# Someone please help reading these levels..



## sherrilynn (May 11, 2010)

I am new to this site, just found it. Though I am not new to graves disease. I was diagnosed in Feb. 08 whle in the midst of a thyroid storm. I do not have copies from my labs when I was in the hospital, but I know they were off the charts. Been on ptu, atenolol, and xanax since that time. My latest labs from thursday just came in today. The phys. asst. had called and told me the thyroid is good and to continue doing what I am doing. But, I feel lousy! I actually feel more like hypo than hyper but here are my new levels and I am having a difficult time understanding them...

Free T4... 0.97 (range 0.48-1.23)
TSH .... 0.02 (range 0.44-4.21)
T3.... 35.7 (range 32.0-48.4)
Anti-thyrglb ab .... <0.9 Then it says reference range < 4.0 (I have no idea what this level is or how to read it)

Sodium is low at 133.... (135-146)
CO2 is low at 21 (23-33)
Anion Gap high at 12.0 (3.0-11.0)

Glucose is high at 130 (65-1000 though this is range for fasting glucose and I was not fasting, that is what the asst. said not to worry about it cause it wasn't a fasting test)

WBC is high at 15.0 (4.5-11.0)

All the other ranges are good and in range. Liver, kidneys etc. I can list them all if you would like..

Below is test results from 6 mths ago. ( I can't fine the ones from 3 mths ago but they were about the same as these from 6 mths ago)

T3... 44.1 (32.0-48.4)
T4free .. 2.13 (0.48-1.23)
TSH ... 0.04 (0.44-4.21)

Sodium was low then too.. 134 (135-146)

I can't understand why my tsh went down more. t3 and t4 came into range and that is the first time in 2 years! I do have more results from other dates, but figured I would give you the most recent I have. If you need further info please let me know..
Just wondering if these sound right, where am I??? Am I going hypo or still very hyper?? Why do I feel lousy??
Anyone know about the sodium or thise anion gap level?

I am now on ptu 50 mg day, atenolol 25 mg. up to 3 times a day, and xanax .5 as needed. I only take the xanax during stressful times or to help me sleep. Don't need any other problem on top of this graves disease battle.

I sure am glad I found this group. Wish I had found it 2 years ago. I really hope someone out there can help.. Thanks for your replies.
Sherri
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## Andros (Aug 26, 2009)

sherrilynn said:


> I am new to this site, just found it. Though I am not new to graves disease. I was diagnosed in Feb. 08 whle in the midst of a thyroid storm. I do not have copies from my labs when I was in the hospital, but I know they were off the charts. Been on ptu, atenolol, and xanax since that time. My latest labs from thursday just came in today. The phys. asst. had called and told me the thyroid is good and to continue doing what I am doing. But, I feel lousy! I actually feel more like hypo than hyper but here are my new levels and I am having a difficult time understanding them...
> 
> Free T4... 0.97 (range 0.48-1.23)
> TSH .... 0.02 (range 0.44-4.21)
> ...


Welcome to the board. Actually, your thyroid panel does not look too bad but as you say, you don't feel well. Could be that the antibodies are wreaking havoc behind the scene.

Have you ever had TSI (thyroid stimulating immunoglobulin) lab test. TSI is responsible for the hyper state and it is a good one to monitor to see how treatment is progressing.

And.......................wonder why the doc does not run the FREE T3? This would be ever so helpful for this is your active unbound hormone and the results of that test would be so revealing.

I presume you have had a radioactive uptake scan?

Do you have the "typical" symptoms of Graves' which are exophthalmos, goiter, pretibial myxedema and thyrotoxicosis (thyroid storm which you had so we know you had that one.)


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## hillaryedrn (Dec 14, 2009)

Hi there!! Andros can tell you better about the thyroid labs, but I can help with the rest!

Sodium - Yeah, it's low, but nothing crucial. They would start to worry when it was over 5 points low.

Co2 - This is a base (like acid/base balance). With this being slightly low, it means you are in a slightly acidodic state. I can't really speculate what this means, as it might mean nothing at all if this is the only thing "out of whack".

Glucose - Yeah, that's slightly high, but if you weren't fasting, then I agree - no real concern there.

WBC - that is just a tad elevated. Curious. Do you feel "sick"? Congestion? Coughing? Cut or wound somewhere? Burning when you urinate? Low abdominal pain?

Keep us updated!


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## chopper (Mar 4, 2007)

Regarding the things that are slightly off....I will never dismiss an irregularity however, when something on the body is messed up, the labs usually SHOUT "hey look at me!".

For instance, if you had a big problem with blood sugar, it might show up as 380 instead of 130, like my uncle who is full blown diabetic. Labs will always fluctuate and sometimes the smallest things could throw them out of whack, like a cold, small infection somewhere, extra tired, extra nervous, etc. I know it's annoying as hell not to fall dead center of the range but don't sweat it too much. If and when a body part breaks, it will show up in the labs and it won't be anywhere near the range in most cases.

Of course if there is a pattern of things being slightly out of range over time it could mean something so it is something to keep an eye on. For instance, my cortisol is almost always either at the tippy top of the range or just slightly out of range. It's been that way for years and docs are yet to isolate a problem other than chalking it up to other screwed up hormones, like my thyroid.


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## GD Women (Mar 5, 2007)

If your FT-3 runs the same as your T-3, meaning low, and if I am not looking at your levels cross eyed, I would suggest low T3 syndrome or conversion. I would suggest to retest 6 weeks after your last test to see if levels repeat, perhaps asking for FT-3 to be tested as well, ie both T/F3s. Normally this is a temporary problem and caused from a few reversible issues. Stress physical or mental as well as during acute and chronic calorie restriction (dieting), starvation, acute illness and affected by a few medications such as Inderal, steroids and amiodarone.

