important, and the person reading the results of the uptake didn't know the whole picture (ie TSH results) like she did."

I was pretty shocked, she was very patronizing and took little time to examine me. I asked why I am having all the above symptoms and she told me it must be something else and couldn't be my thyroid.

They did take bloodwork, probably only testing for TSH because she said additional bloodwork (like the TSI I asked for would be a waste of money and probably wouldn't be covered by insurance (a lie)). I am suppose to go back in six months for an ultrasound.

I am not happy with the total dismissal of my symptoms. Not a great experience.


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## webster2 (May 19, 2011)

Oh goodness, is it possible for you to get a second opinion with another endo? Are you able to research the ones in your area that have experience with Graves? The one you saw seems to have been riding a high horse that day. Even if she feels you don't have Graves, there was no reason to berate your GP, nor be rude to you. By the way, I think your GP did a great job!


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## Serenia (Sep 27, 2011)

You really really need to have both Free T3 and Free T4 labs - and if possible a TRab (aka TBII) test as well.


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## Andros (Aug 26, 2009)

aceandmee said:


> Thanks for all the responses!
> 
> Once the doctor discovered the thyroid was enlarged, I spoke with several family members. Both grandmothers have/had thyroid issues. My aunt just had surgery on hers. My paternal grandmother said her mom and siblings had thyroid issues as well. So a family history.
> 
> ...


I hope you are running like hell from this doctor?? This is just too scary and very hard to believe but we all do believe you! Because, guess what? We all have had very similar experineces just like yours.

Go back to your GP. This person knows what he/she is doing. You need medical intervention. You are hyper and early intervention is essential.

Your GP will do the TSI; no sweat. At least I don't think so. If I could, I would report that doc to the AMA and AACE for being a total idiot and and dangerous one at that.

Harumph!


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## Octavia (Aug 1, 2011)

You know...sometimes it seems like Endos believe they have a very limited supply of definitive diagnoses to "give out" (like raffle tickets or something) over the lifetime of their practice, so they have to be very protective and don't want to give one out unless they are 500% certain because someone's labs are way off the charts or something. Not sure if that makes sense to anyone else, but it's just an analogy I came up with. I don't get it.

Do you feel like you can be adequately treated for this by your GP? If so, I'd stick with her or him. Or try another endo.

I also love what Andros said above!


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