# New here and very confused!



## PennyS (Mar 16, 2011)

Hello,

I am new here and will try to keep this is as brief as possible. In June 2007, during a routine office visit my Dr. said my TSH level was low. I was 2 months postpartum at the time. She rechecked it 2 months later and it had dropped to .008. She then referred me to an endo. who diagnosed me with postpartum thyroiditis. She also checked my TPOab which were 900. My thyroid reverted to normal on its own without medication. I then became pregnant again and developed hyperthyrodism during the postpartum period. My endo has been following me with blood work only and will not check my free T4 level. The only time it was checked was when she was out and a nurse was filling out the lab form and I asked her to check it. This was in January 2009. Results from that day were --

TSH: 0.303 (Normal Range = 0.5 to 5.0): Out of Range
T4: 7.2 (Normal Range = 5 to 11)
FT4: 1.1 (Normal Range = 0.8 to 1.8)

Details of other blood chemistry tests as follows:
T3 Uptake: 1.06 (Normal Range = .8 to 1.2)

I went in last Thursday because I have been having a variety of symptoms that I feel are both hyper and hypo. They include: heart palps., heavy menstrual bleeding, irregular menstrual cycles, hair loss (including patchy areas on outer eyebrows), cold, tired, irritable. I have not received all my results but here are some initial ones that I find pertinent given my research:

TSH: 0.768 (0.5-5.7)
T4: 6.6 (4.6-10.7)
T3 Uptake: 0.9 ((.8-1.2)
TPOab: 379 (0-20)
Sodium: 135 (136 - 145)
Potassium: 3.6 (3.4-5.0)
Calcium: 8.7 (8.8 - 10.7)
Vitamin D: 36 (25 - 80): my level keeps dropping despite upping my supplementation
WBC: 3.74 (4-10)
RBC: 3.79 (3.9-6.0)

I should also mentioned that there is a huge autoimmune hx in my family. My endo ran a celiac panel on me as well (brother diagnosed a few years back). Results not back yet.

I feel that I have been mismanaged for over 4 years. My doctor refuses to run Free T4 and only looks at my TSH and then says "see you in 3-6 months for more bw"despite the fact that I feel like crap most of the time. I am looking for a new doctor who hopefully will be more progressive and help me to feel better.

Can anyone make heads or tails out of any of my lab results and advise as to what I should do next?!


----------



## lainey (Aug 26, 2010)

Post partum thyroiditis often does resolve on its own, so I don't know necessarily that your doctor has mismanaged you in that regard--the standard is to watch and wait, and twice you seemed to have gone back to "normal".

A TSH of around 1 is generally considered ideal. You could get a new doctor to run the free T4 and free T3 and also the antibodies and see where they are and go from there.

Generally, the presence of antibodies indicates the potential for a problem, but it is not common to prescribe medication to treat the antibodies, but rather to wait to treat the thyroid once the levels fall out of range.

It will be difficult to find a doctor that will medicate you with your present TSH, even with the T4 a bit on the low side.

You might also consider a sonogram or uptake scan of the thyroid. Both will show structural changes, and the uptake scan can reveal functional changes. These will help with a diagnosis.


----------



## lavender (Jul 13, 2010)

I went undiagnosed for years myself. Looking back with what I know now, I would want a doc to do the following labs: TSH, Free T3, Free T4, TPO, Anti-thyroglobulin, and TSI.

Something is definitely off when I look at your bloodwork. Your TSH is low and your Free T4 is also low in the range. This is unusual in that your body is supposed to make more TSH when your T3 and T4 are low. That's why it's so important to have your Free T3 checked as well to get a complete picture. It is true that you may have a hard time getting a doc to script meds at your current levels. Which makes it even more important to have all the labs run and to have someone who is willing to be thorough and discuss your results and treatment options with you.

Has your doc said anything about your other abnormal bloodwork?

How much and what kind of vitamin D are you taking? It's important to take a high quality D3. I take 5000 iu daily. It took several months on this dose for my levels to rise from the low 30s to the 50s. My doc and I discussed this, and I am staying on this dose to maintain my D levels for now.

When I switched docs, I asked my doctor's office to print out a copy of all the lab work I had done in the past year, and took it with me to my first appointment. Saved me from having to repeat bloodwork.


