# Need feedback about lab results



## Bungee (Jul 2, 2011)

Hi Ya'll...
I am still a newbie and would like feedback about the lab results while waiting to see the Dr. 
My thyroid is inflamed and an ultrasound found three nodules and their location and size. NO information at all about the characteristics of the nodules (i.e. if they are hypo or hyperechogenic or if they are solid or not). 
They say one is "large" measuring 1.4 x 1.4 x 3.0 cm. Is that unusually large?Another one measured 1.5 x 1.2x 1/3 cm. It says they also see two lymph nodes each measuring 8x4x5. Wondering if that is cause for concern. 
Impression: Heterogeneous thyroid gland with enlarged thyroid nodules. Ultrasound guided tissue sampling may be performed for definitive characteristics. 
My Sed rate is very high, my TSH level is low and my white count and neurtrophil counts are high.
My new labs this week show my TSH is till very low, T4, Free is high (2.3 with range of .5-1.7). My T3 is also high 3.3 (range .0 - 1.8). 
My Anti Thyroglobuline Ab and Thyroid Micorsomal Antibody are both norma. 
I will be going for the radioactive uptake scan in a couple of weeks. 
Does this sound like it could be a virus? Or not? Any thoughts? Thanks!!!


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## Andros (Aug 26, 2009)

Bungee said:


> Hi Ya'll...
> I am still a newbie and would like feedback about the lab results while waiting to see the Dr.
> My thyroid is inflamed and an ultrasound found three nodules and their location and size. NO information at all about the characteristics of the nodules (i.e. if they are hypo or hyperechogenic or if they are solid or not).
> They say one is "large" measuring 1.4 x 1.4 x 3.0 cm. Is that unusually large?Another one measured 1.5 x 1.2x 1/3 cm. It says they also see two lymph nodes each measuring 8x4x5. Wondering if that is cause for concern.
> ...


Does not sound like a virus to me. Glad you are getting RAIU. Make sure you stay on an iodine free diet from now until then and there are some meds that negate the uptake as well so ask what that might be.

Pathologist/radiologist recommended FNA; why did your doc not order that? Also, lymph node involvement does suggest that further investigation would be extremely wise.

You could have something else going on simultaneously which might be bacterial or virus in nature.


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## Bungee (Jul 2, 2011)

Thanks again Andros for your reply. 
The radioactive uptake test is delayed because they did not tell me not to eat seafood! I had no idea. Now have to wait several weeks to do it. 
I assume they were holding off on the FNA until the radioactive uptake test was done. Wouldn't that give them a better idea of where to stick the needle?
Just my guess. This is all very new to me!
I am mostly wondering at this point what the thyroid blood tests tell....other than that I am hyperthyroid. Does it give any clues?


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## Andros (Aug 26, 2009)

Bungee said:


> Thanks again Andros for your reply.
> The radioactive uptake test is delayed because they did not tell me not to eat seafood! I had no idea. Now have to wait several weeks to do it.
> I assume they were holding off on the FNA until the radioactive uptake test was done. Wouldn't that give them a better idea of where to stick the needle?
> Just my guess. This is all very new to me!
> I am mostly wondering at this point what the thyroid blood tests tell....other than that I am hyperthyroid. Does it give any clues?


Your labs definitely point to hyper. There is no question of it except I do wonder about the T3; it would have been better to do the FREE T3 which unbound hormone only. T3 is bound, unbound and rT3 (reverse.)

Make sure you check all foods for iodine including supplements and vitamins.

Yes; RAIU would give a better lay of the land as they say.


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## Bungee (Jul 2, 2011)

Thanks Andros.
Yeah lab sheet just says T3...nothing about "free". 
Well, in any event it looks like I won't know anything else for several weeks until the radioactive uptake test is complete. The thing about that that stinks is that I do not feel so great. So several more weeks of feeling like this before any type of intervention can take place. Gotta love it!


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## Andros (Aug 26, 2009)

Bungee said:


> Thanks Andros.
> Yeah lab sheet just says T3...nothing about "free".
> Well, in any event it looks like I won't know anything else for several weeks until the radioactive uptake test is complete. The thing about that that stinks is that I do not feel so great. So several more weeks of feeling like this before any type of intervention can take place. Gotta love it!


I know you don't feel good but it is a very good thing to get this RAIU. If you had medical intervention, you probably would have to go off all meds for several weeks in prep for RAIU.

In hindsight, you will be glad about the RAIU.


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## Bungee (Jul 2, 2011)

Had the radioactive uptake scan done. Do not have results yet. But from what the techs were saying while I was there, it sounds like the uptake is low. They kept asking me if I was taking thryroid meds to account for the results and if I had eaten seafood. Definite no to these questions. I am going to try to get the report in the next day or so. I didn't think of this before, but the largest of the palpable nodules seems hard. I am still hoping that this could be thryoditis...hopefully will have some answers before long.


