# Newbie Back from FD



## Generally Frustrated (Mar 21, 2012)

So I just got back from the FD
She is concerned, doing an EKG and an ultrasound on my thyroid, and more blood work 

So my current blood work

TSH 0.95 (0.3-5.6)
FT4. 11.8 (7.2-21.0) she's concerned because my TSH is on the low side
FT3. 4.6 (2.9-6.0)
Ferritin 52 (11-145)
Cortisol AM-serum 353 (185-624)
ACTH 5.2 (<10.0)
TPO Negative (no normal values shown) 
B12 still low, gave me injection today

Any ideas? Thank you


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## Generally Frustrated (Mar 21, 2012)

Octavia said:


> Since doc won't test you for Celiac, what do you think about starting to behave as if you have it, eating gluten-free for a month or two, and seeing if that helps? That's one good thing about Celiac--you don't have to treat it with medicine (at least that I know of), but you change your behaviors. Might be worth a try.
> 
> Did your doctor call your anemia "Pernicious Anemia"? That's different from "standard" anemia, and I'm thinking that's what you have. Many of the symptoms match what you're describing.
> 
> ...


(I am on a gluten-free diet since I was 5)

You got me really thinking and digging into my lab results, and my Family Doctor didn't really touch base on this with me BUT Pernicious Anemia is a Macrocytic Anemia. I am however according to my lab results showing as Microcytic Anemia.

RBC Count 6.01 (3.80-5.80)
MCV 77.3 (80-97)
MCH 24.9 (27.0-32.0)
MCHC 322 (320-360)
RDW 16.1 (11.0-14.5)
Hypochromia - Mild
Microcytosis - Mild
Polychromasia - SL Increased
Target Cells - Few
Ferritin 52 (11-145)


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## Andros (Aug 26, 2009)

Generally Frustrated said:


> So I just got back from the FD
> She is concerned, doing an EKG and an ultrasound on my thyroid, and more blood work
> 
> So my current blood work
> ...


Your FREE T4 and FREE T3 are both below the mid-range of the ranges provided by your lab. "Sometimes" when binding, blocking and stimulating antibodies are at work, the TSH, FT3 and FT4 don't match up as they should.

Really really glad you are getting an ultra-sound of the thyroid for I do feel something is going on w/that.


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## Generally Frustrated (Mar 21, 2012)

I did a bit of digging into the "anemia" pernicious anemia is also macrocytosis meaning the RBC's are enlarged and pale in color. I have microcytosis, smaller than normal RBC's but are still pale in color.

Macrocytosis is indicative of an iron deficiency, marked low low levels of ferritin. Most commonly found in hypoactive thyroid patients.

Microcytosis is indicative of a deficiency, however ferritin levels are within normal ranges. Most commonly found in hyperactive thyroid patients. This is a copper deficiency.

Does this sound right?


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## Andros (Aug 26, 2009)

Generally Frustrated said:


> I did a bit of digging into the "anemia" pernicious anemia is also macrocytosis meaning the RBC's are enlarged and pale in color. I have microcytosis, smaller than normal RBC's but are still pale in color.
> 
> Macrocytosis is indicative of an iron deficiency, marked low low levels of ferritin. Most commonly found in hypoactive thyroid patients.
> 
> ...


It sounds right. Another good "marker" for hyperthyroid.

How are you feeling?


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## Generally Frustrated (Mar 21, 2012)

Thank you 

I'm still feeling zoomy, my resting heart rate is sitting in the 90's. As long as I don't "over do it" I don't get the flutters.

I was doing a lil more reading, and I have come to find out that the pressure/hurting in my eyes along with my decreasing eye sight (had laser correction in 2005) is contributed to hyperthyroidism and my ophthalmologist didn't see anything unusual (ha ha, typical) but it makes sense now, and it's not so scary.

All in all, even though researching does lead to some information that can scare the crap out of you, there is a level of comfort that can be found in knowledge.

I also checked into what I just got tested for, and TSI nor copper were on the list. TIBC (the four iron tests is on there, but I'm sure they are going to come back normal since my anemia is due to copper) And she did not test me for the graves antibody.

