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New labs


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Old 01-15-2010, 08:53 PM   #1
lulu2008
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New labs

So I got some new labs in today, what a difference from my last set which was taken 8 days prior to these. First, here are my labs from 1/5/10:

TSH: .25:L (.40-4.50)
T4, total: 4.2L (4.5-12.5)
T3, total: 69L (76-181)


Labs from 1/13/10:

TSH: 16.35H (.40-4.50)
T4, free: 0.6L (.8-1.8)
ACTH, plasma: 40H (5-27
Cortisol, AM: 25.5 (4.0-22.0)

Same lab did these, different doctor ordered them which was why the first was a total T4 and total T3 and the latter was the free T4 and no T3. What do I make of this? I see an endo on Tuesday, my primary wants me to have a thyroid u/s, MRI, Thyroglobulin test, anti-TPO AB, and I recently had an ESR on 1/5/10 and it was 1 (< or = 20 mm/h)

What is going on?!

 
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Old 01-16-2010, 02:13 AM   #2
SandieRC
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Re: New labs

Wow, seems like you have a thyroiditis of some sort. The endo I started seeing said that when he looked at my labs which are similar to yours. What are your symptoms?

 
Old 01-16-2010, 08:17 AM   #3
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Re: New labs

Those last labs are seriouly hypo. The first labs are weird with that low TSH, but the total T4/T3 are seriously low (it's best to get free T3, free T4 tests if at all possible)
Your doc is right to test for antibodies. Autoimmune thyroiditis can cause wild fluctuations of TSH and thyroid hormones. Make sure he does an anti-Tg test along with the anti-TPO. It might be a good idea to do a TSI as well to see if Graves disease is going on. I also think you need an MRI of your pituitary just to make sure the dysregulation isn't coming from there. And an U/S of the thyroid is always a good idea.
The high am cortisol and ACTH indicates you probably have early adrenal fatigue which will happen with undiagnosed hypothyroidism. Your adrenals are producing high levels of cortisol to compensate for the low thyroid output. Saliva cortisol testing will give a more sensitive read on your adrenal function.

 
Old 01-16-2010, 02:09 PM   #4
lulu2008
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Re: New labs

Thanks for your replies! This is so frustrating as I have been dealing with the same symptoms for about 2 yrs now on and off. I had similar labs run about 18 mos ago and my am cortisol was borderline high at 20.5 and my acth was also at the high normal but in range, I forget the level. I had acute thyroiditis caused by a virus at the age of 15 and was on Tapazole for 6 months (also had a TSI at that time.) That cleared up and I was fine until the birth of my first baby 4.5 years ago. I went to my primary complaining of unexplained weight loss, fatigue, hair loss, constipation, and he ran some thyroid labs. It showed I was hypo w/ a TSH of 10 and low fT4 and ft3 (forget those.) This was when I was 24 years old. I felt better after being put on Synthroid 50mcg and my levels optimized. After the birth of my second child 2.5 years ago I felt the same way. I felt really tired, had weakness, lost a lot of weight, lost more hair, and had joint pains. My thyroid was checked and I was still on Synthroid but my levels were normal. That is when they ran the am cortisol and acth along w/ an ana, sed rate, rh factor and crp. Everything came back fine. Then I started feeling nauseated, dizzy, my blood pressure started going down and I had a hard time getting over simple things like colds, etc. My doctor said it was stress which I didn't believe because I knew something was wrong. I kind of left it alone because I felt as though I was not getting anywhere with my current primary and wasn't able to change to anyone else in our area. Then, 5 months ago I had our third and last baby and the same thing started happening all over again, this time much worse. My hair is so thin on the hairline and front that I see my scalp, I lost all 22 lbs I gained from being pregnant within 2 wks of having him, all while eating like crazy. Since then I have lost an additional 10 lbs, putting me very underweight for my height (I am 5'8 and 107 lbs.) I eat all the time plus drink Ensure shakes and I am not currently working out. My joints aches, my muscles in my legs hurt, and I feel tired all the time yet I have a hard time sleeping. I often feel nauseous and my hands shake. My resting pulse has been 120-130. I have also been having headaches and a lot of pressure behind my eyes, along with some floaters and a dry, gritty feeling. I also have a lot of irritability and anxiety now, which is very new to me, but I don't know if its because I am always feeling so poorly. I finally found a doctor who listens to me and said we will get to the bottom of this. I go to an endo he referred me to on Tuesday and he said if the endo doesn't order the tests he feels necessary then he will. So I plan on doing the free T3, anti TPO and anti TG, along with the ultrasound of my ultrasound. I can't do the TSI now as I am breastfeeding, and the MRI will have to be w/o contrast. I know I have an arachnoid cyst on the right parietal area of my brain, it was found via MRI about 2 years ago. Could this be causing my thyroid to be off, or my pituitary? There were also some instances of protein and keytones in my urine when I would go in for regular physicals (not pregnant) but an ultrasound of my kidneys only showed mild dilation and extra renal pelvis. What do you make of all of this? I am only 28 and I feel like I am 100 sometimes!