If test repeats after the second test you might ask doctor a for temporary T3 replacement and see if it corrects the problem. See if doctor will do a coritsol to eliminate adrenal insufficiency.

If I remember correctly from long time ago, PTU works the same with our levels as T4 Synthroid or Levoxyl. Your Labs from 6 months ago are like mine are, for the last 13 yrs with the exception when my med. dose is too low making me hypo. It suggest late stage of Hyper/Graves'.

I wouldn't worry too much about the change in your levels just yet for it might change again. That is why I suggest a second test from the same Lab, before acting upon the first test.

Have you been stressed?


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## sherrilynn (May 11, 2010)

Thank you all for your replies!! I am elated to have found people who understand this battle. I don't know why she didn't test the Free T3 this time, she usually does. Had the TSI test about 8 months ago, it was still high, but had come down some. Don't have it right in front of me right now, I will look and see if I have a copy of that test. She will only test the tsi every 6 mths, no idea why. Every time I ask for that test she says she only does that once every 6 mths. What are those antibodies she tested this time, I don't remember having that one done before. I don't understand why she won't run the Free t3 every time either. I don't know if it is the insurance or what it is. Took me quite a while to even find a doctor around here in PA who would work with me. At least she listens to me and I really like that she cares about my symptoms, not like some I have seen. Oh, I was having issues with ear problems from my allergies recently, wonder if that is the why the wbc is high? She won't do another test for 8 weeks, that was the soonest I could get back in to see her and she does her own blood testing. I do feel a little better today. Do my ranges still indicate hyperthyroid or going hypo? Would someone who is hyper need T3? I guess I still have a lot to learn and it has been over 2 years.. uggh.. Had scan back then when I was in hospital 2008. Thank you all so much
________
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## GD Women (Mar 5, 2007)

If your doctor listens to you, cares about your symptoms, and work with you then she is a keeper, for now anyway.

Allergies can effect thyroid levels. No if your levels state you are hyper then NO! T3 meds. are not healthy.

Your TSH states hyper. However your Ts are the issue. They relate a possible conversion issue. However it may be temporary issue.

8 Weeks is an acceptable length of time between testing.

Keep us up dated.


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## sherrilynn (May 11, 2010)

I had no idea Allergies can effect the thyroid levels. Okay, when you say the Ts are the issue, can you please explain a bit more. Aren't the t3 and t4 actually in range and only the tsh out of range? Yes, I agree for now this doctor is a keeper! I'm just not real sure how much she seems to understand the antibodies.
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## sherrilynn (May 11, 2010)

ABDROS: Yes, I do have all the classic symptoms. I do have a goiter. Was huge two years ago, but has gotten much smaller since than. The only eye involvement I have is very sensitive to light, twitches, and watery. Also have gotten small waxy brown spots on my legs really bad, don't even like to wear capri's because of how many I have gotten in the last few years. I am just a little confused because I thought like you do that the levels seem pretty good, but wondered why I felt so lousy. HOwever sometimes I think we blame everything on our thyroid when sometimes it could be something else. My seasonal allergies are really bad right now and can be a factor in the way I am feeling. My doctor is very happy with the levels and was thrilled to find the nodules disappeared, which I guess is another good sign. Do you know what those antiboidies are that she tested?
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## GD Women (Mar 5, 2007)

Your FT4 is at one end of the range and your T3 is at the other end of the range. They need to be closer together. However, keep in mind its not FT3 and that could make a difference.


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## sherrilynn (May 11, 2010)

Thank you for all the good information. What about those Anti-thyrglb ab levels? Any idea what they are and what that even shows? Why would she measure that level? Seems like she did different levels checks this time than usual.
________
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## GD Women (Mar 5, 2007)

Antithyroglobulin antibody is a test to measure antibodies to a protein called thyroglobulin, which is found in thyroid cells.

Antithyroglobulin antibodies can lead to the destruction of the thyroid gland.

Anegative test is normal and means no antibodies to thyroglobulin are found in your blood.

I don't know what your doctors reasoning for testing.


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## Andros (Aug 26, 2009)

sherrilynn said:


> Thank you all for your replies!! I am elated to have found people who understand this battle. I don't know why she didn't test the Free T3 this time, she usually does. Had the TSI test about 8 months ago, it was still high, but had come down some. Don't have it right in front of me right now, I will look and see if I have a copy of that test. She will only test the tsi every 6 mths, no idea why. Every time I ask for that test she says she only does that once every 6 mths. What are those antibodies she tested this time, I don't remember having that one done before. I don't understand why she won't run the Free t3 every time either. I don't know if it is the insurance or what it is. Took me quite a while to even find a doctor around here in PA who would work with me. At least she listens to me and I really like that she cares about my symptoms, not like some I have seen. Oh, I was having issues with ear problems from my allergies recently, wonder if that is the why the wbc is high? She won't do another test for 8 weeks, that was the soonest I could get back in to see her and she does her own blood testing. I do feel a little better today. Do my ranges still indicate hyperthyroid or going hypo? Would someone who is hyper need T3? I guess I still have a lot to learn and it has been over 2 years.. uggh.. Had scan back then when I was in hospital 2008. Thank you all so much


It is true; TSI and FREE T3 does not have to be checked every single time "unless" there is a really weird thing going on and the patient is really really ill. And those two tests are expensive so it could also be an insurance thing.

No, hyper persons to my knowledge do not need T3 supplement. That is unless the doctor is doing "block and replace" and that is a whole different ball game.


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## GD Women (Mar 5, 2007)

I strand corrected - PTU inhibits T4-to-T3 conversion so you don't have a conversion problems per se. So your FT-4 and T3 is doing what they are suppose to per your PTU treatment. So in your case, don't worry about it or what I said about it. Sorry!


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