# Help with labs



## Sharon (Mar 30, 2011)

Hello,
I just joined today. I was diagnosed with Hashimoto's Autoimmune and Hypothyroid a couple of months ago. The doctor prescribed 25 mcg for two weeks and then 50 mcg of Levothyroxine for the rest of the time and Vitamin D. I couldn't tolerate the Levothyroxine because of severe headaches and problems breathing. The doctor's nurse told me to quit taking the medication and I didn't need anything else. Needless to say I'm looking for a new doctor.
I would appreciate it if someone could help me understand the labs. One thing I don't understand is why the calcium is normal when the vitamin d is so low. There wasn't a Free T3.
Thanks,
Sharon

ULTRASSOUND

INDICATION:	Hypothyroidism.

FINDINGS: The right lobe measures 4.1x 1.5 x 1.8cm and the left lobe 3.3 x 1.4 x 1.6
cm in greatest dimension. There is diffuse heterogeneity without a discrete mass noted on either side.

IMPRESSION:	grossly normal sized gland with diffuse heterogeneity of the echotexture. No discrete mass is appreciated.

ANA SCREEN EIA W/REFL$TITER IFA

NEG NEGATIVE

VITAMIN D (25 hydroxy)

[L] 19 ng/mL

CALCIUM 9.7 mg/dL 8.5-10.7

TSH

[H] 5.437 uIU/mL 0.350-4.500

FREE T4

0.99 ng/dL 0.80-1.80

THYROID PEROXIDASE$ANTIBODIES
(TPO) Ab

[H] 1290.2 U/mL 0.0-60.0


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## Andros (Aug 26, 2009)

Sharon said:


> Hello,
> I just joined today. I was diagnosed with Hashimoto's Autoimmune and Hypothyroid a couple of months ago. The doctor prescribed 25 mcg for two weeks and then 50 mcg of Levothyroxine for the rest of the time and Vitamin D. I couldn't tolerate the Levothyroxine because of severe headaches and problems breathing. The doctor's nurse told me to quit taking the medication and I didn't need anything else. Needless to say I'm looking for a new doctor.
> I would appreciate it if someone could help me understand the labs. One thing I don't understand is why the calcium is normal when the vitamin d is so low. There wasn't a Free T3.
> Thanks,
> ...


Hi there Sharon and









As you probably already know, heterogeneous means irregular (Composed of parts having dissimilar characteristics or properties) so that is not what we like to see.

And the TPO sure is high. My goodness.

I am going to suggest that you might consider getting the tests listed below with the exception of the TPO.

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/

There is much more to this than meets the eye. On what was the diagnosis of Hashimoto's based? The high TPO which we do see in Hashimotos' but happens to be "suggestive" only and can be present in a myriad of other autoimmune diseases.

You may read about that here... http://www.nlm.nih.gov/medlineplus/ency/article/003556.htm

Too bad they did not do a FREE T3; you have to twist arms to get this test.

I agree w/your questioning the status of your Vitamin D at this time and this may be the reason why it is low and Calcium is fine.
Vitamin D
http://www.eurekalert.org/pub_releases/2009-04/arf-vdm040809.php

What prompted the doctor to do the sonogram? And are you symptomatic and if so, could you list your symptoms?

You could have very well been allergic to the filler in the levothyroxine. Did you get a brand name or generic? Did you start the vitamin D at the same time, I am wondering?


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## Sharon (Mar 30, 2011)

Andros said:


> Hi there Sharon and
> 
> 
> 
> ...


Andros,
Thank you for the welcome and the help!

The symptoms I've had are fatigue, sensitive to the cold, dry skin, ridges in my nails, hoarse voice, extreme joint pain and swelling, (my hands swell so bad the skin splits), weight gain. Not related to the Hashimoto I have osteoarthritis.

I really don't know why he ordered an ultrasound. I started the vitamin D a week before the levothyroxine. The levothyroxine was a generic. I'm not surprised that I would be allergic to the filler. I have a sensitivity to a lot of medication. No, he didn't do a Free T3. He was basing the diagnosis on the symptoms, the ultrasound and the TSH. He didn't order the TPO Ab another doctor who saw my records (in the same office) ordered that test.
I don't see a new doctor for another two weeks so I'm not on any medication right now. I quit taking the Vitamin D this past weekend. I wouldn't be surprised if it's another autoimmune disease. My mother had hyperthyroid and her goiter was taken out many years ago. She also has RA. An aunt had MS. Two cousins have MS.

Sharon

I forgot to mention my face and sometimes the top lip also swells, mostly on the right side. Starting on the bridge of my nose and down to my cheeks and sometime the top lip turns red. It would go away and come back a few days later. Now there is a red patch that stayed just on my nose. My back also itches like mad even though there isn't anything there.


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## Andros (Aug 26, 2009)

Sharon said:


> Andros,
> Thank you for the welcome and the help!
> 
> The symptoms I've had are fatigue, sensitive to the cold, dry skin, ridges in my nails, hoarse voice, extreme joint pain and swelling, (my hands swell so bad the skin splits), weight gain. Not related to the Hashimoto I have osteoarthritis.
> ...


