# Help with new blood-work and ultrasound findings??



## Zugora (Feb 14, 2010)

Hello-
I've had a laundry-list of undiagnosed "thyroid-type" issues for a while now (still feeling pretty crappy) and I recently got my lab results and ultrasound findings in from my NEW doc. My follow-up appointment isn't scheduled until Jan 11. Could anyone help decipher these findings?

TSH: 2.97 (.450 - 4.5) - slowly creeping up

Free T3: 2.6 (2.0 - 4.4)
Free T4: .98 (.82- 1.77)
T3: 87 (55 - 170)
T4: 6.5 (4.2 - 13)
Reverse T3: 175 (90-350)
Anti-TPO: <10 (<35)
TGAB: <20 (<40)
*
Ultrasound Findings:*
*Right Lobe:* 4.7 x 1.5cm in cephalocaudad and AP dimension and 1.3 cm in transverse dimension. The thyroid gland is homogenous in echotexture. A hypoechoic area measuring 6 x 11 x 3mm is present posterior to the lower aspect of the right lobe. No blood flow demonstrated. Finding my represent a parathyroid adenoma. The thyroid gland is heterogeneous in echotexture.

*Left Lobe: * 3.9 x .9 cm in cephalocaudad and AP dimension and 1.5 cm in transverse dimension. The left lobe is is homogeneous in echotexture. No dominant nodule demonstrated.

Isthmus measures 1mm in AP dimension.

A 6 x 11 x 3mm parathyorid adenoma just posterior to the lower aspect of the right lobe of the thyroid is present.

*Other weird blood-work that were flagged and highlighted:*
Anticardiolipin Ab, IgM: <9 (just highlighted)
M pneumoniae IgG Abs: 140 (0-99) *HIGH*
EBV Nuclear Antigen Ab, IgG: >8.0 *HIGH*
IGF-1 (Insulin-Like Growth Factor): 324 (115-307) *HIGH*
EBV Ab VCA IgG: >8.0 *HIGH*
HHV 6 IgG Antibodies: 11.19 *HIGH*

The doctor's office called when results were in to see if I could come in earlier than Jan.11. They didn't say why. Unfortunately, I was out of state for the holidays and now they are booked solid until Jan 11. Can anyone help interpret these findings? Thanks so much!!


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## Negative101 (May 23, 2011)

Not a doctor by any means, but i dont think its your thyroid thy called you about. Seems like you may have an infection, or maybe mono? Have u been feeling very sluggish? Any throat pain?


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## Zugora (Feb 14, 2010)

Negative101 said:


> Not a doctor by any means, but i dont think its your thyroid thy called you about. Seems like you may have an infection, or maybe mono? Have u been feeling very sluggish? Any throat pain?


My lymph nodes have been swollen on and off for the past two years. Front of throat pain/discomfort, too, along with eustachian tube fullness/crackling. No sign of respiratory infection. Other sxs are:

- Cold intolerance, especially in extremities (getting worse over last 10 years). Freezing all of the time.
- Muscle aches in legs and rear-end (getting worse).
- Terrible, chronic dry eyes
- Extremely fatigued, no energy, limbs feel very heavy. Feel like I am functioning at 50% or less.
- Very foggy, concentration problems. Feel spaced out.
- Front of throat pain/discomfort/fullness.
- Eustachian tube fullness (clogged/crackling feeling)
- Low blood pressure (85/50 at times)
- Low basal body temp (average: 96.5 - armpit, 97.3 - oral)
- Depression for no reason
- Anxiety/jittery
- Heart palpitations/racing at times (for no reason)
- Extremely emotional at times (crying jags for no reason)
- Trouble sleeping
- Dizzy feeling at times
- Arm/hand/feet tingling at times (also, itchy/prickly sensations)
- Dry hair, thinning
- Excessive sweating (hands, feet, under-arms)
- Chronic post-nasal drip
- Light, irregular periods/PCOS (but since low carb/low sugar, gluten free diet, I have regulated it somewhat (still very light and short)
- Sugar issues (get shake-y easily, especially in the morning)


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## Andros (Aug 26, 2009)

Zugora said:


> Hello-
> I've had a laundry-list of undiagnosed "thyroid-type" issues for a while now (still feeling pretty crappy) and I recently got my lab results and ultrasound findings in from my NEW doc. My follow-up appointment isn't scheduled until Jan 11. Could anyone help decipher these findings?
> 
> TSH: 2.97 (.450 - 4.5) - slowly creeping up
> ...


There may be several areas of concern. I am wondering if you were ever tested for Lupus Ab?

Read this about Cardiolipin..................; please

http://labtestsonline.org/understanding/analytes/cardiolipin/tab/faq

And as you no doubt know, the parathyroid adenoma would be of concern as well. Ultra-sound does have it's limitations so maybe a follow up with RAIU might be a good idea for you. Maybe. Talk to your doc about all of this. Let us know.










And for the record, your thyroid numbers do look poorly; I do think you would benefit from some thyroxine replacement.


