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Blood work results for Thyroid
hello,
I am a 49 year old female, post menopausal (1 year) , pre hypertension, pre diabetic, and obese. I have never and nor am not on thyroid meds, I have not been ill or in the hospital, haven't had any radioactive testing, corticosteroids or any other medications that would effect thyroid. Back in 2013 my TSH was 0.01 (range, same as below). Prior years TSH tests where all within normal range. I have had problems with anxiety and depression off and on my whole life and fatigue that waxes and wanes. Recent life events are death of a loved one and loss of one of my part time jobs which has made me lose my health insurance to boot. So major stressful life events happening...now this.
Test results from 9/7/15
Test My result Range
TSH: 600
Thyroid Stimulationg Immunoglogin: dont' have an exact value, was only told that: "they are there, but not significantly high.
I went to my family doctor a month ago just for a check up and complained that I am suffering from fatigue, difficulty concentrating when I'm tired, anxiety and increase in depression (which could be related to life events) and my hair has thinned a lot over the past year or 2. I understand that all these symptoms could have many causes and I could have more then one, and in fact, I could have several disorders at the same time.
My family doctor ordered other blood work including a CBC, levels all within normal range, and a TSH test in July results: <0.005 (same range as above) and referred me to an endocrinologist who ordered the tests I listed above with their results.
I am scheduled for a Nuclear Medicine Thyroid Uptake and Scan for next week. My understanding is that this test is needed to see how the thyroid is functioning and to see if I have any nodules, or inflamation of the thyroid. And depending on what that shows will discuss what my treatment options are. Mentioned treats where methimazole, Radioactive Iodine Ablation, and Thyroidectomy.
It's all pretty scary and confusing stuff. Any input from anyone would help.
Thank you.
I am a 49 year old female, post menopausal (1 year) , pre hypertension, pre diabetic, and obese. I have never and nor am not on thyroid meds, I have not been ill or in the hospital, haven't had any radioactive testing, corticosteroids or any other medications that would effect thyroid. Back in 2013 my TSH was 0.01 (range, same as below). Prior years TSH tests where all within normal range. I have had problems with anxiety and depression off and on my whole life and fatigue that waxes and wanes. Recent life events are death of a loved one and loss of one of my part time jobs which has made me lose my health insurance to boot. So major stressful life events happening...now this.
Test results from 9/7/15
Test My result Range
TSH: 600
Thyroid Stimulationg Immunoglogin: dont' have an exact value, was only told that: "they are there, but not significantly high.
I went to my family doctor a month ago just for a check up and complained that I am suffering from fatigue, difficulty concentrating when I'm tired, anxiety and increase in depression (which could be related to life events) and my hair has thinned a lot over the past year or 2. I understand that all these symptoms could have many causes and I could have more then one, and in fact, I could have several disorders at the same time.
My family doctor ordered other blood work including a CBC, levels all within normal range, and a TSH test in July results: <0.005 (same range as above) and referred me to an endocrinologist who ordered the tests I listed above with their results.
I am scheduled for a Nuclear Medicine Thyroid Uptake and Scan for next week. My understanding is that this test is needed to see how the thyroid is functioning and to see if I have any nodules, or inflamation of the thyroid. And depending on what that shows will discuss what my treatment options are. Mentioned treats where methimazole, Radioactive Iodine Ablation, and Thyroidectomy.
It's all pretty scary and confusing stuff. Any input from anyone would help.
Thank you.
COMMUNITY LEADER
I'll try to explain a little better... Graves Disease is "always" associated with hyperthyroidism and most of the time, it has to be treated with anti-thyroid medications like methimazole or PTU that keep the thyroid from producing too much thyroid hormones. If your thyroid produces too much thyroid hormones, you can go into thyroid storm, which is a life-threatening condition and should be avoided at all costs. If medications don't work, RAI or thyroidectomy is often recommended; RAI "kills off" the thyroid, so it can't produce hormones at all, which leaves you with hypothyroidism and you will be dependent on replacement thyroid hormones for the rest of your life. Thyroidectomy also leaves you hypo, because you won't have a thyroid, so of course, there's nothing to produce the hormones you need and we can't live without them...
Hashimoto's is associated with hypothyroidism, except in the early stages, it's often characterized by periods of hyperthyroidism and one can swing back and forth from hyper to hypo without warning, so even though you're hyper now, you could swing to hypo at any time.
Even if one starts out being hyper with Hashimoto's, ultimately, they will end up hypo, because the antibodies, eventually, destroy the thyroid so it can no longer produce the hormones we need to live.
