# Can someone help with new test results?



## buckerine11 (Oct 24, 2009)

Hi all, I just got my new blood test back with all the antibodies checked, which seems to be in normal range...

TSH (ssTSH): 2.06 (.3-5.50)
Free T4 : 1.00 (.76-1.7)
Free T3 : 3.6 (1.9-3.9)
Blood Cortisol : 14.1 (7-22)
Vitamin D : 15 (25-80)
Thyroglobulin : 7.5 (0-60.0 ng/ml)
TPO : 10 (<30 U/ml)
TSI: <1.0 (<1.3)

Everything except vitamin D looks normal, but I'm having symptoms. I don't even know where else to turn at this point...


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## Andros (Aug 26, 2009)

buckerine11 said:


> Hi all, I just got my new blood test back with all the antibodies checked, which seems to be in normal range...
> 
> TSH (ssTSH): 2.06 (.3-5.50)
> Free T4 : 1.00 (.76-1.7)
> ...


Hi and welcome to the board. I do believe that you are "trying" to be hyperthyroid. The 2 give-a-ways are the FT3 is climbing up there and you have evidence of TSI (thyroid stimulating immunoglobulin) and while it is only a smattering, you should have no TSI.

What do the test results mean?
Normally, there is no TSI in the blood. If TSI is found in the blood, this indicates that this abnormal antibody is responsible for causing the person's hyperthyroidism.

http://uimc.discoveryhospital.com/main.php?t=enc&id=1516

Please tell us of some of your symptoms. In the meantime, try to sit in the sun for about 15 minutes per day.


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## buckerine11 (Oct 24, 2009)

Andros said:


> Hi and welcome to the board. I do believe that you are "trying" to be hyperthyroid. The 2 give-a-ways are the FT3 is climbing up there and you have evidence of TSI (thyroid stimulating immunoglobulin) and while it is only a smattering, you should have no TSI.
> 
> What do the test results mean?
> Normally, there is no TSI in the blood. If TSI is found in the blood, this indicates that this abnormal antibody is responsible for causing the person's hyperthyroidism.
> ...


Hi Andros, thanks for the response. My symptoms are mostly indicative of hypothyroidism. I am tired most of the day, my body temperature last time I was at the doctor's was 96.7 F, I'm losing quite a bit of hair all over my body (pubic, scalp, leg, eyelashes, etc), I'm having a hard time concentrating, my appetite has gone wayyy down, and so has my libido. 
I don't know what's causing this, but it really seems like my symptoms match those of hypothyroidism. The test results, though, don't show that... 
thanks.


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## Andros (Aug 26, 2009)

buckerine11 said:


> Hi Andros, thanks for the response. My symptoms are mostly indicative of hypothyroidism. I am tired most of the day, my body temperature last time I was at the doctor's was 96.7 F, I'm losing quite a bit of hair all over my body (pubic, scalp, leg, eyelashes, etc), I'm having a hard time concentrating, my appetite has gone wayyy down, and so has my libido.
> I don't know what's causing this, but it really seems like my symptoms match those of hypothyroidism. The test results, though, don't show that...
> thanks.


Symptoms don't always hold true and do cross over. For instance, I gained weight while hyperthyroid and so did many others and interestingly, I ate little (no appetite as you say.)

TSI is proof in the pudding.

When hyperthyroid, the patient is exhausted for even at rest the body is in a hypermetabolic state causing extreme exhaustion.

You might find this interesting about binding and blocking antibodies to TSI. You could feel hypo depending on what is going on and that also would be why your TSI is below the range.

http://www.suite101.com/lesson.cfm/19330/2899/4

In other words, there are antibodies to the autoantibodies. We have binding, blocking and stimulating antibodies and autoantibodies. You may have Thyrotropin Binding-Inhibitory Immunoglobulin (TBII) and it would be interesting to have that lab test.

http://www.eje-online.org/cgi/content/abstract/122/4/499


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## buckerine11 (Oct 24, 2009)

Andros said:


> Symptoms don't always hold true and do cross over. For instance, I gained weight while hyperthyroid and so did many others and interestingly, I ate little (no appetite as you say.)
> 
> TSI is proof in the pudding.
> 
> ...