It's been a few days since my B12 injection, and I'm not getting the relief my FD promised I would get from the muscle and joint pain. And I have started some pretty annoying muscle spasms almost leading to full out charlie horses. I'm going to start drinking warm jello again and see if it makes a difference (it is proven that gelatin "lubricates" the muscles and prevents cramps. Worked well while I was pregnant) 
I'll let you know how it goes


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## Generally Frustrated (Mar 21, 2012)

Old Labs (Mar 12/12)

TSH 0.95 (0.3-5.6)
FT4. 11.8 (7.2-21.0) she's concerned because my TSH is on the low side
FT3. 4.6 (2.9-6.0)
Ferritin 52 (11-145)
Cortisol AM-serum 353 (185-624)
ACTH 5.2 (<10.0)
TPO Negative (no normal values shown)

New Labs (Mar 23/12)

TSH 0.82 (0.30-5.60)
Free T4 - 10.1 (7.2-21.0)
Free T3 - 4.3 (2.9-6.0) 
Iron - 14 (10-26)
UIBC - 47 (19-51)
TIBC - 61 (45-63)
Iron Saturation - 0.23 (0.25-0.50)
Prolactin - 10.2 (3.3-26.7)

Ultrasound Results (Mar 27/12)

The right lobe of the thyroid gland measures 5.2 x 2.2 x 1.6 cm
The left lobe of the thyroid gland measures 4.2 x 1.9 x 1.9 cm
The isthmus is thickened measuring 6 mm in AP width
The thyroid gland is hetergeneous in echotexture 
Tiny simple cysts measuring about 3 mm in diameter noted at the superior inferior poles of the left lobe and a mid-portion inferior pole of the right lobe. There are no discrete solid nodules seen in the thyroid gland. No significant cervical adenopathy

Please help the symptoms are unbearable! My thyroid has also become way more enlarged since the ultrasound, and is extremely tender to the touch, I have lost 10 lbs in 3 days.

Also my family doctor has flat out refused to test my TSI, as in her her words, it's pointless to test for it since she can detect it from the blood work a person has already had!


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## Andros (Aug 26, 2009)

Generally Frustrated said:


> Old Labs (Mar 12/12)
> 
> TSH 0.95 (0.3-5.6)
> FT4. 11.8 (7.2-21.0) she's concerned because my TSH is on the low side
> ...


Clearly your gland is not healthy. I don't get how a doctor can refuse a test that a patient has requested? Cannot wrap my brain around that at all and from the labs you have listed, there is not a clue either way as to whether or not you have TSI.

It is my humble opinion that this doctor could possibly cause you to end up in the ER and I advise you to find a better doctor STAT.

And here are they symptoms of a thyroid storm which you should familiarize yourself with.

Thyroid Storm Symptoms
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001437

While your numbers do not reflect your status, the proper antibodies tests would. Especially the TSI. Or TBII

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

TBII (Thyrotrophin Binding Inhibiting Immunoglobulin)
http://www.ncbi.nlm.nih.gov/pubmed/1969138

I am worried for you and I know you are worried for yourself as well you should be. Do you have anyone who can personally advocate for you?


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## Prairie Rose (Nov 17, 2011)

Oh gosh yes. Get to a different doctor. An endocrinologist, preferably.


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## Generally Frustrated (Mar 21, 2012)

She sent me for more bloodwork today (just TSH and the FT3 and FT4) she did say the she was sending me to an endo but I've heard that all before  She threw "thyroiditis" at me as she exited the appointment. No I do not have anyone to advocate for me and it seems as though its an on going battle with the FD. Unfortunately, there is a huge shortage of GP's in Canada and I'm lucky I have one at all


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## Andros (Aug 26, 2009)

Generally Frustrated said:


> She sent me for more bloodwork today (just TSH and the FT3 and FT4) she did say the she was sending me to an endo but I've heard that all before  She threw "thyroiditis" at me as she exited the appointment. No I do not have anyone to advocate for me and it seems as though its an on going battle with the FD. Unfortunately, there is a huge shortage of GP's in Canada and I'm lucky I have one at all


Yeah; the "system" is not working too good, is it? Well, it's no better here really unless you are very wealthy. Most of us are not. LOL!

Such is life! Sigh!


