# Nervous about hyperthyroidism...what happens next?



## maverickx12 (Mar 10, 2015)

31 year old white Male. 6'3, 306lbs.

Taking lisinopril for high blood pressure, taking Paxil (10mg) (just started less than a week ago) and klonopin (1mg) for anxiety.

I've been referred to an endocrinologist by my primary doctor because due to my lab results (TSH was 0.006 uIU/mL) she believes I have an overactive thyroid. My TSH this time last year was 2.290 uIU/mL...would it change that quickly to be as low as 0.006? After doing some thorough Googling (which is a terrible idea, I know) I've been freaking myself out about having hyperthyroidism. My mother has hypothyroidism so thyroid issues are most likely hereditary in my case, I'm assuming.

I guess an overactive thyroid would make sense- I experience anxiety, hypertension, head fog, excessive underarm sweating, occasional heart palpitations, thinning hair, irritability, fatigue, etc. and have for years and years. They are things I've just dealt with and haven't really affected my quality of life too badly. I have occasional muscle weakness but I also don't exercise so I always just figured that was the reason.

I'm just very nervous and now I have a couple weeks to stew about it since the first available appointment with an endocrinologist was March 23rd. Can anyone shed some light on this for me and what I can expect as far as treatment? I know these things are different from everyone but I'm curious. I greatly appreciate it.

Here is my lab work from 3/6/15

*Tests: (1) CBC With Differential/Platelet (005009)*

*WBC 5.4 x10E3/uL 3.4-10.8
RBC 4.85 x10E6/uL 4.14-5.80
Hemoglobin 14.8 g/dL 12.6-17.7
Hematocrit 43.9 % 37.5-51.0
MCV 91 fL 79-97
MCH 30.5 pg 26.6-33.0
MCHC 33.7 g/dL 31.5-35.7
RDW 13.3 % 12.3-15.4
Platelets 252 x10E3/uL 150-379
Neutrophils 45 %
Lymphs 41 %
Monocytes 9 %
Eos 4 %
Basos 1 %
Neutrophils (Absolute)
2.5 x10E3/uL 1.4-7.0
Lymphs (Absolute) 2.2 x10E3/uL 0.7-3.1
Monocytes(Absolute) 0.5 x10E3/uL 0.1-0.9
Eos (Absolute) 0.2 x10E3/uL 0.0-0.4
Baso (Absolute) 0.0 x10E3/uL 0.0-0.2
Immature Granulocytes
0 %
Immature Grans (Abs) 0.0 x10E3/uL 0.0-0.1

Tests: (2) Comp. Metabolic Panel (14) (322000)
Glucose, Serum 95 mg/dL 65-99
BUN 17 mg/dL 6-20
Creatinine, Serum 0.80 mg/dL 0.76-1.27
eGFR If NonAfricn Am 119 mL/min/1.73 >59
eGFR If Africn Am 138 mL/min/1.73 >59
BUN/Creatinine Ratio [H] 21 8-19
Sodium, Serum 136 mmol/L 134-144
Potassium, Serum 4.5 mmol/L 3.5-5.2
Chloride, Serum 97 mmol/L 97-108
Carbon Dioxide, Total
24 mmol/L 18-29
Calcium, Serum 9.6 mg/dL 8.7-10.2
Protein, Total, Serum
6.8 g/dL 6.0-8.5
Albumin, Serum 4.4 g/dL 3.5-5.5
Globulin, Total 2.4 g/dL 1.5-4.5
A/G Ratio 1.8 1.1-2.5
Bilirubin, Total 0.4 mg/dL 0.0-1.2
Alkaline Phosphatase, S
42 IU/L 39-117
AST (SGOT) 25 IU/L 0-40
ALT (SGPT) 34 IU/L 0-44

Tests: (3) Lipid Panel (303756)
Cholesterol, Total 143 mg/dL 100-199
Triglycerides 89 mg/dL 0-149
HDL Cholesterol [L] 36 mg/dL >39
According to ATP-III Guidelines, HDL-C >59 mg/dL is considered a
negative risk factor for CHD.

VLDL Cholesterol Cal 18 mg/dL 5-40
LDL Cholesterol Calc 89 mg/dL 0-99

Tests: (4) TSH (004259)
TSH [L] 0.006 uIU/mL 0.450-4.500*

Here is my lab work from 3/11/14

*Tests: (1) CBC With Differential/Platelet (005009)
WBC 8.3 x10E3/uL 3.4-10.8
RBC 5.01 x10E6/uL 4.14-5.80
Hemoglobin 15.8 g/dL 12.6-17.7
Hematocrit 46.5 % 37.5-51.0
MCV 93 fL 79-97
MCH 31.5 pg 26.6-33.0
MCHC 34.0 g/dL 31.5-35.7
RDW 13.1 % 12.3-15.4
Platelets 281 x10E3/uL 155-379
Neutrophils 70 % 40-74
Lymphs 20 % 14-46
Monocytes 7 % 4-12
Eos 2 % 0-5
Basos 1 % 0-3
Neutrophils (Absolute)
5.8 x10E3/uL 1.4-7.0
Lymphs (Absolute) 1.7 x10E3/uL 0.7-3.1
Monocytes(Absolute) 0.6 x10E3/uL 0.1-0.9
Eos (Absolute) 0.2 x10E3/uL 0.0-0.4
Baso (Absolute) 0.1 x10E3/uL 0.0-0.2
Immature Granulocytes
0 % 0-2
Immature Grans (Abs) 0.0 x10E3/uL 0.0-0.1