I don't "control" my Hashimoto's... there's really nothing you can do for the Hashimoto's, itself... you might be able to lower antibody counts, etc but simply lowering them, doesn't really do a lot because it's not known how many it takes to destroy the thyroid... For instance, your TPOab is 600, so if you were to lower that count by half, you'd still have 300 left, which is still way more than the reference range, so you'd still be left with Hashimoto's! Once you have an autoimmune disease, you always have it, even if the antibodies go into remission.
Nearly everyone with Hashimoto's ends up on replacement thyroid medications to control the resulting hypothyroidism, at some point in their life... it may take many years, but it will usually happen. So you don't really control the Hashimoto's, you control the resulting hypothyroidism...
The antibodies have completely destroyed my thyroid and it produces nothing, so I take 2 medications; one is Levoxyl, which is a T4 med and the other is Liothyroinine, which is a T3 med. I have regular thyroid blood work to make sure my levels are where I need them and get regular ultrasounds to make sure the nodules on my thyroid are not changing in size or characteristics.
Hashimoto's is associated with hypothyroidism, except in the early stages, it's often characterized by periods of hyperthyroidism and one can swing back and forth from hyper to hypo without warning, so even though you're hyper now, you could swing to hypo at any time.
Even if one starts out being hyper with Hashimoto's, ultimately, they will end up hypo, because the antibodies, eventually, destroy the thyroid so it can no longer produce the hormones we need to live.
I don't "control" my Hashimoto's... there's really nothing you can do for the Hashimoto's, itself... you might be able to lower antibody counts, etc but simply lowering them, doesn't really do a lot because it's not known how many it takes to destroy the thyroid... For instance, your TPOab is 600, so if you were to lower that count by half, you'd still have 300 left, which is still way more than the reference range, so you'd still be left with Hashimoto's! Once you have an autoimmune disease, you always have it, even if the antibodies go into remission.
Nearly everyone with Hashimoto's ends up on replacement thyroid medications to control the resulting hypothyroidism, at some point in their life... it may take many years, but it will usually happen. So you don't really control the Hashimoto's, you control the resulting hypothyroidism...
The antibodies have completely destroyed my thyroid and it produces nothing, so I take 2 medications; one is Levoxyl, which is a T4 med and the other is Liothyroinine, which is a T3 med. I have regular thyroid blood work to make sure my levels are where I need them and get regular ultrasounds to make sure the nodules on my thyroid are not changing in size or characteristics.
Interesting that one can have both graves and hashimoto's with one being dominant at any give time. and nodules and inflammation all at the same time. that would be a good question to ask my doctor. Here I'm trying to figure out which ONE thing I have and now finding out that I could have ALL of those things at once. Great.
why do you say that I am headed in the direction of being HYPO? Do you mean that if I do not get treatment for my HYPER that I have now that my thyroid will naturally go HYPO at some point all on it's own without treatment? If so, why would it do that?
I'll ask my doctor about what my TSI results mean, since your saying that if it's not within a certain level then it's considered to be negative for Grave's disease, that's another good question to ask.
I was just hoping that i wouldn't have to get any treatment at all....still am. I'll have to wait to see what the scan results are, I am going to get it done Thursday. Then will wait to hear the results sometime next week maybe. I'm trying to be patient and not call my doctor and ask him about the TSI results cause it sounds to me that's pointless right now since the scan still has to be done to see what's going on with the thyroid itself, if there are nodules, etc.
How is your Hashimoto's controlled? do you need to take medication? Or do you just have to get the ultrasounds to keep a check on things?
why do you say that I am headed in the direction of being HYPO? Do you mean that if I do not get treatment for my HYPER that I have now that my thyroid will naturally go HYPO at some point all on it's own without treatment? If so, why would it do that?
I'll ask my doctor about what my TSI results mean, since your saying that if it's not within a certain level then it's considered to be negative for Grave's disease, that's another good question to ask.
I was just hoping that i wouldn't have to get any treatment at all....still am. I'll have to wait to see what the scan results are, I am going to get it done Thursday. Then will wait to hear the results sometime next week maybe. I'm trying to be patient and not call my doctor and ask him about the TSI results cause it sounds to me that's pointless right now since the scan still has to be done to see what's going on with the thyroid itself, if there are nodules, etc.
How is your Hashimoto's controlled? do you need to take medication? Or do you just have to get the ultrasounds to keep a check on things?
COMMUNITY LEADER
The website doesn't always accept the (greater than) signs when posting lab results, but I haven't had an issue with it for a long time, so I didn't know it was still doing that.
Your labs do look hyper, but as I said, the TSI is the definitive test for Graves and if that's not at a certain level (it's a percentage - something like 142%), it's considered to be negative, though antibodies are antibodies and I kind of figure you shouldn't have any...