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## Generally Frustrated (Mar 21, 2012)

Labs (Mar 12/12)

TSH 0.95 (0.3-5.6)
FT4. 11.8 (7.2-21.0) she's concerned because my TSH is on the low side
FT3. 4.6 (2.9-6.0)
Ferritin 52 (11-145)
Cortisol AM-serum 353 (185-624)
ACTH 5.2 (<10.0)
TPO Negative (no normal values shown)

Labs (Mar 23/12)

TSH 0.82 (0.30-5.60)
Free T4 - 10.1 (7.2-21.0)
Free T3 - 4.3 (2.9-6.0) 
Iron - 14 (10-26)
UIBC - 47 (19-51)
TIBC - 61 (45-63)
Iron Saturation - 0.23 (0.25-0.50)
Prolactin - 10.2 (3.3-26.7)

*Newest Labs (Apr 13/12)*

TSH - 0.86 (0.30-5.60)
Free T4 - 15.2 (7.2-21.0)
Free T3 - 4.9 (2.9-6.0)

Ultrasound Results (Mar 27/12)

The right lobe of the thyroid gland measures 5.2 x 2.2 x 1.6 cm
The left lobe of the thyroid gland measures 4.2 x 1.9 x 1.9 cm
The isthmus is thickened measuring 6 mm in AP width
The thyroid gland is hetergeneous in echotexture 
Tiny simple cysts measuring about 3 mm in diameter noted at the superior inferior poles of the left lobe and a mid-portion inferior pole of the right lobe. There are no discrete solid nodules seen in the thyroid gland. No significant cervical adenopathy.

*UPDATE FOR LAB WORK* Down 6 more lbs in 2 days A total of 20 lbs in 2 weeks. No break in the symptoms.


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## Andros (Aug 26, 2009)

Generally Frustrated said:


> Labs (Mar 12/12)
> 
> TSH 0.95 (0.3-5.6)
> FT4. 11.8 (7.2-21.0) she's concerned because my TSH is on the low side
> ...


That's a lot of weight to lose in 2 weeks! I take it your doctor refused to do the TSI lab test?

The gland is not the healthiest but thank goodness you had the scan and no cancer or other suspicious things have been noted. THAT is good news.

Golly geez!


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## Generally Frustrated (Mar 21, 2012)

Sorry for being gone for so long, been super busy. Update I have an appointment with an Endo in Sept, however I have had this new and strange symptom appear. I have these painful hard lumps in my muscles. I am down in total of 40 lbs now, my doctor is refusing to do any further follow-ups, and no TSI tests. I have been left to suffer in this pain. I added a thyroid suppliment to my daily routine and I have found that is has helped, and I have also started on Magnesium suppliments. The past month I have had to give myself B12 injections every week, I get relief for 5 days then I'm back to the pain. I have had an ultrasound of the lumps in my muscles but nothing was truly abnormal


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## Andros (Aug 26, 2009)

Generally Frustrated said:


> Sorry for being gone for so long, been super busy. Update I have an appointment with an Endo in Sept, however I have had this new and strange symptom appear. I have these painful hard lumps in my muscles. I am down in total of 40 lbs now, my doctor is refusing to do any further follow-ups, and no TSI tests. I have been left to suffer in this pain. I added a thyroid suppliment to my daily routine and I have found that is has helped, and I have also started on Magnesium suppliments. The past month I have had to give myself B12 injections every week, I get relief for 5 days then I'm back to the pain. I have had an ultrasound of the lumps in my muscles but nothing was truly abnormal


Sounds like maybe Dercum's has to be considered and ruled out.

http://www.genome.gov/17516629

Can you get on a cancellation list; Sept. is a long way off!


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## Generally Frustrated (Mar 21, 2012)

*UPDATE* I saw my endo and he has sent me in for a slew of tests and referred me to a Cardiologist which I will see on the 18th. The painful bumps disappear, then reappear in another area, usually my legs and buttox but I have had them in my upper arms and on my back


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## Andros (Aug 26, 2009)

Generally Frustrated said:


> *UPDATE* I saw my endo and he has sent me in for a slew of tests and referred me to a Cardiologist which I will see on the 18th. The painful bumps disappear, then reappear in another area, usually my legs and buttox but I have had them in my upper arms and on my back


Dercum's has been ruled out, I take it? Have not heard from you for a long time. Glad you gave us an update.

And have you been tested for Sarcoidosis?
http://www.nhlbi.nih.gov/health/health-topics/topics/sarc/


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