# Please help me interpret. First bloodwork(s)



## alliebeth88 (Oct 25, 2012)

I have been having a lot of hypo symptoms. Most noticeably I can sleep and sleep and sleep and still be tired, I come out of the shower with little balls of hair that fell out, my nails are brittle and peeling/cracking, my joints are stiff and my hands and feet are almost always freezing.

These started appearing about 1+ year ago, but since I am in pharmacy school and we were learning about thyroid issues at the time, I assumed I was being paranoid. So I let it go. In the past 6+ months my symptoms have escalated and now I'm taking energy drinks every day just to function.

Went to doctor (who was super rude and dismissive of my symptoms..told me not to go out to eat so much and that I couldn't possibly have a thyroid problem because I have "too many symptoms!"). She did TSH only, which was 1.26 (0.34-5.60 range). To her, that was that.

I got private testing done through an online lab and got the results yesterday, which I have faxed to my doctor and plan to bring to my appointment on Tuesday. Until then, would you please help me navigate what they mean? I am so confused why I can feel soooo crappy, and yet everything is "normal":

T4,Free(Direct): 1.12 (0.82-1.77 ng/dL)

T3,Free: 3.1 (2.0-4.4 pg/mL)

TSH: 1.410 (0.450-4.500 uIU/mL)

Thyroid Peroxidase (TPO) Ab: 205 (0-34 IU/mL)

There was about a week in between my first TSH test and this test. Is it normal for TSH to fluctuate in that short a time? I don't know if 0.15 is considered significant fluctuation or not, though.

Any help would be appreciated, including what I should bring up with my doctor on Tuesday. Thank you!


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## Andros (Aug 26, 2009)

alliebeth88 said:


> I have been having a lot of hypo symptoms. Most noticeably I can sleep and sleep and sleep and still be tired, I come out of the shower with little balls of hair that fell out, my nails are brittle and peeling/cracking, my joints are stiff and my hands and feet are almost always freezing.
> 
> These started appearing about 1+ year ago, but since I am in pharmacy school and we were learning about thyroid issues at the time, I assumed I was being paranoid. So I let it go. In the past 6+ months my symptoms have escalated and now I'm taking energy drinks every day just to function.
> 
> ...


Yep; I do think you have a thyroid situation and here is why and probably why the fluctuation as well.

There are binding, blocking and stimulating antibodies to the receptor sites. When they are active, the numbers do not reflect what the body is feeling.

I do think your FREE T3 is way too low. Most of us feel best w/TSH @ 1.0 or less and the FREE T3 at about 75% of the range given by your lab.

I believe you are very symptomatic and while you may think you are hypo, do be aware of the fact that the symptoms can and do cross over and nothing is carved in stone. I and others gained weight while hyper.

So, these tests will be important. You don't need to repeat TPO unless you want to. High TPO is suggestive of a lot of things. I will give you a link w/labs and you can look up TPO.

TPO
Mild to moderately elevated levels of thyroid antibodies may be found in a variety of thyroid and autoimmune disorders, such as thyroid cancer, Type 1 diabetes, rheumatoid arthritis, pernicious anemia, and autoimmune collagen vascular diseases. Significantly increased concentrations most frequently indicate thyroid autoimmune diseases such as Hashimoto thyroiditis and Graves disease.
http://labtestsonline.org/understanding/analytes/thyroid-antibodies/tab/test

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

Trab
http://www.ncbi.nlm.nih.gov/pubmed/17684583

TPO (antimicrosomal antibodies) TBII (thyrotropin-binding inhibitory immunoglobulin), Thyroglobulin Ab, ANA (antinuclear antibodies), (thyroid hormone panel) TSH, Free T3, Free T4.

You can look this stuff up here and more.........
http://www.labtestsonline.org/


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## Babzie (May 30, 2012)

TPO
Mild to moderately elevated levels of thyroid antibodies may be found in a variety of thyroid and autoimmune disorders, such as thyroid cancer, Type 1 diabetes, rheumatoid arthritis, pernicious anemia, and autoimmune collagen vascular diseases. Significantly increased concentrations most frequently indicate thyroid autoimmune diseases such as Hashimoto thyroiditis and Graves disease.
http://labtestsonline.org/understanding/analytes/thyroid-antibodies/tab/test

Andros - have you found what the ranges are for 'mild to moderately elevated' levels vs. 'significantly increased concentrations'...?

I guess it would dependend somewhat on the individual testing lab and their ranges, but wondered if you have come across any info...


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## alliebeth88 (Oct 25, 2012)

Thank you for the links. I will for sure ask my PCP about these tests.

Also I forgot to add that I have a low blood pressure (100/60 usually) and pulse rate (50-52 bpm). My doctor also did some other workup tests on me, including SED rate, which came out as 8 (range 0-20). All my other blood work came out normal or low-normal.


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## sleepylady (Mar 18, 2012)

One doctor that I went to said the exact same thing about having too many symptoms. Isn't that ridiculous?

Well good luck and I hope you get your answers. I am still waiting for mine too.


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