Confused by results

[Blue727]

My Homocysteine was at 45.4, with the high "normal" level being 11.8 about 3 or 4 months ago. It was found my B12 was down to 253 so I started supplementing and getting B12 injections. With in a month my B12 was over 1,200 and the doctor said everything was fine. Last week my homocysteine level was checked again and it is now over 60.0.

I was told three different scenarios for what was going on with my thyroid test results.  1.  I am hypothyroid.  2.  I am subclinical if not clinical hyperthyroid.  3.  I have a problem with my pituitary gland or hypothalmus.  I'm now at a point where I don't know what or who to believe, but I just don't feel well.  It seems all my TSH, Free T3 and T4 are either below the range or at the bottom of the range everytime I test them.  My testosterone is low for a male 28 years old (253), which should actually be for a man 85 years old.  My saliva cortisol results are all backwards showing I'm good late at night and bad during the day, but the blood cortisol shows I'm great during the day.  There has to be something so simple that I'm missing in order to tie all these together.

Results: Ranges:
10/12/05:
Range:
TSH: 1.20 0.40 - 5.5 MU/L

2/21/06:
Free T4: 0.91 Range: 0.59 - 1.17 ng/dL
TSH: 0.94 Range: 0.35 - 4.82 uIU/mL
T-4, Total: 6.4 Range: 4.5 - 12.0 MCG/DL
T-3 Uptake: 34.6 Range: 25.0 - 35.0% Uptake

8/15/06:
TSH: 1.11 Range: .34 - 4.82 uIU/mL

10/12/06:
TSH:1.20 Range: 0.40 - 5.5 MU/L

6/21/07:
T-3, Free: 377 Range: 230 - 420 PG/DL
T3, Reverse: 0.19 Range: 0.11 - 0.32 ng/mL
Free T4: 0.73 Range: 0.75-1.85 NG/DL
TSH: 1.39 Range: 0.50 - 5.00 uIU/ML

7/17/07: Here are the saliva test results;
fTSH 57 Normal
fT4 0.25 Normal Normal: 0.17 - 0.42 ng/dl
fT3 0.27 Borderline Low 0.21 - 0.27 ng/dl

[Mark Lupo, M.D.]

There is a lot of information in your post, but overall, there is not evidence of a significant thyroid problem here and the testosterone of 390 is low normal for 28 but not likely significant.

Would suggest general endocrine evaluation to make sure there is not a problem.

Salivary thyroid testing is not shown to be accurate.

[Blue727]

Dr.
When you get a minute, could you give me your input?  Thanks!

[Blue727]

TPO Positive in Saliva results, but I'm not sure why blood test showed negative and Saliva showed positive.

E2 (Estradiol) 9 Showing I'm higher than an 85 yr. old man......see the next line below;
Male (20-49 yrs): 1-3 pg/ml, Male (50-85 yrs): 1-5 pg/ml

P1 (Progesterone) 30 28yr. old Male (adult): 5-95 pg/ml
Range:
TTF (Free Testosterone) 34 Male (20-30 yrs and I'm a 28 year old male): 60-110 pg/ml

Cortisol (By Saliva Testing @ CanaryClub):

Time: My Range, 28yr old male: Normal Ranges for my age(28yr. old male):
7:00-8:00 a.m. 6 Depressed 13 - 24 nM
11:00-Noon 4 Depressed 5 - 10 nM
4:00-5:00 p.m. 3 Normal 3 - 8 nM
11:00-Midnight 5 Elevated 1 - 4 nM
Cortisol Burden 18 23-42

DHEA: 4 Range: Normal 3-10 ng/ml

My morning Cortisol blood test was 19.3 (Range: 4-22 MCG/DL), but I'm not sure why the saliva tests show the complete opposite and I feel like the saliva test has it correct, as I'm tired all day, but can't sleep at night. Even after taking 2 sleeping pills I cannot sleep. I'm assuming this is because my cortisol is low all day and spikes at night.

Antibodies test was negative in blood. Not sure why it would be positive in saliva, but not blood.

