# Pelzergirl question on TSI



## Pelzergirl (May 24, 2011)

I am just so upset about the barbaric state of the medical community I can't hardly stand to type.. but I know you guys will chime in with some clarity and once I've calmed down.. I swear i will not drive over and beat up the horrid endo... grrrrrrr

6/2
Free T4 1.6 (.6 - 1.1)
TSH .013 (.4 - 4.0)
T3 278 ()

6/30 
Free T4 .6
TSH .032
T3 128

8/18
Free t4 <.2
TSH 69.01 ARGGGG!!!!!!!!!

Finally agreed to a TSI test

8/23
TSI 430 ()
Free T4 .4

Honestly.. I am at a lose for words.. oh and goiter developed in the matter of 5 days.. it's going back down.. now he wonders if the graves diag was wrong 9 years ago.. ya think!!!!! GRRRRRRR


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## Andros (Aug 26, 2009)

Pelzergirl said:


> I am just so upset about the barbaric state of the medical community I can't hardly stand to type.. but I know you guys will chime in with some clarity and once I've calmed down.. I swear i will not drive over and beat up the horrid endo... grrrrrrr
> 
> 6/2
> Free T4 1.6 (.6 - 1.1)
> ...


Graves' is a clinical diagnosis. Do you have the following?

You must exhibit..........goiter, exophthalmos, pretibial myxedema and thyrotoxicosis as per Dr. Robert Graves' of the 1800 era. 3 out of the 4 qualify.

You are hyperthyroid as evidenced by the TSI.

About TSI, Thyroid Stimulating Immunoglobulin

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

Why no FREE T3 test? It looks like FT4 is low because of fast conversion to FT3.

Do you feel well?

If you have a fast growing goiter, cancer needs to be considered. I suggest RAIU (radioactive uptake scan.)


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## Pelzergirl (May 24, 2011)

It was a fight to get the TSI, I'll start in on getting free T3..

My T4 is so low because the absurdly high amount of Tapazole he had me on I believe..

I never had all 4 for the Graves, only the thyrotoxicosis.. I think it's Hashi's at this point..

I understand that the RAIU is suggested and supported by most members.. I'm gonna pass on that for now...

Thank you as always Andros, you are a great gift to these boards ))


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## Andros (Aug 26, 2009)

Pelzergirl said:


> It was a fight to get the TSI, I'll start in on getting free T3..
> 
> My T4 is so low because the absurdly high amount of Tapazole he had me on I believe..
> 
> ...


I feel so bad for you having to fight through the quagmire of the medical establishment to get a diagnosis. And...................proper medical intervention.

You won't want to hear this but cancer can be the cause of hyper. It could have nothing to do with Graves' or Hashimoto's.

Thyroid cancer in patients with hyperthyroidism.
http://www.ncbi.nlm.nih.gov/pubmed/12876418

If I did not tell you, I would be doing you and others a disservice. Press for that RAIU.

And let us know.










We are all "gifts" to each other each bringing a different piece of fruit to fill the basket!


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## Pelzergirl (May 24, 2011)

~Hugh sigh~ I swear the endo is trying to kill me with neglect.. I'm still 5 weeks out on the appt with his replacement ~huge grin~ Although I'm worried that all endos are the same and I may have wasted my time trying to get in with a new one again..

Recap...

( I've previously posted all my labs with ranges)

Presented with borderline storm (T4 was 5.7) in May.. massive doses (60 mg a day) of Tapazole brought it down to 1.6 in short time, by the end of June I'm down to .6 but TSH is still super low (.032)

I wanted to cut the Tapazole back to the maintenance dose of 5 mg, but the endo said nooo we'll cut it to 40 mg a day and wait 6 more weeks (!!!) to test again..

well at the 5 week mark I have a goiter develop.. freak out and force them to see me then.. T4 is now undetectable, TSH is 69 (!!!) and I'm ticked!!

So then this "leader in his field" cuts the Tapazole completely.. and tells me to twist in the wind for 4 more weeks going cold turkey...

2 weeks into that I'm sure I've swung back hyper.. show out at the lab and force them to take the blood work early.. Sure enough I've gotten the T4 back up (.9) and the TSH has bottomed out to .057...

Is it any wonder I feel so terrible swinging back and forth? Why the heck won't they test more often.. sheesh it's my bill what does he care?? I don't want to be jerked back and forth.. how about a little finesse doc?!?!

I am so frustrated!! 

I do wonder about cancer.. he rolled his eyes at me when I asked, literally actually patted me on the head and said I should let him do his job.

I pitched a fit to get the TSI test and he blows that off as proof that I have Graves.. How is that we all know there is no blood test for Graves, yet he tut tuts me and doesn't seem to even care to find out what's really wrong.

Grrrr sorry for the vent but I am so feed up and I know ya'll can relate!!

Thanks gentle readers 

Nik


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## Andros (Aug 26, 2009)

Pelzergirl said:


> ~Hugh sigh~ I swear the endo is trying to kill me with neglect.. I'm still 5 weeks out on the appt with his replacement ~huge grin~ Although I'm worried that all endos are the same and I may have wasted my time trying to get in with a new one again..
> 
> Recap...
> 
> ...


You know what? That would have done it for me if I asked a doc about cancer and I got an eye roll and a pat on the head!

What? He has x-ray eyes now?

Please please find another doc. It does not have to be an endo. Your GP can order RAIU for you. Or go to an ENT. My veterinarian could do this; I kid you not.

Do you know how many posters on just this board have been told they don't have cancer, have been sent on their way to only find out they had thyroid cancer? Many, many!

I am soooooooooooooooooooooooooo worried about you. This has been really dragging on for a long time.


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## Pelzergirl (May 24, 2011)

I'm in the queue for the new endo 10/3 appt... This is the third one.. There has to be a decent one out there.. It can't be me, surely ; )

I've filled out the docs to get all my records from this bozo.. including my original RAIU (was a different endo same office) and I'm just gonna march into the new one's office (without a chip on my shoulder I swear) and say look.. are you going to work with me or not, I don't want to waste either of our time..

I mean honestly, how hard is it? I'm not asking for anything unreasonable, just treat me properly, or for goodness sake just get out of my way, tell me the lab results and I'll adjust my own meds sheesh..

I'm still frustrated that I don't have a true diagnosis yet.. It was 9 years ago they said Graves.. and I was fine with that all this time, because I didn't have any issue.. but something has changed and I want answers!!!

Thanks for being there : ))

Nik


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## Andros (Aug 26, 2009)

Pelzergirl said:


> I'm in the queue for the new endo 10/3 appt... This is the third one.. There has to be a decent one out there.. It can't be me, surely ; )
> 
> I've filled out the docs to get all my records from this bozo.. including my original RAIU (was a different endo same office) and I'm just gonna march into the new one's office (without a chip on my shoulder I swear) and say look.. are you going to work with me or not, I don't want to waste either of our time..
> 
> ...


We will see you through this. One way or the other!


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