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Old 01-13-2013, 02:48 PM   #1
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Got bloodwork done not sure if I have a thyroid issue or not.

Hey guys i'm not sure if I have hypothyroidism for sure. I originally went to the doctor because over the last year or so my face has become generally puffy and bloated looking to the point where others have commented on it. I'm a 19 year old male 5 7 and around 145 lbs 9% body fat (caliper tested) so its not an issue of being fat. My face used to be really skinny and chiseled when I was in highschool as I was a 3 sport athlete. Now even though I still wrestle, workout and run my face seems to be retaining a lot of water.

I decided to go to the doctor and he ran some routine blood work and I received these results. I'm not sure If i should post this in here or lab results as I'm not even sure if I have a thyroid problem yet. My doctor did refer me to the endocrinologist but he said for the cortiosl levels not the thyroid.

He only tested tested cortisol once and I thought to see if you had a problem you would want it tested AM and PM. My test was in the AM so I thought it being high isn't a huge issue. Also my TSH value is in range yet my total t4 and t3 levels are low I'm not sure how to interpret this. I decided to come to this forum as you guys seem well educated on the topic and I'd really value your input while I wait to see my endo.

I do not have any real symptoms of hypo that I've read about. The only thing is a really puffy face for the last year or so. In addition I've noticed that compared to other people I feel colder sometimes especially my hands and my feet. Also the bottom/soles of my feet hurt a decent amount but I'm not sure if thats related to my running or not. I have been feeling generally down mentally as having a constantly puffy face is ruining my self confidence.

Test / Value / Range

Bilirubin, total / 1.8 (high) / 0.2-1.1mg/dL


TSH / 1.87 / 0.5-4.30 mIU/L
T4 free/ 1.6/ 0.8-1.8 ng/dl
T3 free /3.5/ 2.3 -4.2 pg/ml
T4, total / 5.6 / 5.6-14.9 mcg/dl
T3, total / 64 (low) / 76-181 ng/dL

Creatinine 24h/ 2.61 (high)/ .63-2.50

TBG/ <3.5 (low)/ 12.7-25.1 mcg/ml

24 hour urine cortisol / 118.6 (high) / 4-50 mcg/24h

Age: 19
Collected: 02/06/13, 08:16
nkochath1

Last edited by Administrator; 02-16-2013 at 12:22 PM.

 
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Old 01-13-2013, 05:58 PM   #2
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Re: Got bloodwork done not sure if I have a thyroid issue or not..

Hello!

The endocrinologist should be able to test for other metabolic/endocrine conditions that could be a factor, with a higher cortisol level they may do tests for adrenal function. Also other hormone testing. It's good that although your cholesterol is higher, you have a good amount of the HDL, which probably puts you at less risk.

With your free T3 and T4 levels being what they are, you're certainly showing as hypothyroid. Whether or not this is related to the other labs, it's hard to say. When do you see the endo? They will likely want to get a clearer picture with further testing before deciding on a treatment plan.

The cold hands and low mood can definitely be due to your thyroid levels. Everything is so connected to everything else in our systems. I think you're definitely on the right track to getting some answers and having a plan of attack. You're young, active, and it sounds like your doc is wanting to get the ball rolling. I know this doesn't help make you feel better, but there are many of us here that can understand!

 
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Old 01-14-2013, 07:49 AM   #3
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Re: Got bloodwork done not sure if I have a thyroid issue or not..

My endo appointment is for the 30th. One thing I want to mention is that the values posted are my total t3 and t4 not free. I've read that those aren't such a good indicator of thyroid health and the free values paint a truer picture.

I'm not sure how much of a difference it makes because I'd assume if the total values are low then free would be as well? I'm no doctor so feel free to correct me if I'm wrong haha

I hope I get a good endo who will actually listen to me..

My actual doctor didn't take me seriously at all when I presented the problem. He seemed to get annoyed that I brought up possible hormonal issues such as hypothyroid or a pituitary issue. It wasn't until my pressured him to do bloodwork that he actually did something and saw something was wrong.

Last edited by nkochath1; 01-14-2013 at 07:50 AM.

 
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Old 01-14-2013, 09:48 AM   #4
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Re: Got bloodwork done not sure if I have a thyroid issue or not..

From my understanding, the total T3 and T4 levels are more reliable for men than women. They're unreliable for women because of estrogen.

 
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Old 01-15-2013, 10:55 AM   #5
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Re: Got bloodwork done not sure if I have a thyroid issue or not..

Okay thanks. I guess theres not much I can do until the I see the endo. The only fear I have is that I get one who'll say that nothings wrong because the TSH value is within range. From what I've read online this seems to be a common occurence.

My doctor actually said my thyroid was fine and he was more worried about the cortisol but I guess we'll see what further testing reveals

 
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Old 01-30-2013, 12:55 PM   #6
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Re: Got bloodwork done not sure if I have a thyroid issue or not..

