# Labs 4 week after RAI - Very confused



## carreg (Aug 10, 2011)

:confused0064: I just got my first labs results back after having RAI on June 28th and I am very confused. First let me back up a little with some history. I was diagnosed last year with Hashitoxicosis; leaning more toward hyper symptoms. After the latest uptake/scan in June, my endocrinologist recommend the RAI. 
I thought my latest results would show me starting to become hypo. Instead, the TSH is showing hyper. Any ideas on what is going on would be greatly appreciated. I've enclosed the results from before the RAI for comparison. Thanks!!

05/26/12
TSH: 0.59 (normal values 0.40 - 4.50)
T4, Free: 1.0 (normal values 0.8 - 1.8)
Thyroid Peroxidase AB: 549 (normal values less than 35)
TSI: 96% (baseline less than 140)

07/23/12
TSH: 0.04 (normal values 0.40 - 4.50)
T4, Free, 1.4 (normal values 0.8 - 1.8)
*Thyroid Peroxidate AB & TSI not done*


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## JPGreco (Mar 2, 2012)

After RAI, you can go more hyper. This is because as cells die, they dump the T4 hormone they were producing, a process that is usually slow(er). This dump can cause you to go more hyper and in some cases, experience a thyroid storm (you are nowhere close to that based on your labs, but still something to be aware of).

My 1 month labs were really bad as it caught me at the apex of that dumping of T4. I dropped a little a week or two later and more another 2 weeks after that.

Give it another week or two and see if there is any change. It may take you longer to start dropping than it took me.


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## Lovlkn (Dec 20, 2009)

carreg said:


> :confused0064: I just got my first labs results back after having RAI on June 28th and I am very confused. First let me back up a little with some history. I was diagnosed last year with Hashitoxicosis; leaning more toward hyper symptoms. After the latest uptake/scan in June, my endocrinologist recommend the RAI.
> I thought my latest results would show me starting to become hypo. Instead, the TSH is showing hyper. Any ideas on what is going on would be greatly appreciated. I've enclosed the results from before the RAI for comparison. Thanks!!
> 
> 05/26/12
> ...


Your FT-4 is exactly .1 above mid range - completely normal.

This is exactly why you should never dose off of TSH, which can lag up to 6 weeks from an accurate reading.

How are you feeling?


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## carreg (Aug 10, 2011)

Thanks JPGreco and Lovlkn,
This is one of the reasons I like coming to this board. I always know I will receive good information from people who have been there!!
The reason I was so confused/surprised by the lab results is because I have been feeling so bad. Within the last two weeks I have been extremely fatigued (more than before the RAI) but unable to sleep well. I've also had a lot of gastro issues. The "brain fog" has been terrible and I've gained ten lbs. in the last couple of weeks. Granted I could afford to gain because I was down to 90 lbs. on a 4'11" frame. However, I'm gaining without eating any differently. I was so sure from the symptoms I've been having that I was becoming Hypo. . . . .


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## Andros (Aug 26, 2009)

carreg said:


> :confused0064: I just got my first labs results back after having RAI on June 28th and I am very confused. First let me back up a little with some history. I was diagnosed last year with Hashitoxicosis; leaning more toward hyper symptoms. After the latest uptake/scan in June, my endocrinologist recommend the RAI.
> I thought my latest results would show me starting to become hypo. Instead, the TSH is showing hyper. Any ideas on what is going on would be greatly appreciated. I've enclosed the results from before the RAI for comparison. Thanks!!
> 
> 05/26/12
> ...


Your labs look good right now. TSH is not a good indicator of what is going on. I think you are having a brief reprieve and you are currently euthyroid (feeling good?) Are you?

Let me tell you this; "If you feel good right now, you need to save these numbers from July as a "guideline" and you do need to get the FREE T3 done somewhere along the line.

This may be of interest to you............

Dr. Mercola (FREES)
http://www.mercola.com/article/hypothyroid/diagnosis_comp.htm
FREE T3 explained by Woliner
http://thyroid.about.com/cs/testsforthyroid/a/freet3.htm


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## carreg (Aug 10, 2011)

:sick0012: Sorry, It has been so long since I last posted. Just to recap, I had RAI on June 28th. I have not started on any medication because the endo. wants several labs back first. 
I had to return to work; after having summer vacation and it has been all I could do to get through the day. When I first returned, I thought I was so tired because I had been off. However, the last couple weeks have been terrible to the point of being scary and I don't scare very easily :scared0011: The really scary moment happened when I was in a training that I had participated in numerous times before and, for the life of me, I could not concentrate and had the worse overwhelming fatigue. I started also having off and on feelings like I "had a bag" over my head for the lack of a better description. It has been to the point where the other day driving home, it was all I could do to concentrate getting home. I'm an "in control" type of person so this has been very frustrating. 
I went on Monday, the 27th for the second set of labs post RAI and the endo's office left a message yesterday evening saying they want to see before my scheduled appointment the middle of September. Of course, because this is Labor Day weekend, we can't get anything scheduled. I was, however, able to go by the lab office and get the results. They are as follows:

TSH: 54.76 (0.40 - 4.50)
T4, Free: 0.3 (0.8 - 1.8)

I feel like I'm on a roller coaster that just will not stop . . . . . .


