General Medicine

» alibaba25 - understanding test results

Hi, I really need some help with understanding some lab test results. I have suffered from fatigue for a number of years sometimes to the point that I can barely function. Over many years I have been told I am a mystery, one Dr said my thyroid was enlarged and ordered a TFT, It came back normal, no further tests were done and I returned to my struggling life.
To cut a long story short I have Hashimoto's thyroiditis, diagnosed after having subclinical hypo lab test of 5.5 (although within range for the lab)I insisted on a ultrasound, which showed diffuse thyroiditis,I have pushed to see an endocrinologist whom said he would treat me with Levothyroxin for a trial of three months due to my symptoms. I had a blood test before starting treatment as follows. TSH 7.8 T4 14.2, Thyroid peroxidase 189, total protein 79, Albumin 49, Globulins 30, Creatinin 62. some others that were neg.
I have now been on thyroxin for 6weeks and have been to have a blood test today to check to see how im doing.
My question is I have no idea what all the tests mean could you shed some light? as I am so cofused I am supposed to be hypo but why are my T4 levels on the higher end? Could you also explain why I might have high Total protein and Albumin and low? creatinin or would you say these levels are ok. I had some episodes of energy bursts about 3months ago,(although now have gone) I have lost about half the weight of what I gained) but still have weight gain episodes very briefly and then equally briefly I will loose it. I now felt worse that ever for about 8weeks. Help! from Ali

-- posted by alibaba25

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» 2late4bed - understanding test results

In response to understanding test results posted by alibaba25:

Hello, I have been diagnosed with hypothyroidism since the age of 11 years old. I went from a very skinny energetic normal kid to a very fat, sleeping almost nonstop kid almost overnight. My skin was cracked like alligator skin, hair dry with horrible large flaking scalp dandruff that wouldn't stop. I talked very slow and moved very slow. I was always cold and barely ate anything at all. My mouth was very dry and I had no saliva. I, too, have Hashimoto's as does my sister who developed the disease much later in life. My mother had a goiter removed when she was pregnant with me and seemed in every respect from common symptoms to be "hyper-thyroid" even after surgery. I am now 41 years old and have been researching everthing I possibly can about thyroid disease due to the fact that I am having increasing symptoms--new ones that I never suspected of contributing to my thyroid condition. My advice to you is to please, please get off of the levothyroxin medication. You will never feel well or completely alleviate your symptoms with this medication and this is why.....Levothyroxine is only a T4 medication. It is replacing your T4 hormone ONLY, which is probably why your T4 level is high. The active hormone which is the only one that gives you energy and is used for all bodily functions is T3. Most Hashimoto sufferers are very low in the T3 hormone which is not supplied by levothyroxine. The idea behind treating hypothyroidism with T4 only medication is the fact that T4 is normally converted into T3. A small amount of T3 is actually produced by your thyroid but mostly it is converted from T4. Well, the majority of Hashimoto sufferers have difficulty converting T4 into T3. The lack of T3 is what produces all of your symptoms in the first place, not the lack of T4 or the overproduction of TSH. There are drugs available that supply T4 and T3 hormones. The lab tests that are most important to you now that you know you have antibodies are the "free T4 and free T3" levels. The free T3 and free T4 levels should be above the middle range. It does not matter is the levels fall into the so called "normal" lab values range--your symptoms will not go away and you will not feel healthy until they are in the upper half of the range. I was started on Thyrolar when I was 11 years old and the difference was amazing. I grew 4 inches and lost ALL of the weight I had gained very quickly. I started talking much faster and all of my symptoms disappeared. I remained "healthy" until I moved and went to a new doctor that I didn't like and he insisted that Thyrolar was for kids and Synthroid (brand name for levothyroxine) was for adults---that is so not true! Synthroid is a T4 only drug and thyrolar was a T4 and T3 combo drug. I noticed the difference right away but didn't know what to do as I would never argue with the Doctor...after all, he's the Doctor, right?? Well, many years later and many, many dosage increases due to symptoms and very, very high TSH levels, I have finally begun educating myself as much as possible and I am shocked at all of the things I am experiencing that I continued to rationalize was either old age or some other problem but never suspected my thyroid....such as difficulty swallowing--a very distinct feeling that something is stuck in my throat. Joint pain--excruciating pain in my hands, hips, knees, ankles....like I'm 80 years old or something. Feeling like I've taken about 5 sleeping pills every afternoon to the point that I fall asleep sitting up sometimes. Normal cardio workouts after only a few minutes send my heart rate over 200 bpm and I can't breathe and I can't recover for 15 or 20 minutes--not the usual "that got my heart pumping" reaction after exercise---I'm saying literally thinking I was going to pass out from my heart beating out of my chest and can't breath for several minutes afterward. I have never been a stranger to long strenuous exercise routines but in the last few months it actually makes me ill. I have always been very health conscious and follow a very healthy diet--this is not normal. PLEASE....you can find some very, very important information that will explain everything you need to know at www.stopthethyroidmadness.com. It is a wonderful website that supports sufferers. There are also a number of very helpful books available. Patient advocate Mary Shoman has written several books on the subject and has a very good website at www.thyroid-info.com and at www.about.com under the search "thyroid". I hope this helps. Good luck!