8/7/07: Ranges:
TSH: 1.80 0.50 - 5.00 uIU/mL

9/12/07:
Range:
Free T4: 0.75 0.71 - 1.85 NG/DL
Range:
TSH:1.27 0.50 - 5.00 uIU/ML

1/19/08:
Ranges:
Free T4: 0.66 0.71 - 1.85 NG/DL
Ranges:
TSH: 0.17 0.50 - 5.00 uIU/mL

1/30/08:
Range:
TSH: 0.95 0.50 - 5.00 uIU/mL

Estradiol, Serum <32

Estradiol Reference Ranges:
Male: <=54

It goes on to say no pediatric reference range established.

T-3 Uptake: 40.31 High Range: 25.0 - 35.0% Uptake This is oviously high, but I have know idea what it means or doesn't.

T-4, Total: 5.7 Range: 4.5 - 12.0 MCG/DL

Free Thyroxine Index: 2.30 Range: 1.12 - 4.20

T-3, Total: 93 Range 60 - 181 NG/DL Not an expert, but this looks low for my ripe old age of 28.

Testosterone, Total: 393 Range: 241 - 827 NG/DL
------------Doc said this was normal, but I think he didn't realize I was a 28 year old male and not an 85 year old male. This seems very low to me, as I have always been athletic and in shape up until the last 4 or 5 years!!!!!!!!


Here are my latest lab results, but I'm not sure they will help in figuring me out.
Results: Reference Range/Units:

Glucose 80
Bun 4 L 6-24 mg/dL
Creatinine 0.8 .6-1.3 mg/dL
Sodium 138 136-145 mmol/L
Potassium 3.8 3.5-5.0 mmol/L
Chloride 105 98-107 mmol/L
CO2 30 21-30 mmol/L
Anion Gap 7 3-12
Calcium 9.3 8.4-10.3 mg/dL
Total Protein 6.8 6.1-8.1 g/dL
Albumin 4.3 3.1-4.7 g/dL
Globulin 2.5 L 2.7-3.9
A/G Ratio 1.7 .8-1.8
Alkaline Phos 112 50-136
ALT/SGPT 52 30-65 U/L
AST/SGOT 23 15-40 U/L
Total BILI 1.2 H .0-1.1 mg/dL
Iron 215 H 25-156 ug/dL
IBCT 247 L 250-450 ug/dL
%SAT 87.0 H 13.0-45.0

GLYCO 5.1
Est. Mean BLO 84
TSH 0.86 .34-4.82 uIU/mL
Ferritin 179 5-244 ng/mL
Free T4 0.75 .59-1.31 ng/dL

I had to have two gall bladder surgeries postponed on two separate occassions by two weeks, as they put me under anesthesia(sp) and would not go through with it as my CO2 levels were through the roof. They sent me to a heart doctor and she cleared me, so they did the test anyways. My Iron and % of saturation is sky high, but they don't think it's hemotomocrosis(sp). I feel as if my body is shutting down and getting ready to move on without me, but I can't get anyhelp.

My T-3 Uptake is getting higher, while my Free T3, Free T4 and TSH are getting lower (fluctuating occassionaly, but mainly dropping). Almost all the doctors I see, say ya...it looks as though with the sometimes below normal thyroid tests, the thyroid tests that do go below normal, a "very low normal" Testosterone, Total, the low Free Testosterone test in blood and saliva along with my symptoms, would suggest to them a problem with the hypothalmus/pituitary, adrenals, thyroid or possible Estrogen Dominance based on the saliva findings. They don't tend to really on saliva for Hormones, but the Testosterone was pretty close in both of them and it makes me wonder if the Estradiol or Estrogen could in fact be high as well. I have never had a scan of my thyroid or adrenals, nor have I had an MRI with and without contrast of my pituitary/hypothalmus.

My renin, plasma activity was 1.9 ng/ml/hr and aldosterone, LC/MS/MS was 13. I don't know how to read any of this stuff or what it means, but here are so more results by blood (which differ from my saliva test);

Thyroid Peroxidase AB <10.0 IU/ML (Reference Ranges <35)
Thyroglobulin AB <20.0 IU/ML (Reference Ranges <20
Vitamin D, 25-OH, LCMSMS (all reference ranges below 20-100)

Vitamin D, 25-OH, Total 34 ng/mL
Vitamin D, 25-OH, D3 34 ng/mL
Vitamin D, 25-OH, D2 <4 ng/mL

It states; 25-OHD3 indicates both endogenous production and supplementation. 25-OHD2 is an indicator of exogenous sources such as diet or supplementation. Therapy is based on measurement of Total 25-OHD, with levels 30 ng/mL.