 
Old 01-16-2010, 04:06 PM   #5
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Re: New labs

Wow, that's quite a story. You've really been through a lot. Your symptoms kind of sound like you might have both Hashi's and Graves going on or perhaps it's all coming from your pituitary... Hard to tell without further testing. But the onset of viral thyroiditis followed by flares after giving birth are a classic autoimmune type path.
I would also ask for ferrtin, vitamin D and B12 testing as these are often low with hypthyroidism and often need supplimenting. Are you currently on 50 mcg of synthroid? If so it's not enough and you need to increase it and adding some T3 to the meds would be a good idea too. You're far too hypo right now.

 
Old 01-16-2010, 06:13 PM   #6
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Re: New labs

Hi, I forgot to mention I am not currently on any medication..they took me off Synthroid at my 6 week postpartum appt because my TSH was .025 and I was having heart palps, night sweats, losing weight and hair and they thought I was hyper. At that time, only TSH was run. 6 wks later I was .015 and then 5 wks later I was .40 and 8 days later 16. Its crazy how erratic my thyroid is being. During my pregnancies my TSH was stable at 1.0-1.4 and I never even had to up my Synthroid. I feel so much better while pregnant, except I get extreme nausea, so much that I had to take Zofran for most of the pregnancies and gaining weight was a real challenge. My babies are all nearly 9lbs and were all very healthy so I am thankful for that!

 
Old 01-17-2010, 03:05 AM   #7
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Re: New labs

Lulu, your story (except for the babies) and symptoms sound almost identical to what I am going through right now. My numbers are even similar to yours.
I have gone to an endo and we are waiting for my
tests from this Friday. We are testing every Friday to see if there is some sort of pattern. Meanwhile, I feel really bad and my
whole life has stopped. I think it must be some sort of thyroiditis. This
all started when I got sick with bronchitis. I have had terrible anxiety with this and now I am having some depression also, which is way out of character for me. My family is very worried. It seems as though every day it is something different as far as symptoms, I have Been keeping a journal as to try to see if there is some sort of pattern. I do have good days and bad. Yesterday was fairly good and today was bad. I never know. Today I was exhausted with bags and dark circles under my eyes, weakness in muscles and limbs, dizzy, internal tremors, shortness of breath, fast heart rate, anxious and later in afternoon depression. I got some bad news about work this afternoon and it really set off my anxiety and depression. It is like I can't handle anything bad, I can't even watch the news. I have had a pressure headache off and on too. It is really weird but just be looking at my eyes in the mirror, they don't look right. They do no look well. Sometimes they do feel dry and I also have blurry vision. I also have the high morning cortisol, mine was 27 last week. They tested it again this week. The only thing they are testing is my blood. I do not feel like I am having the proper tests and sort of feel
like I am slipping through the cracks. Please
stay in touch and let me know What you find out. Thanks!
like I am getting the proper tests. I want to rule out

 
Old 01-17-2010, 03:12 AM   #8
SandieRC
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Re: New labs

Ignore last sentence on my last post, typed
on iPhone and doesn't want to let me edit!

 
Old 01-17-2010, 12:50 PM   #9
lulu2008
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Re: New labs

We do have a lot of similar symptoms. I never suffered from anxiety, either, until maybe the end of this past summer. Even my husband notices a difference, I am not the kind of person to focus on negative but I, too, can't watch the news much anymore or scary movies. Weird! I also have good days and bad days, but it makes sense after seeing my labs, I am sure every day my hormones are erratic thus causing the various symptoms. I will let you know what my endo says!






Quote:
Originally Posted by SandieRC View Post
Ignore last sentence on my last post, typed
on iPhone and doesn't want to let me edit!

 
Old 01-31-2010, 08:04 PM   #10
SandieRC
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Re: New labs

Lulu, how are you doing now?

 
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