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## lainey (Aug 26, 2010)

> Other weird blood-work that were flagged and highlighted:
> Anticardiolipin Ab, IgM: <9 (just highlighted)
> M pneumoniae IgG Abs: 140 (0-99) HIGH
> EBV Nuclear Antigen Ab, IgG: >8.0 HIGH
> ...


I don't think they are calling about thyroid either.

While about 95% of the population is positive for Epstein Barr, they may think you have a reactivation or other mycosomal infection (M pneumoniae). These can persist on both a clinical and subclinical basis, and could explain some of your symptoms.


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## Zugora (Feb 14, 2010)

Thanks for your input. I've been tested for Lupus about three times and each time, it has come back "negative". However, I AM positive for ANA antibodies (positive in several blood-tests). So, something autoimmune is going on, but all specific autoimmune tests have come back "negative". I've seen the best rheumatologist in town and he's stumped - no diagnosis, but he also suspects thyroid.

Thanks for the link for Lab Tests Online - very helpful. I'm still baffled by what the "high" results on my lab-work actually mean for me, so I guess I have to wait for the doctor for that.

It appears that my FT3 is on the low side. Is that correct?


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## Negative101 (May 23, 2011)

Depends on who you ask... It's on the low side of normal, but that's still perfectly normal. No one said you have to be in the upper half of normal ranges; although, some do feel better at those levels (and I'm sure some feel perfectly fine at your levels also)


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## Andros (Aug 26, 2009)

Zugora said:


> Thanks for your input. I've been tested for Lupus about three times and each time, it has come back "negative". However, I AM positive for ANA antibodies (positive in several blood-tests). So, something autoimmune is going on, but all specific autoimmune tests have come back "negative". I've seen the best rheumatologist in town and he's stumped - no diagnosis, but he also suspects thyroid.
> 
> Thanks for the link for Lab Tests Online - very helpful. I'm still baffled by what the "high" results on my lab-work actually mean for me, so I guess I have to wait for the doctor for that.
> 
> It appears that my FT3 is on the low side. Is that correct?


Oh, yes. FT3 is low. You must feel exhausted most days?

Interestingly, Anti-DNA can come back negative but the patient can still have Lupus. They are tricky to catch sometimes. This is where sometimes clinical evaluation is worth it's weight in gold if the doc has had a lot of experience with certain things. My doc can eyeball me and know what is wrong right away. Of course we back it up with labs.

Glad you like that link! I love that link. It is one of my favorites and most helpful.


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## peacesells560 (Aug 9, 2011)

I definitely think something thyroid related is going on. Maybe there is some sort of thyroxine binding globulin deficiency resulting in what looks to be a normal FT4, but what appears to be a low total T4? I had the same total T4 level with a TSH of 4.85.


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## Zugora (Feb 14, 2010)

Andros said:


> Oh, yes. FT3 is low. You must feel exhausted most days?


Yes, very fatigued and physically exhausted. I feel like I've been hit by a truck ...every day.


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## Andros (Aug 26, 2009)

Zugora said:


> My lymph nodes have been swollen on and off for the past two years. Front of throat pain/discomfort, too, along with eustachian tube fullness/crackling. No sign of respiratory infection. Other sxs are:
> 
> - Cold intolerance, especially in extremities (getting worse over last 10 years). Freezing all of the time.
> - Muscle aches in legs and rear-end (getting worse).
> ...


Are you and outdoors person? Any ticks or a lot of mosquito bites? Are you taking Metformin, any statin or quinalones? (Cipro, Fluorquinalone etc..)


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## lainey (Aug 26, 2010)

Try Googling any combination of High EBV, IgG antibodies and chronic fatigue syndrome. Include the M pneumonie.

There is an awful lot of reading that looks like your antibodies labs.


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## Zugora (Feb 14, 2010)

Andros said:


> Are you and outdoors person? Any ticks or a lot of mosquito bites? Are you taking Metformin, any statin or quinalones? (Cipro, Fluorquinalone etc..)


Nope. No mysterious tick bites and not on any medication. A true mystery for sure. I need Dr. House.


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## Andros (Aug 26, 2009)

Zugora said:


> Yes, very fatigued and physically exhausted. I feel like I've been hit by a truck ...every day.


You need more T3 in your system. FT3 is your active hormone. W/o sufficient, you wither. Cuts don't heal, joints hurt, no energy, confusion, feelings of uncertainty, can't lose weight, edema around ankles, constipation, frequent colds and sniffles, thin fingernails, acites.......................the list goes on. Sound familiar to you?

Wish I had a magic wand. I would send you a truck load of Armour Thyroid®.


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## Zugora (Feb 14, 2010)

Andros said:


> You need more T3 in your system. FT3 is your active hormone. W/o sufficient, you wither. Cuts don't heal, joints hurt, no energy, confusion, feelings of uncertainty, can't lose weight, edema around ankles, constipation, frequent colds and sniffles, thin fingernails, acites.......................the list goes on. Sound familiar to you? Wish I had a magic wand. I would send you a truck load of Armour Thyroid®.


