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Old 04-18-2008, 10:12 AM   #1
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lab results

tsh 0.61 (0.34-4.82) t3 4.43 (2.4-4.2 ) free t4 0.7 (0.6-1.9 ) ive been having problems for 3 years now many mri,s and catscans nothing ! this time they did a catscan of my neck and seen 2 noduals had a sonagram done they didnt tell me the size but said their small and refered me to a endo on may1 st my symptoms are anxiety, panic attacts, tingly in fingers and feet, lips tingly off and on pulsating temples, vertigo, eye problems, got double vision for 20 hours once ! could this be all caused from my thyroid ?? did they finally find the problem ive been having any help appreciated thanks stacie

 
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Old 04-18-2008, 11:12 AM   #2
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Re: lab results

Are you currently taking thryoid medication? Based on your labs something funky is going on with your thyroid. You have a secondary hypothyroid pattern when looking at the TSH/FT4 relationship but the really high T3 doesn't jive. When you look at your T3 level with the TSH only, it suggests Hyperthyroid. Was it T3 they tested or Free T3? Hopefully others who are more saavy will hop on and share their thoughts.

 
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Old 04-18-2008, 11:40 AM   #3
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Re: lab results

im not on any thyroid meds, and the t3 must be free t3 its typed as t3 (triiodothyronine), free thanks for your help stacie

 
Old 04-18-2008, 08:03 PM   #4
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Re: lab results

mm's right, it doesn't jive at all. Neither does mine. If the t3 doesn't specifically say free, then it's total t3. A free t3 should have been run to give a clearer picture. Yes, it's very possible that your symptoms are related to your thyroid. But tonight, I'm too tired to even think straight but your set of labs caught my eye. I have pituitary resistance to thyroid and they're very close to what mine look like after I started treatment with cytomel a couple months ago. Non-supressed TSH with lower end FT4 and elevated FT3. I take it your mri's show no sign of a pituitary tumor?

 
Old 05-04-2008, 06:05 PM   #5
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Re: lab results

went to endo doc, he said i have a 2cm nodual and a smaller one, did a fna on the 2cm one ,that hurt more then expected, had 6 needles the worse part is when they move the needle up and down! dont get results till friday , i asked him about my free t3 levels, which is what i posted it is free t3 !! and he said he dont even look at the t3, it dont matter what should i do ? does anyone know if my levels are off and should i seek a differnt opinion? any info appreciated thanks

 
Old 05-04-2008, 10:26 PM   #6
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Re: lab results

When the T3 is so much higher than your T4 you also have to look at adrenal insufficiency. It causes the T4 to be converted in excess driving you hyperT in T3 and hypoT in T4. It sucks, but 4 little pills a day fix the isssue. Look into adrenal insufficiency and get the thyroid thoroughly looked over as well. My personal research and opinion on endocrine stuff.. thyroid and adrenal I am compiling in weekly threads. My Week 2 - Thyroid care and concerns post has a link to my adrenal insufficiency search and discovery and general thyroid basics and care, I think it may be helpful to you.

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Old 05-05-2008, 04:57 AM   #7
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Re: lab results

My first guess would be that you have a hyperfunctioning nodule that preferentially secretes t3. I hope you realize that multiple nodules are almost never cancerous so by having two, you're on the safe side for that. It's standard procedure to biopsy a nodule that size and it may show if the nodule is hyperfunctioning, but not always. What would be really interesting would be a raiu scan to see if those nodules are hot.

I'd look sideways at any endo who says they don't look at t3. Get your results, get a copy of the fna, listen to what he has to say and then make a decision whether you wanna stick with him.

I'm going to disagree with mg on the adrenal issue. That more applies to hypo's of which she has a lot of research background on. With hypers, of which I'm one, there's something that's called t3 toxicosis where the t3 level is high and the t4 level is normal which has nothing to do with the adrenals. With nodules, it can be a primary issue where the nodule just spits out more t3 than t4 and with graves, it sometimes occurs prior to the t4 levels rising.

Get your fna report and post it here and then we can help you out a little further.

 
Old 05-05-2008, 06:40 AM   #8
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Re: lab results

Access,

You are right it is possible that it is a hot nodule and a form of toxicosis. Why I am leaning to looking into the adrenal function is the level of the T4 in conjunction with the T3. While the T4 is normal, it is suboptimal... Way to low IMO.
Ft3 4.43 (2.4-4.2 ) = 112.7%
Ft4 0.7 (0.6-1.9 ) = 7.7%
The TSH sitting at 0.61 is another thing making me go, huh? With a actual T3 level that high I would expect a lower TSH. This is what is making me think there is an over conversion process of T4 to T3 going on, versus a surplus of T3 being made. Then again if you were making a surplus of T3 this would by a self induced T3 suppression of the TSH thus reducing T4 production as well. So either the production rate of T4 is normal and it is being converted in excess OR there is a hot nodule producing T3. Both are valid assumptions and need investigation. It never hurts to get a baseline Cortisol, ACTH, and DHEA blood serum test just in case as well.

