Aa
Questions about lab work
I recently had full range of labs drawn but specifically looking for for thyroid disease . I told my doctor that I was flipping between hyper and hypo symptoms ... I do have a multinodular goiter...that has not been evaluated in many years .. last FNA showed INCONCLUSIVE...... currently have hoarseness and swollen thyroid .... blood work results ... I will only list thyroid and anything that flagged not normal......
Serology/immunology
ANA Direct- NEGATIVE
TSH-0.493(0.450-4.50)
T4 Free Direct 1.66 (0.82-177)
TPOab 44 (0-34)
TSI 42 (0-139)
T3---/ NOT TESTED
Lymphs (absolute) 3.7. (0.7-3.1)
Hemoglobin A1C 5.9 (4.8-5.6)
My doctor told me that because the ANA Direct showed NEGATIVE that means I have no autoimmune disease and therefore the test of TPOab shouldn't matter because I do not have hashimotos or hypothyroidism... in order to have hypo the TSH ( SHOULD) be extremely elevated and mine is not.... in Dec of 16 he tested my TSH and it was .041 with same range as above... so it has risen over the past year but still low...... I thought if you did not have hashimotos you would have a 0 result on the TPOAB.....yet mine shows 44 which is high .... he still insist the thyroid is NORMAL and has said that no other testing needs to be done .and to not put so much emphasis on the TPOab value...... in the meantime I am still gaining weight increasing fatigue, skin that feels leathery increasing severe constipation even with the use of natural laxatives....and yet still having symptoms of hyper as well i.e. Tremors... sweats... increase in neuropathic pain.... all other results on my lab panels were within normal range but almost everything was high normal ... like within 1/10th of being flagged high .... what would you think the diagnosis should be just based on the thyroid tests?? I know other tests should be run to get the full picture but this is what I've got to work with right now.... I go back on the 5th and would like to have any information in my arsenal to make him investigate more!! I have awesome insurance and a secondary policy so it's not a thing of not having enough insurance or money as to why he won't do full testing ... can nodules cause havoc with the lab work and cause concern to be further evaluated?? I.e. Ultrasound or FNA? Changing doctors is not an option at this point for me ... any info that I can take him to show that the labs are not optimal for me since I have a Miriad of symptoms ?? Thanks for all you do and the information you provide is invaluable!!
Serology/immunology
ANA Direct- NEGATIVE
TSH-0.493(0.450-4.50)
T4 Free Direct 1.66 (0.82-177)
TPOab 44 (0-34)
TSI 42 (0-139)
T3---/ NOT TESTED
Lymphs (absolute) 3.7. (0.7-3.1)
Hemoglobin A1C 5.9 (4.8-5.6)
My doctor told me that because the ANA Direct showed NEGATIVE that means I have no autoimmune disease and therefore the test of TPOab shouldn't matter because I do not have hashimotos or hypothyroidism... in order to have hypo the TSH ( SHOULD) be extremely elevated and mine is not.... in Dec of 16 he tested my TSH and it was .041 with same range as above... so it has risen over the past year but still low...... I thought if you did not have hashimotos you would have a 0 result on the TPOAB.....yet mine shows 44 which is high .... he still insist the thyroid is NORMAL and has said that no other testing needs to be done .and to not put so much emphasis on the TPOab value...... in the meantime I am still gaining weight increasing fatigue, skin that feels leathery increasing severe constipation even with the use of natural laxatives....and yet still having symptoms of hyper as well i.e. Tremors... sweats... increase in neuropathic pain.... all other results on my lab panels were within normal range but almost everything was high normal ... like within 1/10th of being flagged high .... what would you think the diagnosis should be just based on the thyroid tests?? I know other tests should be run to get the full picture but this is what I've got to work with right now.... I go back on the 5th and would like to have any information in my arsenal to make him investigate more!! I have awesome insurance and a secondary policy so it's not a thing of not having enough insurance or money as to why he won't do full testing ... can nodules cause havoc with the lab work and cause concern to be further evaluated?? I.e. Ultrasound or FNA? Changing doctors is not an option at this point for me ... any info that I can take him to show that the labs are not optimal for me since I have a Miriad of symptoms ?? Thanks for all you do and the information you provide is invaluable!!
COMMUNITY LEADER
You already have a thread started that includes these same lab values and most of this information. gimel has already given you some very valuable information and has addressed some of your questions.
Negative ANA does not guarantee that you don't have an autoimmune condition, such as Hashimoto's, as you do have elevated TPOab.
Your Free T4 is high, at 88% of range, indicating hyper, not hypo. I've read that TSI should be 0 if one doesn't have Graves Disease, so you could have Graves Disease, be in a hyper phase of Hashimoto's or have nodules as gimel suggested in your other thread.
Your A1c is elevated, indicating pre-diabetes/insulin resistance or diabetes... this could account for the weight gain, neuropathic pain and some of the other symptoms.
Negative ANA does not guarantee that you don't have an autoimmune condition, such as Hashimoto's, as you do have elevated TPOab.
Your Free T4 is high, at 88% of range, indicating hyper, not hypo. I've read that TSI should be 0 if one doesn't have Graves Disease, so you could have Graves Disease, be in a hyper phase of Hashimoto's or have nodules as gimel suggested in your other thread.
Your A1c is elevated, indicating pre-diabetes/insulin resistance or diabetes... this could account for the weight gain, neuropathic pain and some of the other symptoms.
2 Comments
I do sincerely apologize.. my mistake as I thought I was on another forum... again please forgive me and I will delete this post... really and honestly didn't mean or try to cause any problems
No harm done and there's nothing to forgive; I was just pointing out that gimel has already answered some of your questions. You can't delete your own posts and there's not reason to try.
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