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## miltomeal (May 17, 2011)

Well, the doc probably wants to start you on your thyroid replacement asap, because you are definately hypo.

Hang in there! Pamper yourself this weekend if you can!!!
You will get thru this, but it still will take a little time.

Best Wishes!


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## Andros (Aug 26, 2009)

carreg said:


> :sick0012: Sorry, It has been so long since I last posted. Just to recap, I had RAI on June 28th. I have not started on any medication because the endo. wants several labs back first.
> I had to return to work; after having summer vacation and it has been all I could do to get through the day. When I first returned, I thought I was so tired because I had been off. However, the last couple weeks have been terrible to the point of being scary and I don't scare very easily :scared0011: The really scary moment happened when I was in a training that I had participated in numerous times before and, for the life of me, I could not concentrate and had the worse overwhelming fatigue. I started also having off and on feelings like I "had a bag" over my head for the lack of a better description. It has been to the point where the other day driving home, it was all I could do to concentrate getting home. I'm an "in control" type of person so this has been very frustrating.
> I went on Monday, the 27th for the second set of labs post RAI and the endo's office left a message yesterday evening saying they want to see before my scheduled appointment the middle of September. Of course, because this is Labor Day weekend, we can't get anything scheduled. I was, however, able to go by the lab office and get the results. They are as follows:
> 
> ...


Whoa; you are really hypo and of course you know that. Goodness. See if you can get on a cancellation list. You need thyroxine replacement STAT! Doctor should have called some in for you; truth be told. You could have gotten started on it.

You have to function at work; top priority! Yes?


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## carreg (Aug 10, 2011)

Andros,
I can truthfully say I have never felt this bad. My husband finally got through to the doctor's office Friday morning and the front office staff was no help. Although they said the endo wants to see me before the 19th, they have no openings. I feel if he could have talked directly to the doctor, he would have had me go right in. My husband got the impression from their attitude that if my symptoms got worse to just go to the ER. . . .
I have a job that I definitely need to keep a "clear" head and that is definitely not currently happening.


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## midgetmaid (Jul 22, 2010)

Hon, would your GP's office see you or call in a prescription?

Renee


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## Andros (Aug 26, 2009)

carreg said:


> Andros,
> I can truthfully say I have never felt this bad. My husband finally got through to the doctor's office Friday morning and the front office staff was no help. Although they said the endo wants to see me before the 19th, they have no openings. I feel if he could have talked directly to the doctor, he would have had me go right in. My husband got the impression from their attitude that if my symptoms got worse to just go to the ER. . . .
> I have a job that I definitely need to keep a "clear" head and that is definitely not currently happening.


This is unconscionable and a horrible horrible position for you! There has to be some way you can get started on Thyroxine replacement!

Do you have an urgent care facility in your area?

{{{{carreg}}}}


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## carreg (Aug 10, 2011)

Andros & midgetmaid,
I think my GP will be able to help Tuesday. However, I know I would not be able to get through to him this weekend because his after hours on call go through our local hospital. I'm sure he will be livid that the endo's front office staff was no help. I am praying the symptoms don't progress to the point that I have to go to the ER, however, at this point I'm not so sure . . . .
I like my endo, but I think this may be the last straw with the front office staff. At the very least, they should have squeezed me in Friday knowing this was Labor Day weekend. As a matter of fact, my endo should have called in a prescription to at least get me started on meds.
My husband asked me how I was feeling this morning and my reply was, "I would not wish this on my worse enemy!" I am so thankful for his patience and understanding because, unfortunately, he has had to take the brunt of my feeling so bad . . . .
The worse symptoms I am having today is the more frequent feeling of the blood rushing to my head, dizziness, brain fog, achy joints, and headache . . .
I knew the RAI was not going to be a quick or easy fix. However, I never imagined feeling this bad . . . . .:sad0049:


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## carreg (Aug 10, 2011)

Well, I did end up in the ER yesterday evening. Symptoms were getting much worse. They did another TSH and T4. The TSH came back at 84 up from 54 on the 27th of August. They actually redid the test because they thought the first test was a mistake. I don't remember what the T4 was because the "brain fog" was taking over, but I remember it came back very low. They started me on Synthroid, maintenance dose. I think the ER doctor was really surprised that the endocrinologist at the very least did not call in a prescription this past Friday to get me started on replacement therapy.
I know this is not going to be a quick fix and I still have a long road ahead, but it is a start. I will be following up with my family doctor tomorrow. I have a feeling he will be making a phone call to the endocrinologist voicing his displeasure over not taking any action this past Friday especially with this being Labor Day weekend . . . . .


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## midgetmaid (Jul 22, 2010)

Thank God! You're right-it will take time to feel better, but now you will be headed in the right direction. Try to get as much rest as possible.

Renee


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