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Thyroid Cancer, Nodules & Hyperthyroidism (Expert Forum)
Hyperthyroidism False-Negative?...
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.
Hyperthyroidism False-Negative?...
by bsb_n555kc, Feb 05, 2007 12:00AM
Dear Doc,
I am 20, and was found to have hypertension (140~160/90~110), and my diastolic was known to go up to 128...I was a regular blood donor for 3 years, so my hypertension was a sudden one...
My doctor initially thought I had Thyrotoxicosis/Hyperthyroidism, because in addition to the sudden pressure, I had sweaty palms, tremors, eye-nipping and a systolic murmur...
My TSH, T4 and T3 levels were normal...
I also tested negative for Pheochromocytoma, Renal Artery Stenosis and Conn's...MRI/Ultrasound showed nothing significant, although my doctor thinks my adrenal glands look bulky...
My tremors have since become quite bad...They tremble so badly I am actually aware of it. Sometimes my whole limb is trembling so badly, I feel my whole body tremble as well...And when Im nervous (Im taking a public speaking class, and I have to give weekly speeches), it becomes very bad, and I can't even hold anything, and my legs tremble too...And I get numbness in my fingers, and sudden pain in my legs for no reason...
Last night when I went to sleep, I saw flashes of lights in fornt of my eyes for a few minutes, and I seem to occasionally drool when I lie down...
I am now on Norvasc (Amlodipine) 5mg OD, and Diovan (Valsartan) 160mg OD...Pressure pretty well controlled...
Could my initial TSH, T4 and T3 levels be wrong ie a false negative? Or could my symptoms be because of something else or due to my medication?
By the way, the doctor wants me to get tested for Porphyria...
Please advise.
Thanks for your time, Doc!
I am 20, and was found to have hypertension (140~160/90~110), and my diastolic was known to go up to 128...I was a regular blood donor for 3 years, so my hypertension was a sudden one...
My doctor initially thought I had Thyrotoxicosis/Hyperthyroidism, because in addition to the sudden pressure, I had sweaty palms, tremors, eye-nipping and a systolic murmur...
My TSH, T4 and T3 levels were normal...
I also tested negative for Pheochromocytoma, Renal Artery Stenosis and Conn's...MRI/Ultrasound showed nothing significant, although my doctor thinks my adrenal glands look bulky...
My tremors have since become quite bad...They tremble so badly I am actually aware of it. Sometimes my whole limb is trembling so badly, I feel my whole body tremble as well...And when Im nervous (Im taking a public speaking class, and I have to give weekly speeches), it becomes very bad, and I can't even hold anything, and my legs tremble too...And I get numbness in my fingers, and sudden pain in my legs for no reason...
Last night when I went to sleep, I saw flashes of lights in fornt of my eyes for a few minutes, and I seem to occasionally drool when I lie down...
I am now on Norvasc (Amlodipine) 5mg OD, and Diovan (Valsartan) 160mg OD...Pressure pretty well controlled...
Could my initial TSH, T4 and T3 levels be wrong ie a false negative? Or could my symptoms be because of something else or due to my medication?
By the way, the doctor wants me to get tested for Porphyria...
Please advise.
Thanks for your time, Doc!
Doctor's Answer
by Mark Lupo, M.D., Feb 05, 2007 12:00AM
, Feb 05, 2007 12:00AM
Would not be unreasonable to repeat the thyroid levels to be certain.
Would also repeat 24h urine for catecholamine & metanephrines (PHEO) and also for free cortisol (CUSHINGS). Also consider further eval for ALDOSTERONE overproduction - (plasma renin activity & aldosterone level).
Good luck.
Would also repeat 24h urine for catecholamine & metanephrines (PHEO) and also for free cortisol (CUSHINGS). Also consider further eval for ALDOSTERONE overproduction - (plasma renin activity & aldosterone level).
Good luck.
Member Comments
by Idab, Feb 07, 2007 12:00AM
To: bsb_n555kc
Hi, your last comment caught my eye - Porphyria is usually symptomatic to chronic stomach pains and skin ulcerations - depending on which one you might have (as there are 7 different types). It is a rare enzyme disorder that manifests in the liver. There are wonderful web sites you can view to give you further insight to this condition - the American Porphyria and Canadian Porphyria foundations. It is so hard to come by drs/specialists who are willing to carry out this blood test and if yours is willing, I would take him/her up on the offer. It might save you a lot of unnecessary surgery and procedures in years to come - if results are positive. Good luck.