I saw the endo today and he said the total t3 and t4 aren't really accurate indicators. He ordered new tests of the TSH, free t3 and t4, total t3 and t4 and thyroid binding globullin. He also ordered a 24 hour creatinine and a 24 hour free cortisol.

I'll update once I get those results back

 
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Old 02-06-2013, 05:53 AM   #7
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Re: Got bloodwork done not sure if I have a thyroid issue or not..

So I took the tests today and handed in my urine sample. Does anyone have any experience with the 24hour cortisol test?

I'm worried that I didn't keep my sample cool enough. The lab assistant asked me if I kept it refrigerated and I had it on a bag of ice but before that it was sitting on my bathroom floor for maybe 3-4 hours. She said it should be fine though.

My doctor just said keep it cool so I assumed that would be fine but reading online it says not keeping it refrigerated can affect the results.

 
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Old 02-14-2013, 03:26 PM   #8
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Re: Got bloodwork done not sure if I have a thyroid issue or not.

Hey guys I got my 2nd round of blood work.

https://www.dropbox.com/s/wlzztkfkuti65au/test%202.bmp

My endo checked free t3/t4 this time in addition to the totals because he said they were a more accurate indicator of thyroid health. He said my thyroid seemed fine and the low TBG could be genetic or related to the high cortisol. He's making me take a dexamethasone test tomorrow morning. I'm taking the pill tonight at 12pm.

I have no clue why my cortisol would be that high. I looked at the things that affect it and it was mostly over exercising, large caffeine intake, lack of sleep. The day I was doing the test I had 1 coffee and I didn't go to the gym, I just did some light abwork at home. As for the sleep I've always had sleep issues since around middle school but they come and go. The night of the test I actually slept somewhat better than normal.

Last edited by Administrator; 02-14-2013 at 03:49 PM.

 
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Old 02-15-2013, 09:39 AM   #9
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Re: Got bloodwork done not sure if I have a thyroid issue or not.

Maybe if you shared your free T3 and free T4 lab results people on this board could help you out further.
I quoted what you wrote earlier:
"The only thing is a really puffy face for the last year or so. In addition I've noticed that compared to other people I feel colder sometimes especially my hands and my feet. Also the bottom/soles of my feet hurt a decent amount but I'm not sure if thats related to my running or not. I have been feeling generally down mentally as having a constantly puffy face is ruining my self confidence."
I have had my feet hurt a decent amount as well. I wanted to blame it on aerobics. After some research, I have also seen other people have pain in their feet when the thyroid is out of balance. So it is not out of the question.
Amazing what the thyroid can affect and how different we all are. We may not all get all of the same symptoms..important to know.
The second thing occurred to me, is your puffy face. It makes sense this would be of concern and affect your self confidence. I have been doing a lot of reading about the thyroid. In the book by Mark Starr, Hypothyroidism Type 2, he has research and pictures of people with puffy swollen faces due to hypothyroidism. Photos are before and after proper treatment of the thyroid. People did get better, the results are stunning.
Head to foot, your body is trying to tell you something. Keep looking for answers, you will get what you need to feel better.

 
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Old 02-16-2013, 12:23 AM   #10
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Re: Got bloodwork done not sure if I have a thyroid issue or not..

Quote:
Originally Posted by nkochath1 View Post
My doctor actually said my thyroid was fine and he was more worried about the cortisol but I guess we'll see what further testing reveals
Well yeah, that's the lab result that's not boringly normal. I would suggest keeping an open mind and not get attached to one diagnosis. And it's seems you're actually getting reasonable care from your doctor. Hopefully your endo will be through.

 
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Old 02-16-2013, 07:22 AM   #11
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Re: Got bloodwork done not sure if I have a thyroid issue or not.

I looked at the pictures and they seem very similar to what I have. The face area looks bloated especially around the cheeks and under the jaw.

 
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Old 02-16-2013, 07:08 PM   #12
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Re: Got bloodwork done not sure if I have a thyroid issue or not.

Just want to mention, the 'dexamethasone test' is to check out your adrenals. I think your endo investigating why the high cortisol. Which is good, you want that. Lot of doctors see a healthy looking young man in the chair and diagnose him as 'healthy, get out of my office' then and there.

It's hard to tell sometimes if you are being taken seriously or not. High cortisol could be due to Cushing Syndrome and is potentially serious. Likely the your endo doesn't want to alarm you in the event it's nothing. Especially since he doesn't know anything more than you do. But sounds like your Endo is taking this seriously, at least for now.

Last edited by Administrator; 02-16-2013 at 09:11 PM.

 
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Old 02-26-2013, 01:06 PM   #13
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Re: Got bloodwork done not sure if I have a thyroid issue or not.

yeah I like him so far he seems to be covering all the bases. He just called me with the results of my dexamethasone test. He said he typically wants his patients to be <1.8 mcg/dl Mine was was 2.5 mcg/dl He wants me to do a salivary cortisol test at midnight now to be absolutely sure if I have a problem or not.

Last edited by nkochath1; 02-26-2013 at 01:20 PM.

 
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