Tests: (2) Basic Metabolic Panel (8) (322758)
Glucose, Serum 99 mg/dL 65-99
BUN 19 mg/dL 6-20
Creatinine, Serum 1.01 mg/dL 0.76-1.27
eGFR If NonAfricn Am 99 mL/min/1.73 >59
eGFR If Africn Am 115 mL/min/1.73 >59
BUN/Creatinine Ratio 19 8-19
Sodium, Serum 137 mmol/L 134-144
Potassium, Serum 5.1 mmol/L 3.5-5.2
Chloride, Serum [L] 95 mmol/L 97-108
Carbon Dioxide, Total
24 mmol/L 19-28
Calcium, Serum 9.9 mg/dL 8.7-10.2

Tests: (3) Hepatic Function Panel (7) (322755)
Protein, Total, Serum
8.4 g/dL 6.0-8.5
Albumin, Serum 5.1 g/dL 3.5-5.5
Bilirubin, Total 0.6 mg/dL 0.0-1.2
Bilirubin, Direct 0.19 mg/dL 0.00-0.40
Alkaline Phosphatase, S
46 IU/L 39-117
AST (SGOT) 36 IU/L 0-40
ALT (SGPT) [H] 48 IU/L 0-44

Tests: (4) Lipid Panel (303756)
Cholesterol, Total 174 mg/dL 100-199
Triglycerides 124 mg/dL 0-149
HDL Cholesterol 44 mg/dL >39
According to ATP-III Guidelines, HDL-C >59 mg/dL is considered a
negative risk factor for CHD.

VLDL Cholesterol Cal 25 mg/dL 5-40
LDL Cholesterol Calc [H] 105 mg/dL 0-99

Tests: (5) TSH (004259)
TSH 2.290 uIU/mL 0.450-4.500

Tests: (6) Thyroxine (T4) Free, Direct, S (001974)
T4,Free(Direct) 1.40 ng/dL 0.82-1.77*


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## webster2 (May 19, 2011)

Sorry for what brings you here. I can only speak from my experience. I believe that your endo may want a few more thyroid related labs and perhaps antibody testing. An ultrasound would be a good idea too. You might have a RAIU (radio active iodine uptake) as well. Quite a few people are given an anti-thyroid drug like methimazole along with a beta blocker in hopes of stabilizing until a solution can be found. The ATDs can be hard on the liver and are not usually a long term remedy. Sometimes, radio active iodine is used to ablate the thyroid or a partial thyroidectomy or total thyroidectomy are another solution.

Take it easy and don't stress your body by exercising; being hyper is really hard on the body, especially the heart.

Yes, take it easy on the googling, you will frighten yourself unnecessarily. There are some very knowledgeable posters here; they will be able to help you interpret your lab results as well as helping you learn to ask the correct questions and navigate this thyroid business.


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## Lovlkn (Dec 20, 2009)

Ditto what Webster said -

Hang in there!


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## jenny v (May 6, 2012)

TSH is a good diagnostic tool in the beginning to see whether there's an issue or not. It looks like there might be in your case, so hopefully the endo follows up with testing a full thyroid panel (including Free T3, Free T4, and thyroid antibodies). When is your appointment?


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## maverickx12 (Mar 10, 2015)

Thanks for the replies everyone!

My appointment is on March 23rd, luckily only 2 weeks.

I'm just afraid of the unknown. This is the first time I've ever had to see any kind of specialist so maybe that's why I'm so nervous.

And generally, I feel fine physically. For work I get up at 4am everyday so if I'm tired that's what I'll usually attribute it to....no real aches or pains ever, my heart rate is usually anywhere from 75-100 (doctor is fine with that). That's why this whole thing is confusing to me because I thought I was relatively fine physically. Anxiety is my #1 issue in life and that's why my doctor put me on Paxil....but if the anxiety is due to the thyroid and fixing that takes the edge off...that would be great.

I'm just rambling right now...just hate uncertainty. I'm worried that whatever I take to treat this (if anything) will screw me up somehow.


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## Andros (Aug 26, 2009)

SUGGESTED TESTS
TPO (antimicrosomal antibodies) TBII (thyrotropin-binding inhibitory immunoglobulin), Thyroglobulin and 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/
(Copy and paste into your browser)

Trab
http://www.ncbi.nlm.nih.gov/pubmed/17684583
(Copy and paste into your browser)

Blocking TRAbs (also known as Thyrotropin Binding Inhibitory Immunoglobulins (TBII)) competitively block the activity of TSH on the receptor. This can cause hypothyroidism by reducing the thyrotropic effects of TSH. They are found in Hashimoto's thyroiditis and Graves' disease and may be cause of fluctuation of thyroid function in the latter. During treatment of Graves' disease they may also become the predominant antibody, which can cause hypothyroidism.

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://labtestsonline.org/understanding/analytes/thyroid-antibodies/tab/test
(Copy and paste into your browser)

Substances not found in normal serum
http://www.thyroidmanager.org/Chapter6/Ch-6-6.htm
(Copy and paste into your browser)

men more likely to have cancer than women
http://www.umm.edu/endocrin/thytum.htm
(Copy and paste into your browser)

Thyroid cancer, cold nodules, men, uptake etc.
http://www.aafp.org/afp/2003/0201/p559.html
(Copy and paste into your browser)

Lord have mercy; you have had the tests! But sadly, you need more that are related to your thyroid which I am listing above and you seriously either need RAIU (radioactive uptake scan) or at the very least and ultra-sound of your thyroid.

Because, the male gender in fact has a greater propensity for cancer of the thyroid which is often the cause of hyper. You need to know; don't ignore this.

Welcome to the board!


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