# What to ask doctor about these numbers?



## shafree (May 8, 2014)

In a few days I'm seeing an endocrinologist for the first time after blood work showed my TgAB to be >3000 IU/mL (<20) and my TPO antibodies >1000 IU/mL (<35). Since I was actually being tested for other diseases, no other thyroid numbers were checked. Based on those numbers and my medical history, my GP already said it's Hashimoto's. Is there anything I need to make sure to ask, or any blood tests I should request at the appointment? The receptionist already said the doctor will want an ultrasound.


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## jenny v (May 6, 2012)

That's good about the ultrasound, you definitely need one. I would also make sure Free T3 and Free T4 are included on the list of blood work. I'm sure others will chime in.


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## Andros (Aug 26, 2009)

Substances not found in normal serum (scroll down to autoantibodies)
http://www.thyroidmanager.org/chapter/evaluation-of-thyroid-function-in-health-and-disease/
(Copy and paste into your browser)

TPO and thyroglobulin
http://onlinelibrary.wiley.com/doi/10.1111/j.1699-0463.1994.tb04888.x/abstract
http://www.wikigenes.org/e/gene/e/7173.html
(Copy and paste into your browser)

Understanding Thyroglobulin Ab.
http://www.labtestsonline.org/understanding/analytes/thyroglobulin/test.html
(Copy and paste into your browser)

Thyroglobulin Ab and cancer
http://qjmed.oxfordjournals.org/content/59/2/429.full.pdf
(Copy and paste into your browser)

Wow! Thyroglobulin Ab and TPO are really high. Please insist on an ultra-sound and I am enclosing information which I do hope you will read.

Welcome to the board and please let us know when you have that ultra-sound scheduled.


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## Lovlkn (Dec 20, 2009)

FNA if they find anything suspicious on your sonogram.


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## shafree (May 8, 2014)

Thanks, all! I read all the links and will follow your advice and post an update after the appointment.


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## Andros (Aug 26, 2009)

Good; let us know when your ultra-sound is scheduled!


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## shafree (May 8, 2014)

Update: The doctor did the ultrasound during the appointment and said it only showed the ravages of Hashimoto's. I'll have another ultrasound at the end of the year.


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## Andros (Aug 26, 2009)

Are you satisfied w/that? With your thyroglobulin that high; something is very wrong. May I suggest that you see an ENT?

Have you read the links I posted to you?

Sending hugs,


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## visc (Feb 22, 2014)

A T3 and Free T4 should be the the labs you want. My endo never mentioned ultrasounds as a action item to complete. She's a thyroid doctor at a major medical university. I'm guessing thyroid cancer is still relatively rare for people with Hashimotos. As far as the antibodies are concerned, I was told they are just a mark, positive means positive. It doesn't matter how many there are; there is no indication from research that suggests levels correlate to severity. Thats just what I've been told.


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## shafree (May 8, 2014)

Thanks, Andros, I did read your links and while I'm satisfied with this doctor for now I've also been reading up on ENTs just in case.

TSH, Free T3 and Free T4 were the only blood work my doctor has ordered so far. She got the results the next day and put me on Synthroid. The numbers weren't shared with me but I'll get the lab report next week. She told me that she wouldn't bother running my antibodies again unless I asked, because she already knows what she needs to know. I realize there are different schools of thought about that, but I'm so new to all of this that I don't know yet what I think of her approach. I still have a lot to learn.

One thing I appreciated was not having to request the ultrasound. I have a history of other autoimmune diseases in which I experience pretty crazy inflammation, so if her recommendation was unusual it could possibly be a function of that. On the basis of my own reading I believe there's a relationship between Hashimoto's and papillary thyroid cancer, so I would prefer that the health of my thyroid be monitored by more than just routine blood work.


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## shafree (May 8, 2014)

Lab work finally made its way to me and frankly, I was expecting worse!

TSH is 4.18 (0.4 - 4.5 mIU/L)

Free T3 is 3.5 (2.3 - 4.2 pg/mL)
Free T4 is 1.1 (0.8 - 1.8 ng/dL)

There's definite room for improvement, though, and when I next see the doctor I'm going to ask about selenium and explain that I'm uncomfortable pretending like the antibodies don't exist. I've also settled on an ENT that I'll contact if it ever comes to that, but hopefully the endocrinologist will come up with something that takes away the sore throat, neck tightness, ear fullness and whatnot. I realize it could be weeks or longer before I see any kind of improvement with my current medication.

This site has been an invaluable resource as I learn more about all of this, so thanks to everyone who posts.


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