Thanks Andros. What do you think I should do next? Is it necessary to go get a TBII antibody test?

Also, have you ever seen test results that have "<" next to it? It seems like <10 for my TSI could mean anything under 10. And also, it had no units like "pg/dL," so it's impossible to tell what they actually mean. If I am around "10," and the range is around "1.3," then I think it might be a strong case for TSI, but with these wacky numbers and lack of units, I really don't know how to interpret these results. Thanks.


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## chopper (Mar 4, 2007)

Your TSI is LESS than one and the "normal range" for TSI per your lab is less than 1.3, indicating you did not test positive for TSI if I have my greater thans and less thans correct.


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## buckerine11 (Oct 24, 2009)

nasdaqphil said:


> Your TSI is LESS than one and the "normal range" for TSI per your lab is less than 1.3, indicating you did not test positive for TSI if I have my greater thans and less thans correct.


Yeah, I understand that, but according to Medshelf.org, normal individuals without Graves Disease should have around <.02 TSI activity. I'm at 1.0, which according to the website is 100% activity, and those individuals with non-medicated Graves Disease has >130% activity.

So, my area of confusion is what <1.0 actually says. Does it mean I'm around 1.0, or does it mean that I'm anywhere between 0-1.0. If I am like 0.01, then obviously I have nothing that would indicate any thyroid autoimmunity. However, if "<1.0" actually means i'm around 1.0, then I think I should probe deeper about my thyroid condition, since a number like that is generally for people who have Graves, but on medication (which I'm not on).

http://graves.medshelf.org/Lab_Tests

Source.


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## chopper (Mar 4, 2007)

Zero is less than one. Theoretically you could be completely negative for TSI.

I have hashi's and graves and can tell you, my TSI goes from 165 to around 185 typically with a reference range of less than 125.

I have tested in the 60's in the past and felt awesome. I think I was in some sort of remission or something. As soon as my TSI climbs above that normal range is when I start getting hyper symptoms.

Your test was negative. I would have preferred to see actual values instead of "greater than" or "less than" but for the lab you used, your TSI was untraceable so they put the lowest score they offered, less than 1. It could mean zero or it could mean .999 but regardless, with thousands of tests performed in order to establish that range, they considered your score to be normal.

TSI can fluctuate. I know this for a fact as mine does and I've had about 8 TSI tests in all. Only once was I in the normal range. Given your symptoms, TSI is likely so you may want to see if you can test at another lab.

If you want to shell out some cash, healthcheck USA offers the TSI test or at least they used to. I think it was like $200. You might want to check them out. I use their thyroid profile regularly in between doc visits or you can ask your doc to write a script for a different lab if you are concerned.

From what I gather from years on these boards, most people with "clear cut" Graves test really high for TSI, like 180 - 300 and higher. My docs are still not even sure I have Graves or a crossover from Hashis even with my high TSI.

www.healthcheckusa.com


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## chopper (Mar 4, 2007)

Can I ask how old you are? Have you gained or lost weight recently? Are you on any prescription drugs? Oral contraception? Special vitamins? Special diet? Anything unusual?

Have you had any other tests yet like a metabolic panel? Iron? Ferritin? Sex hormones?

There are a lot of things that appear to be thyroid related which is why I ask. Now since it appears you could have the onset of Hashi's with TPO Ab and TG antibodies present, although within the normal range, you may have Hashi's and when you got your blood drawn you were having a particularly good day. If it is hashi's, you may go back next week, get retested and everything is off the charts.