-- posted by 2late4bed

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» Elaine Moore - understanding test results

In response to understanding test results posted by alibaba25:
Hi Ali,
The new range for TSH ids 0.3-3.03, but, unfortunately, many labs are using the old ranges that the manufacturer of the reagents set up years ago. The hope is that the endos will know how to interpret the results.
Total T4 measures thyroid hormone that's linked to protein molecules. This form of thyroid hormone is inactive. The results are high if thyroid hormone is high or if binding protein levels are high. Estrogens in women cause an increase in these proteins so levels are often falsely increased in women.
The test you should have is a free T4 (FT4) test. FT4 directly measures the amount of free active available thyroxine in your blood circulation. You should also have a free T3 (FT3) before starting meds. Most people with mild hypothyroidism only need thyroxine, but nearly everyone with severe hypothyroidism (atrophic or RAI-induced hypothyroidism or longstanding hypothyroidism) can be deficient in FT3. However, because our bodies require freshly converted T3 from T4 in the brain, pituitary and in skeletal muscle, levothyroxine is the major hormone needed. Note FT4 and FT3 are measured in different units, rather like pounds for FT4 and ounces for FT3.

The protein and albumin levels are influenced by diet as well as metabolic functions, and you may have had more dietary protein than usual when you had your test. Creatinine is a breakdown product of protein and it's elevated when the kidneys aren't functioning properly. A low creatinine is usually a good thing.
In hypothyroidism you can have some transient periods of hyperthyroidism as dying cells release thyroid hormone.
If you've been hypothyroid for a long time without treatment, you might have some adrenal insufficiency. When you have both hypothyroidism and adrenal insufficiency and only treat the hypothyroidism, the adrenal insufficiency can worsen. It would be good to have a cortisol level and a test for adrenal antibodies. You might also want to read some of the articles on adrenal insufficiency that I've written. best, Elaine

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» alibaba25 - understanding test results

In response to understanding test results posted by daisyelaine:

Hi, thankyou for your response, it's good to have some information to help me understand. I have had a ACTH (syacthen) test, would this have ruled out adrenal problems?
I am having problems with areas of my skin feeling sensitive like burning, especially around my left eye lid and cheek, although I get it in other areas at times. My eyes are very dry and sometimes gritty feeling and I have problems opening my eyes the reaction is slowed slightly so when I blink it take slightly longer to open, mostly in my left eye but does happen in both, my left eye has a drooping eyelid. Would this be associated with the thyroid or should I seek further help with this? Any suggestions appreciated Thankyou Ali

-- posted by alibaba25

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» alibaba25 - understanding test results

In response to understanding test results posted by 2late4bed:

Hi, thankyou for your information I will research this area.
Just had reslts back for the halfway trial stage my TSH have gone down and is now 1.5, feeling a bit better but still have some problems (please read latest post) can you shed some light on these symptoms)My endocrinologist wont test T4 unless your TSH is abnormal, and never tests T3, (This could be a problem when managing my disease)
Hope to hear back. Ali

-- posted by alibaba25

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» Elaine Moore - understanding test results

In response to understanding test results posted by alibaba25:
Hi,
The ACTH helps rule out adrenal deficiency. It's sort of like TSH in that it indirectly measures what's going on. If your adrenal glands aren't producing enough cortisol, more ACTH is produced to help stimulate cortisol production.
The eye symptoms you mention can be from thyroid eye disease. TED can cause dryness and it can cause drooping.
I'd see an ophthalmologist for an evaluation. This will give you some baseline measurements, a diagnosis and treatment if it's needed.
Here's an article I recently wrote on dry eye syndrome that mentions other causes of dry eye. autoimmunedisease.suite101.com/article.cfm/dry_eye_syndrome

Here's an article I wrote on thyroid eye disease
autoimmunedisease.suite101.com/blog.cfm/thyroid_eye_disease

Best, Elaine

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» Elaine Moore - understanding test results

In response to understanding test results posted by alibaba25:
Hi,
TSH can be very misleading in Graves' disease. It's usually always falsely decreased by the stimulating TSH receptor antibodies seen in Graves' disease. It can be falsely decreased in hypothyroidism as well due to blocking TSH receptor antibodies. Best, Elaine

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