Goodness; after reading the symptoms, I am not entirely convinced that you are hypo. You could be hyper as some symptoms do cross over. The splits in your hands tell me a lot. As you see in my siggie; I have Graves'. You could put dimes in the splits in my hands and they would not heal up for anything. They were puffy and very very painful.

Oh, sure...............this is all familial (genetic.) Alas.

I believe you were allergic to the filler in the generic. Your lip thing could be peripheral neuropathy. I am not saying it is but I suspect it is. All kinds of weird things happen. For me it was a non-stop twitching eyelid and some other crazy things.

If you are hoarse, it would be very very wise to also get RAIU (radioactive uptake scan) which they should do anyway to be honest with you. Cancer must be ruled out.

Thyroid cancer symptoms
http://www.cityofhope.org/patient_care/treatments/thyroid-cancer/Pages/symptoms.aspx

2 weeks seems a long way away but it will be here before you know it. I am very anxious for you.

Just remember; we are here for you as much as we can be. Everything ultimately will be okay so try not to worry too much.


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## Sharon (Mar 30, 2011)

Andros said:


> Goodness; after reading the symptoms, I am not entirely convinced that you are hypo. You could be hyper as some symptoms do cross over. The splits in your hands tell me a lot. As you see in my siggie; I have Graves'. You could put dimes in the splits in my hands and they would not heal up for anything. They were puffy and very very painful.
> 
> Oh, sure...............this is all familial (genetic.) Alas.
> 
> ...


Andros,
Thank you for the reply! I feel like a kid, two weeks feels like forever. I'm trying not to worry - getting my list of everything together. I take it graves cause your skin to split. I'll have to read up on this. So far the splits in my hands aren't anything like what you have. The hoarseness comes and goes. Go figure. The fatigue is doing me in. In the past two days I've been getting migraine like headaches. It's always something new!
Sharon


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## Andros (Aug 26, 2009)

Sharon said:


> Andros,
> Thank you for the reply! I feel like a kid, two weeks feels like forever. I'm trying not to worry - getting my list of everything together. I take it graves cause your skin to split. I'll have to read up on this. So far the splits in my hands aren't anything like what you have. The hoarseness comes and goes. Go figure. The fatigue is doing me in. In the past two days I've been getting migraine like headaches. It's always something new!
> Sharon


Yes, in my case Graves' caused the skin to split on the feet as well and severe Carotenemia.

Don't mention the internet to the doctor. They do not like that..............at all. Just a little tip. Aaaaaaaaaaaaaaaaaaaargh!explode


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## Sharon (Mar 30, 2011)

Andros said:


> Yes, in my case Graves' caused the skin to split on the feet as well and severe Carotenemia.
> 
> Don't mention the internet to the doctor. They do not like that..............at all. Just a little tip. Aaaaaaaaaaaaaaaaaaaargh!explode


Funny how strange doctors are. The first doctor I saw wanted me to search things on the internet. The second didn't hear a thing I said and insisted I was depressed and the numbers weren't high enough. Let's hope the new one is better.


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## Andros (Aug 26, 2009)

Sharon said:


> Funny how strange doctors are. The first doctor I saw wanted me to search things on the internet. The second didn't hear a thing I said and insisted I was depressed and the numbers weren't high enough. Let's hope the new one is better.


That "is" strange on both counts. LOL!! What a life!

Keep us in the loop here. When is your appt. w/ the new doc?


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## Sharon (Mar 30, 2011)

Andros said:


> That "is" strange on both counts. LOL!! What a life!
> 
> Keep us in the loop here. When is your appt. w/ the new doc?


I will let you know. The appointment is on the 13th of this month.


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## Andros (Aug 26, 2009)

Sharon said:


> I will let you know. The appointment is on the 13th of this month.


The countdown begins. I sure hope this doc is good!


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## Sharon (Mar 30, 2011)

Andros said:


> The countdown begins. I sure hope this doc is good!


Andros,
I won't have a copy of my tests until Monday. The doctor's office called and only told me two things today. 
One is that my cholesterol is very high 346. Can you believe this? 
The second is that my TSH went from [H] 5.437 uIU/mL 0.350-4.500 to 3.610.
When I get the tests Monday I'll know the ranges. They used a different lab.
As far as the doctor is concerned I found a gem. He immediately said he was going to put me on a natural thyroid hormone which I'll be getting today along with Lipitor. He ran every test you suggested and a few more. He didn't mind running the tests or about me researching online. He said he prefers to have a knowledgeable patient. Did I hit the jackpot or what! 
Sharon


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## Andros (Aug 26, 2009)

Sharon said:


> Andros,
> I won't have a copy of my tests until Monday. The doctor's office called and only told me two things today.
> One is that my cholesterol is very high 346. Can you believe this?
> The second is that my TSH went from [H] 5.437 uIU/mL 0.350-4.500 to 3.610.
> ...


