# Would be happy about some input on blood work :)



## Fluke83 (Oct 28, 2012)

Hi 

I was recently told I have autoimmune thyroiditis, it was discovered after I had a chemical pregnancy in september and started having weekly blood drawn to see if I had hormonal imbalances that could be the cause.

At one of the appointments I asked the doctor if he could do thyroid tests as well since I thought I'd been having symptoms and because thyroid problems and autoimmune conditions in general run in my family.

To add some medical history I think is relevant I first started having medical issues when I woke up one morning with bad ankle pain christmas 2007.

It didn't go away and more joints wanted to be in on the "fun" so when I finally went to the doctor a couple of months later it had spread to include both knees, one side of my hip, a wrist and various fingers and toes.

My doctor said the joints were inflamed, gave me a prescription for ibuprofen and referred me to a rheumatologist.

The rheumy confirmed the inflammation but could find no apparent cause, othet than to say it was an autoimmune reaction.

I knew about how thyroid problems and this could be related and since my mother is hypothyroid I asked that the rheumy check my thyroid function quite early on, but didn't get to see the results or what she checked, she only said the tests didn't indicate a thyroid problem.

I was put on an arthritis medicine (Sulfasalazine) that didn't do squat for me except mess with my liver and I was allowed to take up to 1200 mg of Ibuprofen pr. day.

The next three years the joint inflammation played tag around my body. I switched rheumatologist and got taken off the sulfasalazine since it didn't have any effect, the only thing helping somewhat was the painkillers.
The new rheumy could also not find any cause.

Then suddenly, three years later I started noticing that the inflammations were less frequent, and within 6 months they were practically gone. That was about a year ago and it's been quite stable since.

About 2-3 years ago I started noticing symptoms I felt could be related to thryoid issues, fatigue, weight gain (55 lbs in about 2 years), increasing anxiety levels.

The last year in particular I've had trouble with nervousness, insomnia, anxiety and panic attacks and fatigue to the point where I was on sick leave for 5 months and had to take anti anxiety meds to be able to even go to the grocery store, and afterwards I would be knackered the rest of the day...

I also have a 8 year old daughter and I got in trouble with her school because I didn't have the energy to stay on top of her homework..

Anyway, after the first thyroid tests at my doctor's he gave me a beta blocker since he felt my symptoms, apart from weight gain and cold intolerance, could indicate a hyper phase even though it didn't show up on bloods, especially after I told him I'd also had premature ventricular contractions most of my adult life.

I just didn't think to mention it before he asked, since they're not particularly uncomfortable and I've had them for so long. Now it feels almost strange to have a heart that's NOT jumping all over the place... 
One other reason he felt a beta blocker could be useful is that I was found to have high blood pressure at the appointment, I didn't ask how high, but afterwards I found it strange since my blood pressure has always been on the low end of normal, even when I was pregnant and gained 55 lbs from that as well.

Anyway, after all that yammering, here are my results, they are taken a week apart. I'm in Norway, if anyone is wondering about the units and ranges 

Taken Oct. 12 2012:

TSH 3.0 mU/L (0.20 - 4.0)

FT4 16.9 pmol/L (11.0 - 23.0)

Anti-TPO >1300 kU/L (<100)

TRAS 1.1 IU/L (<1 negative, 1.0-1.8 borderline >1.8 positive)

The TRAS I've only been able to translate as "TSH-receptor antibodies", but there are several kinds, binding, blocking and stimulating as far as I've understood, the test doesn't specify anything. 
The only thing I know about that specific test is that is mostly used to diagnose Graves.

Taken Oct. 18 2012

TSH 1.6 mU/L (0.20 - 4.0)

FT4 15.6 pmol/L (11 - 23)

Anti-TPO >1300 kU/L (<100)

TRAS 0.8 IU/L (<1 negative, 1.0-1.8 borderline >1.8 positive)

One thing I do find confusing is that TSH dropped from 3.0 to 1.6 in a week? And while TSH dropped the FT4 didn't budge, it even dropped a little too, I thought as TSH dropped FT4 would rise and vice versa?
Could the high antibody count have something to do with this?

I'm still going for weekly blood tests and I have an ultrasound scan of my thyroid scheduled in a few days.
I'll se what my doc has to say after the thyroid scan and if anyone have any suggestions as to what other tests I should get done (Im thinking FT3 as well, at least) I'd be happy to get some suggestions 

In the middle of this I'm trying to conceive, the chemical pregnancy was what led to the discovery of the autoimmune thyroiditis.

I haven't discussed that too much with my doctor in relation to any eventual thyroid issues, but I've seen several studies where high anti-TPO counts in specific are related to a significantly higher chance of miscarriage. 
The chemical pregnancy affected me more than I was prepared for, I don't even want to think about what I'll do if I have a miscarriage further along.. 

I'll stop yammering now, I'd be surprised if anyone has even read this far, you deserve a cookie..


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## jenny v (May 6, 2012)

Welcome!

I would definitely push for the Free T3 test, just to get a complete picture of what's going on, and it's good that you are getting an ultrasound soon. Are you actively trying to get pregnant while all of this is going on? I only ask, because I've read a few things that indicate your chance for a miscarriage and birth defects is increased when your thyroid is out of whack. So that's something to consider.



> Now it feels almost strange to have a heart that's NOT jumping all over the place...


 Isn't it the truth?? I'm so used to my heart skipping and pounding all over the place that when it calms down I freak out, thinking maybe it's somehow stopped beating! LOL!


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## Andros (Aug 26, 2009)

Fluke83 said:


> Hi
> 
> I was recently told I have autoimmune thyroiditis, it was discovered after I had a chemical pregnancy in september and started having weekly blood drawn to see if I had hormonal imbalances that could be the cause.
> 
> ...


If you have Trab, you have TSI as Trab is there to block the activity of TSI.

Here is info on that.

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

Trab
http://www.ncbi.nlm.nih.gov/pubmed/17684583

Now; you really really need ultra-sound or RAIU (radioactive up take.) RAIU would be the better choice.

One reason why is that TPO is really high.

TPO
Mild to moderately elevated levels of thyroid antibodies may be found in a variety of thyroid and autoimmune disorders, such as thyroid cancer, Type 1 diabetes, rheumatoid arthritis, pernicious anemia, and autoimmune collagen vascular diseases. Significantly increased concentrations most frequently indicate thyroid autoimmune diseases such as Hashimoto thyroiditis and Graves disease.
http://labtestsonline.org/understanding/analytes/thyroid-antibodies/tab/test

Cancer needs to be considered and hopefully ruled out.

Another reason why is hyper and cancer are often bedmates.

Thyroid cancer in patients with hyperthyroidism.
http://www.ncbi.nlm.nih.gov/pubmed/12876418

Many of us have gained weight while hyper so this is deceiving. Symptoms can and do cross over.


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## Fluke83 (Oct 28, 2012)

jenny v: I discussed this with my doctor and he wasn't too concerned and said that if I get pregnant I get pregnant, but that he'd keep a closer eye on my blood work and probably draw blood more often than in a normal, healthy pregnancy.
From what I've read on my own though the high anti-TPO does increase the chance for early miscarriages quite significantly, so I'll discuss this more with him on my next visit.

Andros: I just had the ultrasound today actually, and the tech found a big, whopping NOTHING, which I'm happy about 

I didn't know that about the trab-tsi conncetion, it explains a few things..!

I suppose it's just a waiting game now, since the US was fine and everything, there's not really much more to do as long as I'm not terribly sick.

Anyway, thanks for the input guys, it helps to get some other opinions


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