# Labs, hashimoto...next steps?



## aldroe (Sep 8, 2010)

Hi...new here and recently had some labs run that I need advice on...

T4 free 1.2. (.8-1.7)
T3 free 3.8. (2.0-4.8)
Tsh. 2.16. (.45-4.5)
Tpo less than 10. (less than 35)
Thryo antibodies. 390. (<41)
ferritin 36. (9-120)
I ALso had my adrenals checked and they weren't too off, a little low at midday but the rest were ok..
My liver alt number was slightly elevated as well though no reason for this to be.

I am wondering about medication or other actions? I know if tsp appears normal many dr don't recommend treatment? But also read that by treating it can bring the levels back to normal zone and slow the hashimoto? Do u recommend a scan or any other exam?

Thank you!!! I feel better reading the updates here..I know there is hope and answers!


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## desrtbloom (May 23, 2010)

Hi:

What symptoms are you having? Are you seeing an Endo or?

Yes, there are a lot of great and knowledageable people on this site. I'm very happy I found it too.

Best Regards,
Patti


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## lainey (Aug 26, 2010)

aldroe said:


> Hi...new here and recently had some labs run that I need advice on...
> 
> T4 free 1.2. (.8-1.7)
> T3 free 3.8. (2.0-4.8)
> ...


If a thyroid problem is suspect, an ultrasound and possibly a radioactive uptake may be done.

With the exception of mildly elevated antibodies, your numbers are pretty good. The ferritin could be higher--around 50 is ideal.

What are your symptoms?

What did the doctor say regarding these?


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## Andros (Aug 26, 2009)

aldroe said:


> Hi...new here and recently had some labs run that I need advice on...
> 
> T4 free 1.2. (.8-1.7)
> T3 free 3.8. (2.0-4.8)
> ...


Did the doctor say you have Hashimoto's but has declined to treat you?

What symptoms brought you to the doctor in the first place?

Not liking that your thyroglobulin is so high. That can suggest cancer.

Read this, please.....

http://qjmed.oxfordjournals.org/content/59/2/429.full.pdf

http://www.thyca.org/thyroglobulin.htm

Given that the thyroglobulin is so high, I personally would request a RAIU (radioactive uptake scan) to have a look for nodules and any other irregularities.

Please keep us in the loop with this. I feel that the RAIU is very very important at this time.


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## aldroe (Sep 8, 2010)

This was found by my naturopath. I like her quite a lot but am doing my own research too. She wanted to run the labs again and said she may end up recommending the scan. Of course I can tell her I want the scan and I can also make an apt with an end on my own. I am not overly symptomatic....some hair loss, heavy periods are worst. We are trying to get my ferritin up some as well as my vitamin d and afternoon adrenals. I see her Tuesday and will ask her to refer for the scan or recommend an end here in phoenix area. Not taking any med. As of yet we just got this Info 2 wks ago or so..


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## aldroe (Sep 8, 2010)

After my research and some inputs I have rec'd I will go ahead and request the RAIU to ensure there are no nodules or growths etc. My dr had said it would likely be something she would refer me to, but again she wanted to run them again - I am taking a few meds and doing some acupuncture - meds being, vitamins, anti-inflammatory natural meds etc and then the isocort to boost my adrenals in the afternoons. She wanted to see if any of these help, run the labs again in a about 6 wks and then see. i do however have insurance and though I dont want to have any procedures done, I would rather do it and know i didnt need it or know I need to take some action.

If I do the scan and there are no irregularities (if you have raised antibodies do you always have a physical change to the thryoid???) then is it just assumed to be Hashi's? and if it is, then it seems many things I am reading say by taking thryoid meds it can slow the progression or make it dormant so it doesnt burn the thryoid up? so once you have elevated antibodies can they really go back down into normal range and stay there? there is really more than i want to know about all this - so complicated! 
thank you!!


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## Andros (Aug 26, 2009)

aldroe said:


> This was found by my naturopath. I like her quite a lot but am doing my own research too. She wanted to run the labs again and said she may end up recommending the scan. Of course I can tell her I want the scan and I can also make an apt with an end on my own. I am not overly symptomatic....some hair loss, heavy periods are worst. We are trying to get my ferritin up some as well as my vitamin d and afternoon adrenals. I see her Tuesday and will ask her to refer for the scan or recommend an end here in phoenix area. Not taking any med. As of yet we just got this Info 2 wks ago or so..