Yes, some of that sounds right (see previous sxs list). I feel like I'm on death's door. I'm 35 years old, 5'4, 125 lbs, eat healthy, but I feel like I'm in the grave. I see the new doc again on Jan 11 and I'll definitely bring the FT3 up with him.

The ultrasound report says that there appears to be a parathyroid adenoma (6x11x3mm). My calcium hasn't been taken in about 2 years, but I did have "normal" PTH-Intact" last month of 28 (range: 10-65). This will need further investigation, I'm sure. Thanks again!


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## Zugora (Feb 14, 2010)

oh yes, and swollen, distended abdomen, too. I've been gluten free now for the past year (figured it might be a good idea since I have positive ANA anti-bodies) and still have the bloated stomach-look and feeling.


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## Andros (Aug 26, 2009)

Zugora said:


> oh yes, and swollen, distended abdomen, too. I've been gluten free now for the past year (figured it might be a good idea since I have positive ANA anti-bodies) and still have the bloated stomach-look and feeling.


You could have insuline resistance. Where is your glucose in the range? If high in the range, that could suggest it. Buddha Belly is a symtom.

Look up cinnamon and insulin resistance. I used to do over 100 sit ups a day to no avail. Started putting cinnamon in my yogurt and/or apple sauce and goodby Buddha Belly. You can get the capsules if you prefer but it ends up to be costly. We get our cinnamon powder in bulk at Sam's Club and it is cheap.


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## Zugora (Feb 14, 2010)

Andros said:


> You could have insuline resistance. Where is your glucose in the range? If high in the range, that could suggest it. Buddha Belly is a symtom.


I think there definitely is an insulin resistance component - even though my previous doctor said otherwise. Grrr.... For one, I have PCOS, despite being thin (but w/ bulging stomach). I was diagnosed through sxs and polycystic ovaries found on US. Also, since being low-carb, low-sugar, and gluten-free, I have had a period every month (definitely not the case before)! They are still very light periods, but at least they come every month now.  So I think there is a insulin/sugar connection here. My latest glucose (2 months ago) was 87 (range: 79-115).

Btw, you know that supposed "parathyroid adenoma" that was found on my US? Well, it turns out that the 2 things that they look for parathyroid function and adenomas are "normal", not high at all. My PTH was 28 (range 10-65) and my calcium was 9.4 (8.3-10.8). It makes me wonder what they saw in the ultrasound...

Thanks again for your input, Andros. :hugs:


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## Zugora (Feb 14, 2010)

Andros said:


> Oh, yes. FT3 is low. You must feel exhausted most days?


Btw, I goofed. I just realized that FT4 and Free Thyroxine are the same thing. I listed a previous FT4 and my current Free Thyroxine (or FT4). I edited the original post so that the new numbers are:

TSH: 2.97 (.450 - 4.5) - slowly creeping up
Free T4: .98 (.82- 1.77) 
Free T3: 2.6 (2.0 - 4.4)

I'm thinking the frees are pretty darn low... (?)


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## Andros (Aug 26, 2009)

Zugora said:


> I think there definitely is an insulin resistance component - even though my previous doctor said otherwise. Grrr.... For one, I have PCOS, despite being thin (but w/ bulging stomach). I was diagnosed through sxs and polycystic ovaries found on US. Also, since being low-carb, low-sugar, and gluten-free, I have had a period every month (definitely not the case before)! They are still very light periods, but at least they come every month now.  So I think there is a insulin/sugar connection here. My latest glucose (2 months ago) was 87 (range: 79-115).
> 
> Btw, you know that supposed "parathyroid adenoma" that was found on my US? Well, it turns out that the 2 things that they look for parathyroid function and adenomas are "normal", not high at all. My PTH was 28 (range 10-65) and my calcium was 9.4 (8.3-10.8). It makes me wonder what they saw in the ultrasound...
> 
> Thanks again for your input, Andros. :hugs:


That makes me wonder as well. Do remember, ultra-sounds are only as good as the operator. You might wish to request another one w/ a different technician.

Get some cinnamon. I love it in chocolate yoplait' yogurt, unsweetened apple sauce, cooked oats if you eat that. Just put a heaping tableware tsp. each day. Once a day.


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## Zugora (Feb 14, 2010)

Haha. Yes, good point about the U/S reading.

I've heard that cinnamon is known to reduce blood pressure. Mine is already on the low side (average about 90/55 or so - sometimes in the 80s for top number), so I'm reluctant to take anything that may make it lower. I do hear wonderful things about it, though for PCOS-ers and diabetics.


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## Andros (Aug 26, 2009)

Zugora said:


> Haha. Yes, good point about the U/S reading.
> 
> I've heard that cinnamon is known to reduce blood pressure. Mine is already on the low side (average about 90/55 or so - sometimes in the 80s for top number), so I'm reluctant to take anything that may make it lower. I do hear wonderful things about it, though for PCOS-ers and diabetics.


Well, that won't work then will it? Drats!


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## Zugora (Feb 14, 2010)

Removed my message here to post under a different thread.


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