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## Andros (Aug 26, 2009)

Bungee said:


> Had the radioactive uptake scan done. Do not have results yet. But from what the techs were saying while I was there, it sounds like the uptake is low. They kept asking me if I was taking thryroid meds to account for the results and if I had eaten seafood. Definite no to these questions. I am going to try to get the report in the next day or so. I didn't think of this before, but the largest of the palpable nodules seems hard. I am still hoping that this could be thryoditis...hopefully will have some answers before long.


I for one will be very anxious to hear the RAIU report when you get it.

Some reasons for low uptake are listed here.

http://enotes.tripod.com/hyperthyroidism.htm


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## Bungee (Jul 2, 2011)

I was able to get a copy of the report today from the uptake scan. Looks like it is thyroiditis! That is good...but there is ...just like my ultrasound..no information about the nodules! One is 3cm...no info about them at all!

This report says 
Imaging shows extremely low uptake. Evaluation of glandular tissue is not possible. Activity within the thyroid gland is barely above the adjacent soft tissue structures. 
Extremely limited imaging study due to very low uptake of iodine by the thyroid gland. Markedly diminished 7 and 24 hour thyroid uptake values. With ultrasound findings, suppressed TSH and elevated T3 and T4 these findings suggest thyroiditis.

So this is good, and I assume it means that they will not need to further look at the nodules to determine their characteristics?? What do you think?


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## Andros (Aug 26, 2009)

Bungee said:


> I was able to get a copy of the report today from the uptake scan. Looks like it is thyroiditis! That is good...but there is ...just like my ultrasound..no information about the nodules! One is 3cm...no info about them at all!
> 
> This report says
> Imaging shows extremely low uptake. Evaluation of glandular tissue is not possible. Activity within the thyroid gland is barely above the adjacent soft tissue structures.
> ...


The path is only saying the findings suggest thyroiditis. I personally think it would be a very good idea to get FNA.

Going back to the "impression" from the ultra-sound.



> Impression: Heterogeneous thyroid gland with enlarged thyroid nodules. Ultrasound guided tissue sampling may be performed for definitive characteristics.


If you read that link, you will see that cancer is a possibility re low uptake.

Low RAIU = radioactive iodine uptake 
Common causes

Painful Subacute thyroiditis 
Painless thyroiditis (includes painless postpartum thyroiditis) 
Chronic thyroiditis with transient thyrotoxicosis

Uncommon causes 
Iatrogenic/surreptitious thyroid hormone 
Metastatic thyroid cancer 
Amiodarone-induced thyroiditis 
Struma ovarii

http://enotes.tripod.com/hyperthyroidism.htm

While I may err on the side of caution, it has paid off in the past. Please talk to your doctor about this.

Nag, nag, nag!! That's what I do best. LOL!

Let me know what you think! I want you to "know" you are home-free! So you can sleep at night.


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## Bungee (Jul 2, 2011)

Hey Andros,
Thanks so much for your response. I couldn't agree with you more. Thanks for that great link. It's excellent.
I am going to ask about the FNA when I meet with the endocrinologist later this month. To have nodules and one large and have NO information about the characteristics is unsettling. While cancer would be rare, I agree that issue just needs to be put to bed with the FNA. It's such an easy procedure..why not? Especially when I have no info about the glandular tissue. Yes, I just want this whole issue behing me. Will let you know what happens!


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## Bungee (Jul 2, 2011)

One quick question.
Is the thyroglobulin test the same as the Anti Thyroglobulin Ab test?
My Anti Thyroglobulin Ab is normal...I don't see that I was tested for just Thyroglobulin.
I read if the the Thyroglobulin level is normal that it rules out thyroiditis. So not sure if these two tests are the same thing or not?


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## Andros (Aug 26, 2009)

Bungee said:


> One quick question.
> Is the thyroglobulin test the same as the Anti Thyroglobulin Ab test?
> My Anti Thyroglobulin Ab is normal...I don't see that I was tested for just Thyroglobulin.
> I read if the the Thyroglobulin level is normal that it rules out thyroiditis. So not sure if these two tests are the same thing or not?


They are 2 different tests.

http://www.thyca.org/thyroglobulin.htm

Understanding Thyroglobulin Ab.
http://www.labtestsonline.org/understanding/analytes/thyroglobulin/test.html

cancer TPO and thyroglobulin
http://onlinelibrary.wiley.com/doi/10.1111/j.1699-0463.1994.tb04888.x/abstract


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