----------



## PKTHV1 (Mar 16, 2011)

I am new to this area and also confused. I was diagnosed today with both Hashimoto's and Graves disease... is there an area in this group for that specific problem... I am very confused with what the Dr. told me. Thanks. Pattie


----------



## lavender (Jul 13, 2010)

Hi Pattie! 
You have come to the right place. I was diagnosed with both Hashi's and Graves myself. We have so many different boards, the choice is really yours, Graves, Hashi's, the General Discussion Forum or Lab Results if you have labs you want someone to help you understand. Whichever one you pick, it's generally best to start one thread and to keep posting on that thread so those of us responding can keep track of who you are and what your issues are. Otherwise, we get confused with new posts by the same person (thyroid messes with our brains a bit). Feel free to post a little about yourself, ask questions, vent, whatever you need. We're here to help.


----------



## Andros (Aug 26, 2009)

PennyS said:


> Hello,
> 
> I am new here and will try to keep this is as brief as possible. In June 2007, during a routine office visit my Dr. said my TSH level was low. I was 2 months postpartum at the time. She rechecked it 2 months later and it had dropped to .008. She then referred me to an endo. who diagnosed me with postpartum thyroiditis. She also checked my TPOab which were 900. My thyroid reverted to normal on its own without medication. I then became pregnant again and developed hyperthyrodism during the postpartum period. My endo has been following me with blood work only and will not check my free T4 level. The only time it was checked was when she was out and a nurse was filling out the lab form and I asked her to check it. This was in January 2009. Results from that day were --
> 
> ...


Welcome to the board.







I agree that you have been mismanaged and I wonder why you have not found another doctor after all this time.

All those tests and only TPO? See, that is ridiculous. There are many antibodies indigenous to the thyroid and here they are and they should be run.

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

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/

TPO is only "suggestive" of thyroid disease. It is present in many many autoimmune disease although I do think you have thyroid but you may also have something else going on. Many of us have "multiple" autoimmune challenges.

A positive test may be due to:

•Autoimmune hemolytic anemia
•Granulomatous thyroiditis
•Hashimoto's thyroiditis
•Nontoxic nodular goiter
•Rheumatoid arthritis
•Sjogren syndrome
•Systemic lupus erythematosus
•Thyroid cancer

TPO
http://www.nlm.nih.gov/medlineplus/ency/article/003556.htm

So, I think a new doc is in order here and I also think that you should have RAIU (radioactive uptake scan) to make sure you don't have cancer of the thyroid.

In thyroid disease, the body automatically down regulates Vitamin D because D triggers the antibodies. The body is trying to protect it's self.

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

Your Total 4 is in the basement too. This is bound and unbound hormone and really not the best of tests as are the FREE T4 and FREE T3, the FT3 being the most important test as this is your "unbound" and active hormone available for cellular uptake.

http://www.thyroid-info.com/articles/freet3woliner.htm

Some of your tests are sadly out-dated.
Understanding thyroid lab tests.....http://www.amarillomed.com/howto/#Thyroid

So, it is my sincere hope that you can latch on to a doctor who cares about getting you well and does that by doing proper diagnostic procedures.

We are here to help you and I hope we do.

Let us know.


----------



## PennyS (Mar 16, 2011)

Andros said:


> Welcome to the board.
> 
> 
> 
> ...


I know it was not your intent but you just scared the crap out of me! In any event, I researched doctors yesterday and just made an appointment with a new doctor. I lucked out because she was booking into July but just had a cancellation so my appointment is at the end of April.

I think that I may have some more blood results coming in and I think she did run some of the antibodies test that you mentioned. The lab told me they had to be sent out (including the Celiac panel) and it would take 7-10 days.

I have felt for some time now that I should be seeing a new Doctor but my life is crazy busy and I just kept putting it on the back burner. Not a good excuse, I know! But I am glad I found this board! I also requested some books out the library so I can educate myself and be the advocate that I need to be!


----------



## Andros (Aug 26, 2009)

PKTHV1 said:


> I am new to this area and also confused. I was diagnosed today with both Hashimoto's and Graves disease... is there an area in this group for that specific problem... I am very confused with what the Dr. told me. Thanks. Pattie


Hi, Pattie! Welcome to the board!









I believe I was also Hashi's and then full-blown Graves'!

So, what testing has been done on your behalf and are you on any meds yet? Are you symptomatic? If so, care to share?


----------