That said, your TPOab, at > 600 would be confirmation of Hashimoto's and as noted, it's common to have periods of hyperthyroidism in the beginning stages. Some people have, both, Graves and Hashimoto's, with one or the other being dominant at any given time, but again, if your TSI is not elevated, that would rule out Graves.
You will probably be prescribed methimazole (or a similar anti-thyroid med) for the time being, until your labs turn hypo, unless your doctor advises RAI or thyroidectomy, either of which will leave you permanently hypo, which is the direction you're headed anyway - you'll simply get there more quickly.
Since, both, Hashimoto's and Graves Disease are autoimmune, nodules and inflammation are common, but most are nothing to worry about, unless they're very large or have unusual characteristics. I have Hashimoto's and have multiple nodules; we do an ultrasound a couple of times/year to make sure their characteristics aren't changing.
Your labs do look hyper, but as I said, the TSI is the definitive test for Graves and if that's not at a certain level (it's a percentage - something like 142%), it's considered to be negative, though antibodies are antibodies and I kind of figure you shouldn't have any...
That said, your TPOab, at > 600 would be confirmation of Hashimoto's and as noted, it's common to have periods of hyperthyroidism in the beginning stages. Some people have, both, Graves and Hashimoto's, with one or the other being dominant at any given time, but again, if your TSI is not elevated, that would rule out Graves.
You will probably be prescribed methimazole (or a similar anti-thyroid med) for the time being, until your labs turn hypo, unless your doctor advises RAI or thyroidectomy, either of which will leave you permanently hypo, which is the direction you're headed anyway - you'll simply get there more quickly.
Since, both, Hashimoto's and Graves Disease are autoimmune, nodules and inflammation are common, but most are nothing to worry about, unless they're very large or have unusual characteristics. I have Hashimoto's and have multiple nodules; we do an ultrasound a couple of times/year to make sure their characteristics aren't changing.
for some reason this website is not keeping the info about my test results. I do not understand this at all. Serious malfunctioning website.
So i'll try it again.
TSH is less then 0.005 range is 0.450-4.500, Free T4 is 1.85 range is 0.82-1.77, T3 is 167 range is 71-180, Free T3 is 4.7 range is 2.0-4.4, TPO is greater then 600, TSI, no number given but was told not significantly high.
So i'll try it again.
TSH is less then 0.005 range is 0.450-4.500, Free T4 is 1.85 range is 0.82-1.77, T3 is 167 range is 71-180, Free T3 is 4.7 range is 2.0-4.4, TPO is greater then 600, TSI, no number given but was told not significantly high.
Thank you for your reply Barb135. When I started reading your reply I started to realize something was wrong and I looked back at my post and I realized that not only had all the test results that I entered were missing from my post, but the ones that remained where not 100% accurate. I don't understand what happened because I did proofread my post 2x's before I hit the Post a Comment button. Ugghhh! So I will try this again.
My test results from 9/7/15 are:
TSH: 600 (range 0-34), and the Thyroid stimulating immunoglobulin Antibodies (TSI), is the only one that I do not have the exact number for (because my Endo Doc gave me these results over the phone) when he gave me this result he said: "the TSI ones are there, they are not significantly high, but they are still present".
My doctor has what is called a patient portal where you can sign in and look at your actual blood work results from the lab online and all the results are listed there EXCEPT the TSI results are NOT, which I do not understand why they aren't, but I plan on calling his office on Monday to find out, if I can, what that result is and what the range is. Again, at this point I only know that he said the TSI are present, not significantly high. But maybe it doesn't matter at this point in time and can wait till later for that as he said they're not significantly high.
As for the TgAb that you mention in your post-that was NOT ordered. I did ask him about that when I went for my first visit with him, I had researched online what further tests should be done when a patient has a TSH result of <0.005 and a TgAb was one of the tests that I saw was mentioned along with the T4, Free T3, T3, TPO and TSI and of course, a repeat of the TSH in what I read online, and I can't remember why he said that wasn't needed,I'd have to review my notes.
Upshot was that because of the blood work results showing I was hyper thyroid, my Endo said that the next step I needed to take was to get the Nuclear Medicine Scan and Uptake done to see what that showed, so that as he put it "this test can actually tell me which way we are heading". What ever that means...again... I was kinda of stunned by hearing the TPO was so high...I wasn't able to really think too well after that and didn't ask him exactly what that meant.
His info. about treatment types where made at my first visit, I assume due to the fact that I had an undectable level of TSH (<0.005, in July 2015 that I got after I saw my Family Doctor, and in 2013 TSH was 0.01.
I'm very stressed out at the idea of having any of the treatments he described. I do not have any clinical symptoms of Hyper thyroidism, no racing heart, no tremors, no insomnia, or anything, other then a worsening of my anxiety over the past few yearsy but I attribute that to worsening of life circumstances, grief and stress.
