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Don't understand my test results
Answered by
Mark Lupo, M.D. - Thyroid Nodules, Thyroid Cancer, hyperthyroidism, hypothyroidism, Thyroid Ultrasound
Thyroid & Endocrine Center of Florida Sarasota - FL
Questions in the Thyroid forum are answered by Mark Lupo, MD. Topics covered include Goiter, Graves Disease, Hyperthyroid, Parathyroid/Calcium Problems, Thyroid Cancer, Thyroid Nodules/Cysts, Thyroiditis, Thyroid & Pregnancy, Thyroid Stimulating Hormone (TSH), Thyroid Tests, and Thyroid Surgery.

Don't understand my test results

by MamaA, May 26, 2008 02:59PM
Hello, I need help understanding my results.  My doc has still not asked me my symptoms and only cares about measurable ones. *sigh*  I am 39 and have a 13 month old.  I had severe hyperemesis during the ENTIRE pregnancy. I lost about 25 pounds during the pregnancy.  About 3 months post-partum I was still generally unwell. I thought it was due to the effects of the pregnancy.  Then I was feeling breathless, heart racing, etc.  I have no tolerance for heat (sometimes my hands and feet feel like ice) frequent stools, occasional tingling in hands, problems sleeping and muscle soreness.

After seeing a cardiologist for my heart (88-135 beats a minute resting).  He said my heart is in excellent shape after a stress test and EKG. I then asked my GP and she ran a hormone panel.

Test results
3/12/08
Free t4: .88 (reference range: .59-1.25), TSH: .32 (.34-4.82) cholesterol: 229 (<200), LDL: 162 (<100), All others were in the Normal range (DHEA, FSH, LH, Progesterone, Prolactin, Testosterone, Estradiol)

I was seeing an Endo for my diabetes (type 2) when he noticed the goiter, then saw the test results in my file which the GP had sent.  He put me on simvastatin, requested more blood tests:
04/05/08
TSH: .15 (.34-4.82), thyroglobulin antibodies: <20 (reference <20 IU.mL), thyroid peroxidase antibodies <10 (<35 IU/mL), T3 total: 165 (60-181 ng/dL), LDL Cholesterol 177.   Also ultrasound: no nodules, large goiter.

RAIU results: 5% uptake at 4 hours, tech said very large goiter no nodules
Last week, Endo said it seem "atypical" for Graves; but since I have a family history and my heart rate is so high plus a hard time functioning (excessive energy, occasional fatigue, trouble getting to sleep, serious irritability, etc) he wanted to slow down the thyroid. He ran an additional test: 05/19/08:
T4, Thyroxine: 8.5 (4.8-13.9) and TSH is now down to 0.11 (.34-4.82).
I'm on 5mg of Methimazole 2x/day.
Is this Graves I’m lost!

by Mark Lupo, M.D., May 26, 2008 05:02PM
This could be Graves, though not a typical case -- without nodules the only other possibility (besides you taking thyroid meds...) is thyroiditis but the time course of TSH pattern does not fit. Would test TSI and TBII to confirm Graves.
Member Comments (2)

by MamaA, May 26, 2008 03:14PM
To: Dr Lupo
The thing that most confuses me is that the Endo mentioned if it were Graves, the uptake would have been high and if it were thyroiditis the uptake should much less than mine was (I think he said no uptake).  He frankly looked like he was getting results he didnt expect and then just said "since your pulse is still so high and you are having a hard time keeping up with the baby, let's slow it down a bit.  See you in 2 months".

Can thyroiditis triggered by pregnancy last this long?  Or could this be an "atypical" case of Graves like he said?
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