Hi Dr. Mark,
Welcome back, you were missed!!!
I have been treated for hypothyroidism since 1983 than diagnosed with hyper (not med induced)but(Graves) in 2004 & received RAI in 02/05. I've been working my way back to normal since the RAI & just can't seem to get there. I'm @ 3 grains of Armour & my thyroid lab has finally leveled out in 01/06. It's stayed pretty consistant w/ my last lab done 07/05/06. TSH 0.17 (0.40- 5.0) Free T-3 261 (230-420) Free T-4 1.1 (0.8-1.8) Also thyroid antibodies TSI 152 (<125) & TPO 396 (<35). Is this antibody normally high in Graves? My TSI is going down 196 in 03/06 but this is the first TPO I've had checked. Why would it be high? tested because I'm having my second rt.eye decompression done 07/20/06.
I'm also taking 1 cc of B-12 wkly & my level is now 721 up from 89 in 06/05. Per your suggestion, Intrinsic factor Block AB-negative. Gastric Parietal Cell AB 90.3 (>25 positive). My GP says I have malabsorption but not Pernicious Anemia because I'm not anemic.???? My lab sheet says antibodies to this protein are present in 80% of patients with pernicious anemia. I don't know what to think. Is my GP mistaken?
I'm also having some problems with my 07/05/06 CBC. WBC 16.1 HGB 16.3 HCT 48.3. They were also up back in 03/06 WBC 12.2 HGB 14.4 HCT 42.8. I'm being referred to a hematologist. Is the anything auto-immune that could cause this?
Also what is the best lab to test for Adrenal fatigue? GP wants to test that also.
I'm sorry, I'm a miss........
The TPO is high in Graves in most cases. Ab's including TSI & TPO will likely fall after I-131 but may never normalize. TSI is linked to eye disease. Keeping TSH optimal will likely help keep eyes stable. Good luck with the decompression.
I would say you have Pernicious Anemia (ie malabsorption of B-12) but at an early state without lab evidence of anemia (low Hbg) and the B-12 therapy should keep it that way!
Best test for adrenal insufficiency is an ACTH stimulation test and consider Adrenal Antibody testing.
Thank you very much for your answer. You didn't comment on the CBC though, is there anything auto-immune that might cause this elevation. I also forgot to say the GP. ordered more lab to exclude infection & also many others with the only positive reading to a Leukocyte Alkaline Phosphatase Stain 155 w/ normal of (13-140). Thanks, TJ
cbc showed normal hemoglobin. The high WBC is of unclear origin and with the elevatd LAP I agree with seeing the hematologist, but often this is just an infection or something transient. There may be some autoimmune causes but not something I see that often in my thyroid practice to guess which at this time -- see what the hematologist thinks.
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