Very Confused

[Blue727]

Can you please look at these and tell me what you think?  My results are usually "normal" in range, but are always at the bottom of that "normal" range. Does it sound like pituitary, hypo, hyper or anything like that based on these results over the years. Your help is greatly appreciated.  Thanks!

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

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

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

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

6/21/07:
T-3, Free:377 230 - 420 PG/DL
T3, Reverse:0.19 0.11 - 0.32 ng/mL
Free T4:0.73 0.71 - 1.85 NG/DL
TSH:1.39 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
TPO Positive
E2 (Estradiol) 9 Male (20-49 yrs): 1-3 pg/ml, Male (50-85 yrs): 1-5 pg/ml
P1 (Progesterone) 30 Male (adult): 5-95 pg/ml
TTF (Free Testosterone) 34 Male (20-30 yrs): 60-110 pg/ml

Cortisol:
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 Normal 3-10 ng/ml

My morning Cortisol blood test was 19.3 (Range: 4-22 MCG/DL). Antibodies test was negative.

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

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

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

1/30/08:
TSH: 0.95 Range: 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
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
Testosterone, Total: 393 Range: 241 - 827 NG/DL

[mosesgt]

You would likely benefit from neuro-psychological testing, not because of the labs but because of the traumatic brain injury (TBI). Homocystine is associated w/ hardening of the arteries but no one is sure what to do about it. W/ an high iron, you need to look for hemochromatosis, porphoria, etc. That is dangerous stuff. You will likely need to resume the B12. It is water soluable and a single high reading is not frieghtening. Why were you low at your age would be a good question. Low B12 causes a miriad of problems. Good luck! Stay away from alcohol as well.

[Mark Lupo, M.D.]

The thyroid levels look farily normal - there may be a lowish thyroid binding globulin, so would make sure the levels are tested as free T4 and T3 and that a blood test for TPO is tested as thyroid saliva tests are not reliable. At one point the TSH was a little low, but that appears isolated.  A pituitary problem is not completely exlcuded.

Your post is somewhat complex and brings up many other possible medical problems -- it may be worth going to a university or Mayo clinic type setting to tie all this together to see if there is an underlying problem.

[Blue727]

I thought some of this might be important.  I am a 28 year old male.  I believe this all started four years ago when I broke my nose.  A couple doctors told me that based on my results they believe my pituitary gland isn't asking for thyroid and even if it was, they don't think my thyroid is making any.  At one point I was on Cytomel 5 mcg and Hydrocortisone 5 mg.  I got up to 20 mg of Hydrocortisone and 5 mcg of Cytomel daily, but only for 17 days.  They placed me on Paxil CR, I had a bad reaction and they couldn't say it was due to that, so I was told to discontinue everything.  One doctor told me "if it didn't do anything during that time period, then that is not your problem."  I have posted additional tests and such.  Thanks in advance for your help!

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

Since 2003, I have had the following;  my B12 was at 253 so they started me on shots for one month and it reached 1658 and the shots were discontinued. One thing I noticed is my CO2 levels are either always at the top level or high. I actually had a gall bladder surgery cancelled twice because high C02 levels. They put me under and had to stop.  The doctor said he thought if he gave me more C02, because my levels were so high, that I would possibly go into cardiac arrest.  I was sent to see a cardiologist and she ruled my heart was okay so they took my gall bladder out the following week.  I have had a heart murmur since birth.  I have also had bilateral hernia surgery to remove two hernia's.  Multiple concussions over my lifetime.  Sleep Apnea test came back normal, although they said if woken up I would fall right back into the deepest sleep and would wake up almost every 3 minutes. MRI of head showed white matter at the front lobe, but they said it was from a prior injury. CT scan showed chronic sinusitus, polyps, possible mucus pocket and a deviated septum.  Doctor said I had high iron so I donated blood.  Homocysteine level came back at like 45.4 and shouldn't have been higher than 11.8. % of saturation was at like 80 something, but is now down to 66%.

I have GERD and have had my throat dialated 5 times since 1994 with the last being in 2001.  The same day, two years in a row back in October 2005 and October 2006, showed my absolute eoseniphils (sp) were at 608 (05' with the high being 500) and 911 (06' with the high being 500).