# Help with lab results



## Kairi34 (Oct 3, 2014)

Hello, I could use some help determining if my daughter's labs are normal. She has a lot of health problems including epilepsy, cyclic vomiting syndrome, gastroparesis, and bipolar. Lately she is experiencing many dizzy spells, headaches, and fatigue. She is also very depressed. She is 19 years old.

Here are her results:

thyroxine 7.6 6.0-12.0

free t4 0.93 0.77-1.61

tsh 0.69 0.34-5.60

vitamin d, 25-hydrox 24 30-150

t3 uptake 39.5 22.5-37.0%


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## Kairi34 (Oct 3, 2014)

I should also mention that she has been very thin and underweight most her life, but since August 25th she has gained 14 pounds. Any information or advice would be appreciated. Thanks!


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## Octavia (Aug 1, 2011)

Hi, and welcome!

Okay, something interesting I see is that two key levels--TSH and Free T4--are both low. in a healthy person, if one of these is high, the other is low, generally speaking. For example, my Free t4 is at the top of the range, which makes my TSH very, very low. On the other hand, if someone's Free T4 is low (generally low and out of range), the TSH increases.

So it's interesting that in your daughter, both of those levels are low. Often, this is due to thyroid antibodies. Your daughter's thyroid antibodies need to be tested. If she has high thyroid antibodies, that points to an autoimmune condition such as Hashimoto's or Grave's.

Also, her T3 uptake is high. I personally know very little about T3 uptake because I've never had mine tested...but others here have, and will hopefully share some insights about that.

And importantly, her Vitamin D is in the basement...she really, really needs to supplement heavily. That low Vit D level is probably contributing quite a bit to her fatigue.

What did the doctor say about any of these results? To answer your question, no, they are not normal.


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## Kairi34 (Oct 3, 2014)

Thank you so much for the reply! These tests were ordered by the neurologist she was just referred to due to a recent seizure. He will only deal with neurology, and says she will be referred to another specialist if her tests are abnormal. We have another appointment in a week to discuss these results.

There is a big problem right now though. Her seizure was a first time tonic clonic on the concrete with no one around. She was pretty scraped and bruised and since then is terrified to be alone. She also cries all the time and is too weak to even hang out with her friends. I feel like I need to do something now rather than wait for another specialist. I will for sure start her on a vitamin D supplement immediately, thank you for pointing that out.

We have been searching for answers for many years and it seems like abnormal labs are seldom discussed or interpreted at the doctors. Thats why now I am asking for each result and researching it myself. Any advice or interpretation is much appreciated!


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## Lovlkn (Dec 20, 2009)

> Here are her results:
> 
> thyroxine 7.6 6.0-12.0
> 
> ...


Thyroxine - basically T-4 total and useless. I've had both Total 4 and Free T-4 and they do not correlate.

Free T-4 is extremely low. You need to insist they run a Free T-3 at her next appointment as both give the true idea of what thyroid hormones are in her system and to rule out T-3 toxicosis.

So you are aware... low thyroid and high thyroid can both cause mental symptoms.

TSH - a diagnostic test, she is also low in that.

A low TSH and Low FT-4 would point to T-3 toxicosis, possible goiter or pituitary issue. I would request a sonogram of her thyroid.

Antibodies to ask about testing, TPO and TSI antibodies as well as Thyroglobulin.

I'[ve never understood uptake although mine was on the high side prior to being diagnosed with Graves Disease.

Her vitamin D should be a prescription - usually 50K IU weekly for 12 weeks - then re-test and go to a daily pill. I for one need to take 5K IU daily to maintain in the 70-90 range and I am outside all the time.

I want to close with... you are being a very good Mom. We can help you sort out what is happening with your daughter. It's all going to work out - it may take awhile to sort out but I have to imagine her thyroid imbalance is causing alot of her current issues. My mental state was not good while I was looking for my Graves diagnosis and since my thyroidectomy has completely resolved.


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## Kairi34 (Oct 3, 2014)

Thank you so much for the advice!

We have had a disappointing week so far. My daughter's neurology appointment was pushed back due to tests being rescheduled. She has now attempted a 5 hour glucose test twice, but immediately vomits up the drink they give her. They won't try that test anymore.

Also, since her appointment was rescheduled, I decided to call and ask for a vitamin D rx that she can start while she's waiting. The neurologist doesn't think she needs a prescription and refused. Another irritating thing is that he had his receptionist talk to me, with him in the background. She was our "messenger" through which we talked, even though I could hear all his responses. It felt ridiculous to not be talking to him myself! I can only imagine that if her vitamin D levels are not serious to him, her thyroid test won't be either.

Her psychiatrist who she has had for many years says she is now too old for his pediatric clinic. There is absolutely no other psychiatrists within a 2 hour drive who is taking new patients. Her general doctor seems afraid to deal with her psych meds. I had to take her to the er last week for a psych evaluation because she is talking about suicide.

There is one very good thing though, almost a miracle to us actually. She started having a cvs episode and the imitrex she was recently prescribed stopped the episode. That is the first time in years anything has worked on her vomiting!

She has an appointment with the general dr on the 20th, and I will bring a copy of her labs for him to evaluate himself. I wish it were sooner, but nothing I can do.


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## Kairi34 (Oct 3, 2014)

Hello, my daughter has recently had more thyroid tests ordered by her general doctor, and this time he included the free t3 (which the neurologist refused to do). I was surprised to see that her tsh has changed quite a bit and was wondering what that means.

Here are the new results

free t4 1.03 .77-1.61

free t3 3.1 2.5-3.9

tsh 3.24 .30-5.60


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## Andros (Aug 26, 2009)

http://www.psycheducation.org/thyroid/introduction.htm

bipolar/thyroid disease
http://www.psycheducation.org/thyroid/introduction.htm
(Copy and paste into your browser)

Graves', neuropsychiatric
http://gravesdiseasetimbennie.com/ghdsection3of4part2.pdf
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1324966/
(Copy and paste into your browser)

http://www.stopthethyroidmadness.com/thyroid-depression-mental-health/articles/

T3 Uptake test
http://www.drstandley.com/labvalues_thyroid.shtml (high, hyper---low, hypo)
(Copy and paste into your browser)

The T3 uptake explained.
http://www.nlm.nih.gov/medlineplus/ency/article/003688.htm
(Copy and paste into your browser)

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://labtestsonline.org/understanding/analytes/thyroid-antibodies/tab/test
(Copy and paste into your browser)

And it would be a good idea to get some of the tests listed below for your daughter..........

Trab
http://www.ncbi.nlm.nih.gov/pubmed/17684583
(Copy and paste into your browser)

TBG (thyroxine binding globulin) up, hypo............down, hyper
http://www.nlm.nih.gov/medlineplus/ency/article/003374.htm
(Copy and paste into your browser)

It would appear that your daughter is hyperthyroid according to the T3 uptake.

Some of the above antibodies will in fact cause a change in the numbers. There are binding, blocking and stimulating antibodies to the receptor sites.

This is going to be interesting because maybe your daughter is not bipolar at all.

Info on that above as well.


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## jenny v (May 6, 2012)

TSH can bounce around quite a bit, even in a day, so don't be too surprised by that. Her Frees are leaning a smidge towards hypo, but the T3 uptake is high, so I'm wondering if she's got a lot of antibodies going on. Has her doctor ever done a thyroid antibody panel?


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