# Need advice (a lot of labs...)



## ashdenee (Jun 27, 2013)

I was diagnosed with hypothyroidism in September of 2012 in the ER. This was after years of weight fluctuation, extreme anxiety, and feeling like I was having a heart attack. I was diagnosed via my TSH, which was 8.3 at the time. No further labs were run, I was given 50mcg of levothyroxine (my pharmacy gives Unithroid as their generic). I took this and of course did not feel any better.

Fast forward to March of this year. I finally decided to seek help from a new internist. He found nothing wrong with my thyroid, and upped my dose to 75mcg. Took me off of the supplements I was taking (vitamin D). I was iron deficient anemic, despite taking iron. Labs for that were as follows:

WBC	13.3	4.5 - 10.5	K/uL
RBC	4.65	4.00 - 6.00	M/uL
HGB	12.4	11.0 - 18.0	MG/DL
HCT	38.3	35.0 - 60.0	%
MCV	82.3	80.0 - 99.9	fl
MCH	26.7	27.0 - 31.0	pg
MCHC	32.5	33.0 - 37.0	GM/DL
RDW	15.5	11.6 - 13.7	%
PLATELET COUNT	393	150 - 450	K/uL
MPV	7.5	7.8 - 11.0	fl
GRAN%	73.0	42.2 - 75.2	%
Lymph%	24.8	20.5 - 51.1	%
Mono%	2.2	1.7 - 9.3	%
GRAN#	9.7	1.4 - 6.5	K/uL
Lymph#	3.3	1.2 - 3.4	K/uL
Mono#	0.3	0.1 - 0.6	K/uL

Thyroid lab (TSH only)
TSH	1.71	0.34 - 5.60	uIU/ML

He doubled my iron. Gave me Toprol XL for my heart palpitations (I've had plenty of work, they are benign...despite having over 1000 PAC's and PVC's a day). He gave me omeprazole for chest pain, etc. He tested for my gallbladder because of pain there. All was well. Just addressing issues.

A month later, I was still ill and insisted that something wasn't right...we ran a manual differential

WBC	9.97	4.5 - 11.0	K/uL
RBC	4.45	4.0 - 5.2	M/uL
HGB	11.5	12.0 - 16.0	GM/DL
HCT	37.7	36.0 - 46.0	%
MCV	84.7	80.0 - 100.0	fl
MCH	25.8	26.0 - 34.0	pg
MCHC	30.5	31.0 - 37.0	g/dl
RDW	15.1	12.0 - 16.8	%
PLT	318	140 - 440	K/uL
MPV	8.8	6.7 - 10.8	fl
Diff-Cells Counted	100 #CELLS
Segs%	77	45 - 80	%
Bands%	1	0 - 5	%
Lymph%	17	15 - 50	%
Mono%	3	0 - 15	%
EOS%	1	0 - 7	%
Baso%	1	0 - 2	%
ANC	7.78	1.5 - 7.5	/mm3
Bands#	0.10	0 - 0.6	K/uL
Segs#	7.68	2.0 - 8.8	K/uL
Lymph#	1.69	0.7 - 5.5	K/uL
Mono#	0.30	0 - 1.7	K/uL
EOS#	0.10	0 - 0.8	K/uL
Baso#	0.10	0 - 0.2	K/uL
Poikilocytes	1+ 
Anisocytosis	1+ 
Microcytosis	1+ 
Tear Drop Cells	1+ 
Ovalocytes	1+ 
Platelet Estimate	ADEQUATE 
LARGE PLATELETS	OCCASIONAL 
Platelet Clumps	OCCASIONAL

TSH	1.76	0.34 - 5.60	uIU/ML
Free T3	5.03	4.26 - 8.10	PMOL/L
Free T4	1.12	0.78 - 2.19	NG/DL

CRP	21.8	<10.0	MG/L

Erythrocyte Sedimentation Rate	23	0 - 20	mm/hr

My ESR has stayed elevated for months, but I only have these results sitting in my inbox.

I just got a new endo who put me on name brand Synthroid as a test to see if it helps. I have new labs in a few weeks, and he's testing for RA and celiac as well. Said if Synthroid doesn't help, we will try Armour.

Any thoughts?


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## ashdenee (Jun 27, 2013)

forgot to add iron labs:

Iron	44	37 - 181	uG/DL
TIBC	327	265 - 497	uG/DL
Iron-Saturation%	13	15 - 55	%


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