Your numbers, sans the presence of those antibodies, look pretty good. Your Free T4 could come up a smidge but those are numbers that we usually shoot for. Your FT3 is at the higher end of the range but that number will fluctuate a little too. When I was first diagnosed my Free T4 was normal, like yours and my FT3 was just barely outside the range high but I was nervous as hell. Had jitters and shakes and what not. My TSI was also like 185 at the time and my TPO was 1500 and TG was 1100 so my antibodies were way out of range.

If it were me, I would get a full workup, particularly the sex hormones, a comprehensive metabolic panel (CMP), a complete blood count (CBC) and retest of the thyroid.

I would start there with a good workup. Since thyroid is well related to the sex hormones, usually if the thyorid is off so are the sex hormones, cholesterol, testosterone, prolactin, etc.


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## buckerine11 (Oct 24, 2009)

nasdaqphil said:


> Can I ask how old you are? Have you gained or lost weight recently? Are you on any prescription drugs? Oral contraception? Special vitamins? Special diet? Anything unusual?
> 
> Have you had any other tests yet like a metabolic panel? Iron? Ferritin? Sex hormones?
> 
> ...


I'm a 23 year old male, and I've been having my symptoms for the past 2 years. I'm not taking any medication, and never took any medications. As far as my weight, I haven't seen a dramatic change (maybe 5-10 lb drop), but what I have noticed is that I barely have an appetite. No food really smells or tastes that good to me, it's just eating it, and I never really WANT to eat.

Aside from that, I get the jitters too. I'm experiencing some pretty bad anxiety, as I'm worried all the time about nothing. I'm also losing alot of my hair on my scalp, pubic region, some eyebrow, and eyelashes. I also have a pretty noticeable drop in libido.

I hadn't gotten an iron, ferritin test in awhile, but last year it was normal. My latest testosterone result was about 550, which I personally think is low for a guy my age, but it's still well within range.

I just want to figure out what is wrong with me, and how I would go about fixing it. Thyroid seems to be the most appropriate thing that I can think of that can cause my symptoms. If it's not that, then i'm really out of ideas.

Oh, and this last time around, I got a bloody survey, also. All the RBC, WBCs looked in normal range, except my platelets.

Overall my platelet count was 166 (range: 150-450).
MPV (mean platelet volume) was 8.8 (range: 9-12)
Cortisol was also normal : 14.1 (7-22 for morning)


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## chopper (Mar 4, 2007)

Do you drink/party/drugs? Do you have a lot of stress? Was there a notable time the symptoms started like quit drinking, smoking, bad break up, death in the family? Anything like that?

Im just trying to go through some different things to see if something comes up.

Im 39 and my testosterone is a miserable 185 which is very low. Doc said I should be around the 500s at my age. Your test seems a bit low but at 500-something I don't think it's low enough to be your problem.

Im stumped. All I could offer is advise additional tests- adrenals ACTH, catecholamines perhaps.

I would like to see another TSI with numbers. IGF-1, A1C, TIBC. You can google any of these tests to see what they are all about.

What exactly are the symptoms that bother you most? Are you frequently constipated?

Regarding libido is it just low or low and unable to perform well?


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## buckerine11 (Oct 24, 2009)

I don't party that often, and don't do drugs. I only drink alcohol socially maybe once a month.

I would say the worst symptom for me is either the diffuse scalp hair loss or the anxiety (worrying and jitters). Libido is important too, but I think I'm more affected by the other two. For me, the libido decrease is mostly just decrease in desire, which causes me to not want to have sex as often as before. As for the performance, it's been affected a little bit, but I think it would be affected more if I had to do it as many times as I did in the past. Appetite is probably the least worrisome one, but I'd like to have it back regardless.

Not sure if I mentioned it, but last time I got my temperature checked it was 96.7F, which isn't hypothermic range, but definitely low enough to seem like hypothyroidism, which doesn't reflect my tests at all...


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## chopper (Mar 4, 2007)

Temp is a really crummy indicator unless you take your temp quite a few times and it's consistently low or high.

My last TSH was 14 and change indicating hypo but my temp is almost always in the low 99s.