Now that you have all the complete and correct blood work test done/results...your thoughts?
Again. thank you.
My test results from 9/7/15 are:
TSH: 600 (range 0-34), and the Thyroid stimulating immunoglobulin Antibodies (TSI), is the only one that I do not have the exact number for (because my Endo Doc gave me these results over the phone) when he gave me this result he said: "the TSI ones are there, they are not significantly high, but they are still present".
My doctor has what is called a patient portal where you can sign in and look at your actual blood work results from the lab online and all the results are listed there EXCEPT the TSI results are NOT, which I do not understand why they aren't, but I plan on calling his office on Monday to find out, if I can, what that result is and what the range is. Again, at this point I only know that he said the TSI are present, not significantly high. But maybe it doesn't matter at this point in time and can wait till later for that as he said they're not significantly high.
As for the TgAb that you mention in your post-that was NOT ordered. I did ask him about that when I went for my first visit with him, I had researched online what further tests should be done when a patient has a TSH result of <0.005 and a TgAb was one of the tests that I saw was mentioned along with the T4, Free T3, T3, TPO and TSI and of course, a repeat of the TSH in what I read online, and I can't remember why he said that wasn't needed,I'd have to review my notes.
Upshot was that because of the blood work results showing I was hyper thyroid, my Endo said that the next step I needed to take was to get the Nuclear Medicine Scan and Uptake done to see what that showed, so that as he put it "this test can actually tell me which way we are heading". What ever that means...again... I was kinda of stunned by hearing the TPO was so high...I wasn't able to really think too well after that and didn't ask him exactly what that meant.
His info. about treatment types where made at my first visit, I assume due to the fact that I had an undectable level of TSH (<0.005, in July 2015 that I got after I saw my Family Doctor, and in 2013 TSH was 0.01.
I'm very stressed out at the idea of having any of the treatments he described. I do not have any clinical symptoms of Hyper thyroidism, no racing heart, no tremors, no insomnia, or anything, other then a worsening of my anxiety over the past few yearsy but I attribute that to worsening of life circumstances, grief and stress.
Now that you have all the complete and correct blood work test done/results...your thoughts?
Again. thank you.
COMMUNITY LEADER
Your really need some more blood tests, because some of the most important ones were left out...
Thyroid Stimulating Immunoglobulin is the definitive test for Graves Disease, which would be the first thought for someone with a TSH of < 0.005, since a low TSH, typically, indicates high thyroid hormone levels. However, since your TSH is now at 600, I'd have to suspect Hashimoto's instead, since it's very common for one to swing from hyper to hypo in the early stages of Hashimoto's. Those tests are Thyroid Peroxidase Antibodies (TPOab) and Thyroglobulin Antibodies (TgAb)... you need them both, since they are both markers for Hashimoto's.
All of that said, even more important than the antibody tests are the actual thyroid function tests, Free T3 and Free T4. Those are the actual thyroid hormones, with Free T3 being the one that's used by every cell in the body. I'm totally amazed that any doctor would be talking about prescribing methimazole, doing RAI, or thyroidectomy without even doing those tests to find out exactly what's going on.
One thing is pretty sure, with a TSH of 600, you're not likely to be needing methimazole. Typcially, when TSH is very high, actual thyroid hormone levels will be very low (or low normal) and when TSH is very low, thyroid hormone levels will be very high (or high normal). An exception is when one has secondary hypothyroidism, both TSH and thyroid hormones will be low or low normal... that's why Free T3 and Free T4 are so important.
Thyroid Stimulating Immunoglobulin is the definitive test for Graves Disease, which would be the first thought for someone with a TSH of < 0.005, since a low TSH, typically, indicates high thyroid hormone levels. However, since your TSH is now at 600, I'd have to suspect Hashimoto's instead, since it's very common for one to swing from hyper to hypo in the early stages of Hashimoto's. Those tests are Thyroid Peroxidase Antibodies (TPOab) and Thyroglobulin Antibodies (TgAb)... you need them both, since they are both markers for Hashimoto's.
All of that said, even more important than the antibody tests are the actual thyroid function tests, Free T3 and Free T4. Those are the actual thyroid hormones, with Free T3 being the one that's used by every cell in the body. I'm totally amazed that any doctor would be talking about prescribing methimazole, doing RAI, or thyroidectomy without even doing those tests to find out exactly what's going on.
One thing is pretty sure, with a TSH of 600, you're not likely to be needing methimazole. Typcially, when TSH is very high, actual thyroid hormone levels will be very low (or low normal) and when TSH is very low, thyroid hormone levels will be very high (or high normal). An exception is when one has secondary hypothyroidism, both TSH and thyroid hormones will be low or low normal... that's why Free T3 and Free T4 are so important.
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