# New to the board and would appreciate any help regarding lab results



## broseph (Aug 6, 2010)

Hey I am new to the boards and would appreciate any advice or information regarding my lab results. I am 21 years old and male and have been feeling off for a few months now.

I have been trying to put on weight, since I am slightly underweight (6 feet 135lbs). I have been eating 3k-3.5k calories a day but it doesn't seem effective. If I eat any less than this I start losing weight. I thought my metabolism is overactive so I did some research. I noticed I exhibit many of the symptoms of an overactive thyroid such as difficulty concentrating, fatigue (even after 8-9 hours of sleep), frequent bowel movements, nervousness, nausea, sleeping difficulty, and intolerance to heat. I was thinking that I might have a slightly overactive thyroid so I asked my doctor what to do and he told me he would have some tests run. Here are the results.

*TSH* = *0.35 * Standard Range = *0.10-5.50 uIU/mL*
*Free T4* = *1.6* Standard Range = *0.8-1.7 ng/dL*
*VITAMIN D, 25-HYDROXY* = *21 * Standard Range = *30-100 ng/mL*

The doctor told me that everything seemed normal and that no further thyroid testing was necessary but it appears to me that something is wrong here and I would like to know what you guys thought.

Any advice, opinions, help would be greatly appreciated.

Thank You


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## Lovlkn (Dec 20, 2009)

> TSH = 0.35 Standard Range = 0.10-5.50 uIU/mL
> Free T4 = 1.6 Standard Range = 0.8-1.7 ng/dL
> VITAMIN D, 25-HYDROXY = 21 Standard Range = 30-100 ng/mL


While you results are in "normal" range your TSH is on the low side and your FT4 is on the high side - I would ask for additional testing to include a FT3 and TPO and TSI antibodies.

Has your doctor begun you on any Vit D supplements? 50K IU for 12 weeks is a common approach to address this.


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## chopper (Mar 4, 2007)

You are awful close to hyper. No wonder you cannot gain weight.

I would ask for a TSI - Thyroid Stimulating Immunoglobulins test to confirm. Also add TPO and TG antibodies while you're at it - you can google both those tests to find out more.

Are you nervous, shaky, have frequent very loose stools, feel hot all the time, very sensitive to the sun in your eyes? These are all common symptoms of hyper.

Im going to go out on a limb and probably prematurely say its probably Graves' disease and if not, there may be a thyroid producing nodule. Graves would be more common. I've rarely seen a TSH that low and a T4 that high in someone truly "normal" and I've seen a lot of labs here. Normally you'll see "normal low" TSH at like 0.89 at the lowest to like 1.40 or so is more indicative of "normal".


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## Andros (Aug 26, 2009)

broseph said:


> Hey I am new to the boards and would appreciate any advice or information regarding my lab results. I am 21 years old and male and have been feeling off for a few months now.
> 
> I have been trying to put on weight, since I am slightly underweight (6 feet 135lbs). I have been eating 3k-3.5k calories a day but it doesn't seem effective. If I eat any less than this I start losing weight. I thought my metabolism is overactive so I did some research. I noticed I exhibit many of the symptoms of an overactive thyroid such as difficulty concentrating, fatigue (even after 8-9 hours of sleep), frequent bowel movements, nervousness, nausea, sleeping difficulty, and intolerance to heat. I was thinking that I might have a slightly overactive thyroid so I asked my doctor what to do and he told me he would have some tests run. Here are the results.
> 
> ...


Hi there!! All symptoms and signs point to hyper. TSI (thyroid stimulating immunoglobulin) would rule that in or rule it out. You should have absolutely no TSI.

It always puzzles me that when a patient is symptomatic and they get labs like yours that they don't take the initiative to run antibodies.

TSI (thyroid stimulating immunoglobulin),TPO (antimicrosomal antibodies) TBII (thyrotropin-binding inhibitory immunoglobulin), Thyroglobulin Ab, ANA (antinuclear antibodies), (thyroid hormone panel) TSH, Free T3, Free T4.

You can look this stuff up here and more.........
http://www.labtestsonline.org/understanding/conditions/

Also, it would be most prudent to have you take a radioactive uptake scan of the thyroid.

Thank you for your labs w/ranges intact. That was most helpful.


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## broseph (Aug 6, 2010)

Thanks for all the help!

I will ask my doctor to run FT3 and TPO and TSI antibodies tests for me. My doctor has not mentioned anything about taking Vitamin D supplements but I will be sure to ask him about it.

Yes i feel nervous/anxious sometimes during the day. I have shaky hands and pretty frequently have very loose stools. I do feel hot all the time even when the weather is cool. I also wear sunglasses frequently because my eyes are sensitive to the light I always assumed I just had naturally sensitive eyes.

I will ask my doctor about taking tests for TBII, Thyroglobulin Ab, and ANA as well as the others. Thanks for the link I will definetley read up more about these. Also I will try and get a radioactive uptake scan of the thyroid.

Soon as I get all of these done I will post my results. Thanks for all the help everyone I really appreciate it!


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## Andros (Aug 26, 2009)

broseph said:


> Thanks for all the help!
> 
> I will ask my doctor to run FT3 and TPO and TSI antibodies tests for me. My doctor has not mentioned anything about taking Vitamin D supplements but I will be sure to ask him about it.
> 
> ...


You are welcome! Photophopia is painful. I urge you to get in to see a Board Certified Ophthalmologist who has experience with GED/TED (Graves' Eye Disease/Thyroid Eye Disease.) Early intervention and "baseline" tests are essential.

I recommend a bit of sun daily. Ha, ha!! Not a doctor here but it "would" do the trick.

http://www.eurekalert.org/pub_releases/2009-04/arf-vdm040809.php


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## midgetmaid (Jul 22, 2010)

Hi, broseph! Your TSH is like mine was about 4 months before I was diagnosed. I ended up in the hospital, so if you can get those other tests, maybe you can avoid that. 
I had a toxic nodule and grave's disease.

Renee


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## broseph (Aug 6, 2010)

Thanks for the information Renee! Hopefully my doctor see's the importance of the situation. I hope your treatment goes/went well.


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## broseph (Aug 6, 2010)

My doctor finally responded to my email asking for FT3,TSI, and TPO tests and he said that my TSH and FT4 levels are normal at this time and that he does not recommend doing those other tests.

So I emailed him again saying that I would like the FT3,TSI, TPO tests done anyway to make sure and he said he can tell me with 100% accuracy based on the first two tests that my thyroid is completely healthy and that doing these tests will not help us now nor with it help diagnose Grave's in the future. Nor is it useful to get a baseline.

Is it time to get a new doctor? Or am I missing something?


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## Andros (Aug 26, 2009)

broseph said:


> My doctor finally responded to my email asking for FT3,TSI, and TPO tests and he said that my TSH and FT4 levels are normal at this time and that he does not recommend doing those other tests.
> 
> So I emailed him again saying that I would like the FT3,TSI, TPO tests done anyway to make sure and he said he can tell me with 100% accuracy based on the first two tests that my thyroid is completely healthy and that doing these tests will not help us now nor with it help diagnose Grave's in the future. Nor is it useful to get a baseline.
> 
> Is it time to get a new doctor? Or am I missing something?


Whoa!!!! You are not missing a thing but this doctor sure is. I would move so fast it would not be funny. This guy is scary to the max.

He needs to go back to medical school.

Good luck finding a new doctor who will comply with your wishes or maybe even make the suggestion of his/her own volition to get antibodies' tests done.

We will be waiting w/ bated breath. I am sorry this happened but it is all to the good as you were in for very very poor medical care.


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