It is good to have a med-free uptake scan. I do hope you pursue that avenue and please let us know!

Sounds like you are in very good hands. This is a good thing.

Sending hugs,


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## lainey (Aug 26, 2010)

aldroe said:


> If I do the scan and there are no irregularities (if you have raised antibodies do you always have a physical change to the thryoid???) then is it just assumed to be Hashi's? and if it is, then it seems many things I am reading say by taking thryoid meds it can slow the progression or make it dormant so it doesnt burn the thryoid up? so once you have elevated antibodies can they really go back down into normal range and stay there? there is really more than i want to know about all this - so complicated!
> thank you!!


Your TPO abs were negligible in your lab tests and your numbers are good--who made the diagnosis of Hashi's based on this?


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## GD Women (Mar 5, 2007)

I read normal Labs. Why would you want to be put on thyroid medication when you don't have a thyroid condition and your levels are perfect.

Thryo antibodies. 390. (<41) could suggest cancer although would not be a diagnose of such, but I would suggest to have it checked out. Most thyroid cancers have normal thyroid levels.


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## aldroe (Sep 8, 2010)

My thyroglobulin levels were elevated. No, not in the thousands but they are not normal. There has to be something driving them to be 390. I don't want to take med if not needed but I also don't want the numbers to increase till my thyroid crashes and burns. If it can help slow down any inflammation I would try taking something. I have done a ton of reading and you can absolutely have a higher chance of thyroid ca with the elevated antibodies. I would hate to not check *** out and have something actually happening then it's too late!


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## lainey (Aug 26, 2010)

Just as you can have a thyroid condition and not have antibodies, much the same you can have antibodies and no thyroid condition.

Low levels of thryoglobulin antibodies alone are not going to make your thyroid crash and burn--they interact with thyroglobulin, which is produced naturally by thyroid cells. Measuring thyroglobulin is most helpful when used for cancer post surgery, to detect the return of thyroid cells in someone who has had their thyroid ablated and thryoid cells destroyed due to thyroid cancer--it is helpful in that case to know if they are present, because they interfere with the thyroglobulin test in that instance. Barring that, they may warrant further investigation for cancer, such as ultrasound, but are not indicative of cancer nor the need for replacement treatment.

Even if you have a structural abnormality, such as nodules or a goiter, medication solely to reduce "inflammation" could be dubious at this time.

Medication can be dangerous, especially considering that your free T3 is in the upper half of the range, and your free T4 in the upper half--almost ideal when you are treating someone with replacement. You could easily become hyperthyroid if medicated at this point.


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## Andros (Aug 26, 2009)

aldroe said:


> After my research and some inputs I have rec'd I will go ahead and request the RAIU to ensure there are no nodules or growths etc. My dr had said it would likely be something she would refer me to, but again she wanted to run them again - I am taking a few meds and doing some acupuncture - meds being, vitamins, anti-inflammatory natural meds etc and then the isocort to boost my adrenals in the afternoons. She wanted to see if any of these help, run the labs again in a about 6 wks and then see. i do however have insurance and though I dont want to have any procedures done, I would rather do it and know i didnt need it or know I need to take some action.
> 
> If I do the scan and there are no irregularities (if you have raised antibodies do you always have a physical change to the thryoid???) then is it just assumed to be Hashi's? and if it is, then it seems many things I am reading say by taking thryoid meds it can slow the progression or make it dormant so it doesnt burn the thryoid up? so once you have elevated antibodies can they really go back down into normal range and stay there? there is really more than i want to know about all this - so complicated!
> thank you!!


This is an excellent idea about the RAIU. Please let us know when it is scheduled so we can keep you in our thoughts and prayers.

If the antibodies are indigenous to the thyroid, over time, there will be damage. That is why it is called autoimmune which I know you know this. Silly me!

Depending on which antibodies you have, yes.........taking thyroxine replacement can sometimes slow things up; quite a bit actually.


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