In the case of Hashimoto's, early on it is very common to have Hashitoxicosis. It is just another flavor of an artifically induced hyperT state. I wasn't classifying Murph as true hyperT given the near in range values and the low T4. It looked more like an imbalance. Either way toxicosis due to a nodule or adrenals or antibody attack.. it all makes you feel like crud.

I wish you the best of care and hope that you get good news on Friday. I will be curious to here if it is Hashimoto's thyroiditis. If it is I would be sure to test adrenals and antibody levels TPOAb and ACA, to see just how active it is at this time.

MG
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Last edited by mkgbrook; 05-05-2008 at 06:45 AM.

 
Old 05-05-2008, 09:22 AM   #9
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Re: lab results

Quote:
Originally Posted by accessn12 View Post
I hope you realize that multiple nodules are almost never cancerous so by having two, you're on the safe side for that.
Get your fna report and post it here and then we can help you out a little further.
I was wondering where you got the information that having more than one nodule means you are at less risk for cancer? The cancer expert I talked to a few weeks ago at MD Anderson said that it didn't matter how many nodules you had the risk was equal. MD Anderson is consistantly rated either number one or two as the best cancer hospital in the nation.

Last edited by Curious2013; 05-05-2008 at 09:26 AM.

 
Old 05-05-2008, 09:27 AM   #10
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Re: lab results

thank you so much for the info !! i really appreciated ! ill get back friday with results thanks

 
Old 05-05-2008, 09:30 AM   #11
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Re: lab results

That is a good point. My ENT and soem other references state the number of nodules are proven to not be a determinant for cancer. Whether 1 or 20 it is the size that matters. Once a nodule hits the magic 1 cm. Still not clear on why that is the magic number, but my ENT told me that nodules les than 1 cm even if cancerous are not of sufficient size to impact the rest of your system. Humm.. so once a nodule comes of size it can start mucking with the rest? I still question this. However statistical studies show less than a 2 % deviation in malignant nodule patients have single versus multinodule growth arrangements. Even with this fact the chances of it being malignant are SMALL and nothing to stress over. Even if malignant the successful removal and treatment of thyroid cancer is quite spectacular. If you are going to get a cancer.. thyroid is the one to get.

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Old 05-05-2008, 04:03 PM   #12
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Re: lab results

Thank you curious. I had read that information many times from many different reliable sources. It appears that what I read was old. Here's what the new studies are saying:

"The presence of a diffusely multinodular gland, ascertained on the basis of palpation, US, or scanning, has in past years been interpreted as a sign of safety. Multinodular goiters coming to surgery have a significant prevalence of carcinoma (4-17%), but this finding was believed to be due largely to selection of patients for surgery, and not to be typical of multinodular goiters in the general population (31,32). However, in an era of generalized iodine sufficiency, when multinodular goiters are less common, this opinion needs re-evaluation. Frates et al (32.1) evaluated outcome in 1985 patients who underwent 3483 FNAs. Solitary nodules had the expected higher incidence of cancer than non-solitary nodules. However on a "per patient" basis, patients with MNG had the same incidence of diagnosed cancer (14.9%) as did patients with a solitary nodule (14.8%). Male sex, non-cystic nature, hypo-echogenicity, and stippled calcifications were associated with increased risk of malignancy per nodule. Usually FNA has been recommended for dominant or growing nodules. Frates et al recommend that for exclusion of malignancy in a thyroid with multiple nodules larger than 10mm, up to four nodules should be considered for FNA, and that the risk factors noted above may guide selection of nodules for biopsy."

I took that from [url]http://www.thyroidmanager.org/Chapter18/18-nodulesframe.htm[/url] There's a lot of new information on nodules in there. The one thing I love about thyroidmanager is they are constantly updating the work with new information. Problem is, you turn your back and what you quote as good solid info, suddenly changes on you. I stand corrected.

 
Old 05-05-2008, 07:40 PM   #13
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Re: lab results

Thank you for quoting that. I wasn't sure if we could. I just didn't want people with multiple nodules to feel like they have a "free pass" when it comes to cancer. They need and deserve as thorough an evaluation as someone with a single nodule. Not not sure all of the doctors realize that.

Last edited by moderator2; 05-05-2008 at 08:37 PM.

 
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