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Old 09-20-2003, 06:21 PM   #1
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Question Here are some lab values

A friend and coworker of mine has been feeling very tired and just not right in genereal so she went to her pa and she ordered labs. What do you guys think of these values.

TSH 57.45 Norm .34-5.6

T3 (TBG corrected) 53 norm. 70-180

T4 free .21 norm .58-1.64

Her pa just wanted to put her on some meds but she opted to wait until she could get in to a endo which is on fri. we are hoping to get her a thyroid scan on tue or wen. She is a ultrasound tech so she took a peek at her thyroid last week. she has a couple nodules on the L that look hot and one on the right that looks cold because it has no blood flow. She has a strong fm hx of thyroid cancer. One sister and a aunt. What do you guys think I was looking through the thyroid solution but I could not find the spot with the lab values. Any help would be great. Thanks

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Old 09-20-2003, 07:13 PM   #2
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ehm looks hypo to me...tsh high ( i think you meant to write 5.745 cause 57 is way too much:P) ft4 too low
what about ft3 i guess it's too low too.
SHE HAS to take medication...better talk to a doc and see her options
as for the nodules how does she know she has cold or hot nodules???this needs a RAIU ...did she have a RAIU?
Hot or cold nodules have nothing to do with blood flow and cannot be diagnosed through and ultrasound scan.
She may have diagnosed those nodules with an ultrasound but she cannot say if they are hot or cold.

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Old 09-20-2003, 09:01 PM   #3
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We know she needs a thyroid scan Going to schedule one for next week. And the reason she thinks the one is cold is 99% of the cold nodules have no blood flow in a ultrasound. I double checked the lab values and it was printed as 57.45 for the tsh. I guess it could have been a error at the lab. They did not do a free T3 so I do not know about that one. I will keep you guys posted on the results of the scan next week.

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Old 09-20-2003, 09:15 PM   #4
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hmmm i ll try explain to you why cold nodules can have a normal or high blood flow.
let's say a cold nodule is a cancer because 99% of thyroid cancer is shown in RAIU as a cold nodule.
Malign tumors not only do they have a normal blood flow ...but a way for the docs to distinguish quickly a malign from a benign tumor is the high blood flow that is present in malign tumors.
So as a malign tumor this cold nodule not only doesnt have a low blood flow but on the contrary it must be high.
Anyway...your friend needs a RAIU done to determine the nature of those nodules..

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