You're at a funky age where unfortunately you start making the transition from young and invincible to old and beat up.

It's possible you are going through some sort of "male menopause"

don't laugh...google it. My docs have mentioned it when I was first diagnosed at 34. Granted you are a bit young for that but you are at an age when changes start happening. Might be something to look into.


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## Andros (Aug 26, 2009)

buckerine11 said:


> Thanks Andros. What do you think I should do next? Is it necessary to go get a TBII antibody test?
> 
> Also, have you ever seen test results that have "<" next to it? It seems like <10 for my TSI could mean anything under 10. And also, it had no units like "pg/dL," so it's impossible to tell what they actually mean. If I am around "10," and the range is around "1.3," then I think it might be a strong case for TSI, but with these wacky numbers and lack of units, I really don't know how to interpret these results. Thanks.


They have to have ranges to use as a baseline which includes things like TSI where in fact the healthy patient should have none. That 10 would have the same unit description except that it is below the designated range.

I think that (if I were you), I would request an uptake scan of your thyroid to check for nodules and other irregularities including cancer and that you should request that TBII. That is what I would do.


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## chopper (Mar 4, 2007)

I found an interesting testosterone study online. I've been looking for something like this for a while.

With a testosterone at 185 or so, 100 year old men have more testosterone than me.


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## Andros (Aug 26, 2009)

nasdaqphil said:


> I found an interesting testosterone study online. I've been looking for something like this for a while.
> 
> With a testosterone at 185 or so, 100 year old men have more testosterone than me.


That is an awesome matrix! Have you ever had your FREE Testosterone run?


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## chopper (Mar 4, 2007)

Andros said:


> That is an awesome matrix! Have you ever had your FREE Testosterone run?


Yes, those numbers are just as grim. Looking back, it must have been an absolute miracle I was able to have 2 kids. My doc didn't think it would happen.

Testosterone Total 178 (241 - 827)
Testosterone, % Free of Total 0.44 (0.32 - 0.50) 
Testosterone, Free 0.79 (0.95 - 4.30)


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## Andros (Aug 26, 2009)

nasdaqphil said:


> Yes, those numbers are just as grim. Looking back, it must have been an absolute miracle I was able to have 2 kids. My doc didn't think it would happen.
> 
> Testosterone Total 178 (241 - 827)
> Testosterone, % Free of Total 0.44 (0.32 - 0.50)
> Testosterone, Free 0.79 (0.95 - 4.30)


2 very wonderful miracles to be sure!! Hubba, hubba! Just goes to show ya' that what is meant to be is meant to be.


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## buckerine11 (Oct 24, 2009)

Andros said:


> They have to have ranges to use as a baseline which includes things like TSI where in fact the healthy patient should have none. That 10 would have the same unit description except that it is below the designated range.
> 
> I think that (if I were you), I would request an uptake scan of your thyroid to check for nodules and other irregularities including cancer and that you should request that TBII. That is what I would do.


Ok, I'm going to go get a TBII and redo my TSI.

I don't understand exactly what you mean with the ranges. Are you saying that my 100 isn't exactly 100, or that it should mean it's around 100, just like 130 means 130? If it's 100, shouldn't I be somewhat worried since normal people have around 2?


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## Andros (Aug 26, 2009)

buckerine11 said:


> Ok, I'm going to go get a TBII and redo my TSI.
> 
> I don't understand exactly what you mean with the ranges. Are you saying that my 100 isn't exactly 100, or that it should mean it's around 100, just like 130 means 130? If it's 100, shouldn't I be somewhat worried since normal people have around 2?


I am so glad you are going to get those lab tests.

Ranges are merely guidelines. That is the bottom line. So, if you have antibodies below the range, that means that you do have them. Just that they are not within the suggested range. A lot of people don't understand this and that includes doctors.

As per the url I provided about TSI; you should not have any TSI, period. This may or may not be true of other antibodies/autoantibodies because we do have "good" antibodies as well.

Please let us know of your test results and ranges.


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