Abnormal Blood Test Results

[Helana12]

Hi,

I recently had blood work done and some of the results are out of range. I also had a thyroid ultrasound and the results indicated that I have mild diffuse hypervascularity in both lobes. Can someone please help me interpret these results?

Neutrophils (auto): 46.4 (Normal Range = 48 to 76): Out of Range
Lymphs (auto): 32.1 (Normal Range = 18 to 41)
Monos (auto): 11.2 (Normal Range = 4.0 to 11.0): Out of Range
Eos (auto): 9.8 (Normal Range = 0 to 5): Out of Range
Eos# (auto): 0.55 (Normal Range = 0 to 0.35): Out of Range
HCT: 35.3 (Normal Range = 36 to 48): Out of Range
Hgb: 11.3 (Normal Range = 11.5 to 16.4): Out of Range
WBC: 5.60 (Normal Range = 4 to 10)
MCH: 27.8 (Normal Range = 27-32): Out of Range

ANA titer: 0 (Normal Range = 0.0 to 0.0)
ANA HEP2 (Pattern): 0 (Normal Range = 0.0 to 0.0)
Anion Gap: 10 (Normal Range = 5 to 17)

Ferritin: 8 (Normal Range = 10 to 170): Out of Range
Iron: 50 (Normal Range = 37 to 158)
Hypochromia: PRESENT

FT4: 1.2 (Normal Range = 0.9 to 1.7)
TSH: 3.83 (Normal Range = 0.5 to 5.7)
T3: 128 (Normal Range = 80 to 200)
Thyroglobulin Ab (low ref range 1.8-2.0 IU/mL): 84 (Normal Range = 0.0 to 19.0): Out of Range
TPO Ab: 422.0 (Normal Range = 0.0-33.9): Out of Range

[Helana12]

Thank you for your help

[amealer]

In cases of positive thyroid autoantibodies but a normal TSH, you should be followed up periodically - every 6-12 months - to monitor for symptoms of hypothyroidism and to detect any rise in TSH or cholesterol levels.  Treatment (with Levothyroxine (or Synthroid)) is indicated if the TSH level continues to rise, even if the level is at the upper limit of the reference range.  I think you could easily fit the picture of Hashimoto's thyroiditis.  You have a history of hyperthyroidism in the past, but also have constitutional symptoms of subclinical hypothyroidism - dark circles under eyes, dry skin.

I would suggest having your doctor repeat the thyroid labs in 6 months.  At that time, your levels might be such as to warrant treatment with Synthroid, which would help those symptoms.

[Helana12]

Thank you so much for your help. I've looked at pictures of periorbital myxedema I think I have a mild case of it. Is there some way to fix this condition? I hate the way it makes my face look :(.

Here are some additional lab results:
IGE serum: 254 iu/ml (out of range)
platelet: 176 k/ul (normal)
M.C.V.: 85 fl (normal)

[amealer]

In another post you mentioned dark circles under your eyes, dry skin, palpitations, memory and attention problems.  All of these can be seen in Hashimoto's thyroiditis.  In Graves disease, you get exophthalmos, where your eyes look like they are bulging out.  But Hashimoto's, you get myxedema, which is really dark circles under your eyes.  Go look at pictures on the web of periorbital myxedema and see if that looks like you.  Hashimoto's can have hypothyroidism with periods of hyperthyroidism.  Hashimoto's also has thick, dry skin, palpitations, memory and attention problems, weight gain, depression, fatigue, muscle cramps, constipation, etc.

[amealer]

Bottom line : These labs indicate that you've been sick.

This could either be infectious or allergic.

These values might just indicate that you are recovering from an acute illness.

They also might indicate some form of thyroiditis.

The slightly elevated eosinophil count means that your body is mounting an allergic response to something (virus, bacteria, etc.).  The slightly elevated monocyte count also supports this.  You do not have an elevated white blood cell count as would be expected in an acute infection.  The slightly lower prealbumin with normal albumin and total protein supports this as well.  This means that your body is becoming slightly malnourished from the current infection/allergy, so it is starting to use its protein stores.  There is no evidence of chronic malnutrition, as the albumin and protein are normal.

You didn't report your platelet count or MCV.  There is a borderline anemia (just barely), and with the slightly lower MCH and hypochromia, it suggests a microcytic hypochromic anemia, which would have a low MCV value, and usually indicates an iron deficiency anemia.  Your ferritin (or body's iron stores) is slightly low, while the iron is within range.  All of this just means that your body is exhausting its iron stores and you need iron supplementation before you do develop iron deficiency anemia.

The normal TSH, FT4, and T3 in the presence of elevated thyorglobulin antibody and highly elevated thyroperoxidase antibody indicate that you are currently euthymic (thyroid is functioning normal), but that you have mounted an autoimmune response to the thyroid enzymes.  This does not necessarily mean that you have thyroid disease, as these can both be elevated during illnesses, during pregnancy, or postpartum.  But it could indicate some form of thyroiditis.

[Helana12]

Here are some additional results:
Albumin: 4.3 (Normal Range = 3.5 to 5.2)
Prealbumin: 16.0 (Normal Range = 20 to 40):  Out of Range
Total Protein: 7.2 (Normal Range = 6.4 to 8.3)