Question about Thyroid

[gatorfrog]

Hello Doctor,
My gastroenterologist thinks that I should go back to my PCP for blood work for my thyroid. I have a swollen something in my neck, back of my throat hurts when I eat and I am so fatigued.  I had blood work done in April and my TSH was 2.85.  The year before when I had blood work, it was 1.3

So my question is this:  Should I get more blood work done? Is there a concern? I don't have insurance so all the doctors and testing is really getting hard and I just want to do the right thing.  Other symptoms I have are bloating, feeling of fullness, urinary frequency.

Thanks for any help!

[gatorfrog]

Thank you Kate, for all your sincere help. It is such a blessing. I have been to so many doctors lately, that I just get tired of it all and trying to make decisions.  Naturally, everything happened AFTER I went off my Cobra insurance. But that is ok, I will get through it.  

Thanks for the information on the insurance - insurance is so confusing, but mine does have very nice people that answer when you call and they are always helpful, so I will check with them. Thank you!

Yes, the GI doctor considered GERD, we didn't completely rule that out yet, I am on medicine and we will see. She thought with the swelling in my neck and the fatigue, it should be checked out.

I hope you have a great weekend, thanks for taking the time to answer my post.

Colleen

[borninquisitive]

You are most welcome. I hope you are able to get down to the bottom of this soon and without being too much of a financial burden to you.

On the healthcheck site, a Q&A:

Will my insurance pay for this test?
HealthCheck does not accept insurance claims. However, some insurance plans will reimburse you if it is written in the plan as a preventive coverage with no doctor's script. Other insurance plans will reimburse you if you have a doctors written script. Call your insurance company's toll-free number to find out in advance.

If you plan to visit a doctor first, I would call your insurance ahead of time and ask if the Dr. wrote up orders for a thyroid antibodies (Thyroglobulin Antibodies a.k.a. TgAb and Thyroid Peroxidase Antibodies a.k.a. T.P.O.) labs, if you paid for them on your own, would they reimburse you the costs? Those tests are $70. If the discount code still works, it would be $63. plus $12. shipping.

You can try but...being the cynic that I am-I never hold on tightly to hope. ;-D Worth a shot.

Outside of thyroid (back of your throat hurting) -I know that post nasal drip can cause this kind of  irritation. No doubt, your G.I. doc considered and ruled out G.E.R.D. and L.P.R. (a form of GERD but "silent.")

Best wishes to you, gatorfrog!

~Kate

[Mark Lupo, M.D.]

The blood tests do not address the GI doc's concerns of a possibly enlarged thyroid.  I agree it is important to test the TSH in this process and yours appears fairly normal suggesting that the bloating/urinary symptoms, etc are not related.  Next step is thyroid ultrasound to assess thyroid size and presence of nodules.  Antibodies would also be of interest, but if cost is a concern would go with ultrasound first as it gives more important information at this stage of the evaluation.

[gatorfrog]

Thank you so much both of you for your excellent advice.  I have checked out the healthcheck site and yes, I have a lab near me that could do it.  I have what you called HSA insurance, it is a discounted plan; however, the discount is not great and not everyone takes this insurance, so you end up paying full price. So, I really appreciate this information on lab work. I will look into it as soon as I hear back from the doctor.  Thank you!!

[borninquisitive]

I am not familiar with pricing but I did get one glimpse: my mother had her TSH tested here and the costs was either $146. or $164. (can't remember which) and when I saw that...my jaw dropped.
On the healthcheck site- they only charge $37. What a huge difference! To think a non insured person is paying that much...for just a TSH test! 8-O

It's depressing to know that so many are un-insured. Even with insurance, I know how expensive it can be to have to foot the remaining bill.
I couldn't imagine...being un-insured, have a chronic condition or require immediate, medical attention etc.

I think such places as healthcheckusa serve as a very good thing and for a number of reasons. Hopefully this site will prove to be a cheaper alternative to her doctor's office lab charges.

~Kate

[Lake Lover]

Excellent advice!

All I want to add is that the TSH and FT3&4 cost total should be in the $85 range for all 3 tests which is a whole lot less than someone would pay walking into a doctors office.  The doctor can make a medical decision on what to do with the HealthcheckUSA tests as well.

[borninquisitive]

If you need bloodwork and beings that you don't have insurance, you might want to check out: http://www.healthcheckusa.com/ and see if their pricing is better. If so, you'll have to see if a lab is nearby you (click on their map) or that you'd be willing to drive to.

For thyroid tests:
Free T3/T4 & TSH:
http://www.healthcheckusa.com/lab_tests/Thyroid_Screenings/Thyroid_Panel_II

Just the TSH:
http://www.healthcheckusa.com/lab_tests/Thyroid_Screenings/TSH

Antibodies:
http://www.healthcheckusa.com/lab_tests/Thyroid_Screenings/Anti-Thyroid_Antibodies

and an all around good one that includes the Thyroid Panel II:
http://www.healthcheckusa.com/lab_tests/Combination_Panels/VIP_Plus_II

I do believe code 12345 is long-standing and takes 10% off your order. That said, shipping is about $12.

While on vacation south, I went this route (we don't have a lab here) I placed my order on a Friday evening and received my slip that following Monday. At which point, you can walk into the lab when you are ready.
They are fast to post results (to your online account if you create one) and they also send you your labs via snail mail.
To go this route, you do not need doctors orders.
I was sent to a "Lab One" (because I chose to have antibodies tested) which happens to be the same lab (a chain) then my doctor's office uses.

Good luck to you.
~Kate