Oh, Sharon!! This is so awesome!! I can't hardly believe it myself! Can we clone this guy! Ha ha!

I am so so happy for you. Just the relief of knowing you have a good doc is more than half the battle.

Will look forward to seeing those results and ranges when and if you can.

Whooooooooooooooohoo!


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## Sharon (Mar 30, 2011)

Andros said:


> Oh, Sharon!! This is so awesome!!  I can't hardly believe it myself! Can we clone this guy! Ha ha!
> 
> I am so so happy for you. Just the relief of knowing you have a good doc is more than half the battle.
> 
> ...


It is a relief to have a good doctor. It would be great if we could clone him - this way everyone can have a doctor like him.arty0049: I was so surprised about his great attitude! He prescribed Armour Thyroid 15MG Fore.
What is the best way to take this? I have only taken one pill and my stomach is sick.
Thanks,
Sharon


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## Sharon (Mar 30, 2011)

Just got the copy of the new labs. He didn't re-run most of the labs because he wanted to wait until I was taking Armour for one month.
The new labs were run by a different lab.

Iron and TIBC
Iron Bind.Cap. (TIBC)	288 ug/dL 250-450
UIBC 232 ug/dL 150-375
Iron, Serum 56 ug/dL 35-155
Iron Saturation 19 % 15-55

Thyroxine (T4) Free, Direct, S
T4, Free (Direct) 0.94 ug/dL 0.82-1.77

TSH
TSH 3.610 ug/dL 0.450-4.500

Ferritin Serum 85 ng/mL 13-150

Triliodothyronine, Free, Serum	 2.9 pg/mL 2.0-4.4

Please let me know what you think.
Thanks,
Sharon


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## Andros (Aug 26, 2009)

Sharon said:


> It is a relief to have a good doctor. It would be great if we could clone him - this way everyone can have a doctor like him.arty0049: I was so surprised about his great attitude! He prescribed Armour Thyroid 15MG Fore.
> What is the best way to take this? I have only taken one pill and my stomach is sick.
> Thanks,
> Sharon


Sharon; I am further impressed w/ the starting Rx. This doc does know his stuff.

I always take mine after I have my first cup of coffee with heavy real cream. LOL!! I have done this for over 15 years. But, I am very regimented in all I do and if one is, the med is titrated according to what you always do.

It is not recommended to take iron or calcium supplements around the same time though. That should be taken 4 to 5 hours away from Armour (or any thyroxine) dosing.

So, perhaps a half-slice of toast or a spoonful of peanut butter prior to taking to coat the stomach?

Hope the tummy is better today!

When do you go in for labs? My doc did every 8 weeks until we had the Armour where it should be according to my personal level of activity etc..


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## Sharon (Mar 30, 2011)

Andros said:


> Sharon; I am further impressed w/ the starting Rx. This doc does know his stuff.
> 
> I always take mine after I have my first cup of coffee with heavy real cream. LOL!! I have done this for over 15 years. But, I am very regimented in all I do and if one is, the med is titrated according to what you always do.
> 
> ...


Andros,
I started to crush the Armour and letting it dissolve under my tongue. No more upset stomach.
I have to go back next month for more lab work.
What do you think of the new results that I posted in my previous post? I have to say that I'm quite upset over the cholesterol levels. I've always said my husband eats the junk and I'm the one that gets the bad results!
Total cholesterol 346
Triglycerides 270
HDL 44
VLDL Cholesterol Calc 54
LDL Cholesterol Calc 248

Sharon


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## Sharon (Mar 30, 2011)

Sharon said:


> Andros,
> I started to crush the Armour and letting it dissolve under my tongue. No more upset stomach.
> I have to go back next month for more lab work.
> What do you think of the new results that I posted in my previous post? I have to say that I'm quite upset over the cholesterol levels. I've always said my husband eats the junk and I'm the one that gets the bad results!
> ...


 Well, I found an answer at mayoclinic.com They list elevated blood cholesterol levels as a symptom of Hashimoto disease. 
Learn something new everyday.
Sharon


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## Andros (Aug 26, 2009)

Sharon said:


> Andros,
> I started to crush the Armour and letting it dissolve under my tongue. No more upset stomach.
> I have to go back next month for more lab work.
> What do you think of the new results that I posted in my previous post? I have to say that I'm quite upset over the cholesterol levels. I've always said my husband eats the junk and I'm the one that gets the bad results!
> ...


Good thinking Sharon; glad the tummy is feeling better.

Your labs are typical of a person who is hypothyroid. These numbers will come down as you continue to respond to the Armour and heal.

Once you really start to feel better, you can start walking every day and definitely take about 3000 mgs. (3G) of Omega III a day. That will really bring those numbers down.

Use only olive oil. Eat Walnuts. Just a handful a day. As weird as this might sound, the good lipids are the ones that bring the bad lipids under control. It's true!

Do some research to prove it out.


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