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Avatar universal

Blood work shows Too High/Too Low, but DR. says all good????

(This is my first post on this forum so I hope I'm in the right place, my apologies if not)

background:
- high BP started at 35y, at 40y still trying to get it to normal (recently increased Lisinopril from 5 to 10mg)
- hypothyroid too, on Levothyroxine with "normal" levels
- recent hair loss that made me ask cardiologist if BP med has side effects(he said no)
- with thyroid issue and now hair loss, he recommended seeing endocrinologist
- blood work shows:

Abnormal Lows
Lymphs                13 (range 14-46)
HDL-P (Total)        27.6 (range >=30.5)

  
Abnormal Highs
Hematocrit                 45.5 (range 34-44)
Neutrophils         82    (range 40-74)
Antithyroglobulin Ab 68    (range 0-40)
LDL-P                 1065 (range <1000 is normal)

The DR. said everything was good, that my Anti Ab would be high for the rest of my life because I take med. and if I wanted to see my PCP I could. She mentioned that some BP problems come from hormones.

Question:
Are these highs/lows normal?
Should I find a PCP or get a second Endo?

TIA




14 Responses
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Avatar universal
So I went to a new Dr. today (internal medicine) and spoke to the nurse about specifically wanting to see the Dr. about getting my free T3 checked, abnormal AB etc, etc. Appt was at 2p, showed up at 1:30p to fill out paperwork.(I was literally the only patient in their office)  Was finally brought back at 2:30p.  A few minutes in, her cell phone rang, she answered, spoke a little Polish and hung up.  Maybe saying "don't call me at work".  Then she said next time I come bring a BP log.  I was told to take Biotin 5000 mcg and OTC Rogaine. Also told to see a dermatologist. (sigh)
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Avatar universal
That info is a big help.  And the questions, too. I'm going to start the faxing/search today after kids get to school.
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Avatar universal
In looking for a new PCP, you might have a look at this link to Top Thyroid Docs in Texas.

http://www.thyroid-info.com/topdrs/texas.htm

I always read through the patients comments for their perspective.

As for a Fax with questions, I have found these two questions to be very helpful in finding good thyroid doctors.   1. Is the doctor willing to treat a hypo patient clinically by testing and adjusting the biologically active thyroid hormones, Free T3 and Free T4, as necessary to relieve symptoms, without being constrained by resultant TSH levels?  2. Is the doctor willing to prescribe T3 type meds?  If the answer to either is no, then just keep looking.
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Avatar universal
I had the chance to post my questions on the "Ask and Expert" page of the forum and I just received a reply from the Dr. about the Ab that's 68 and he said it's because of Hashimoto's and I could follow up with primary Dr.  

Now the question is will the PCP hopefully be on board with getting me properly medicated. I hope so.

I haven't felt good for quite a while, scary BP spikes and on and on (I know I'm preaching to the choir). Spent most of today nauseous but needed to eat so the new med wouldn't make the side effects so bad.  

So tomorrow begins the search for a new PCP.

Thank you to all who posted ideas, help, support et al. Hopefully I can update at some point that I've got the right levels working.
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Avatar universal
The fax idea is great.  And I'll post a question re: the hair loss, too.  With so many people having the same issues, it's disheartening to hear about Dr's not being interested in helping.
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Avatar universal
We see many different kinds of doctors for our thyroid problems.  Endocrinology is the specialty that deals with thyroid, but many endos really just want to treat diabetes and have no interest in thyroid.  A PCP should be able to treat basic hypothyroidism.  So much of it has to do with where the doctor's interest lies and how much s/he is willing to research or read the research we present them.  Personally, I found my PCP to be quite clueless...right from the beginning, she did everything wrong.  I live in a small market as well, and I just got very lucky to find a great endo.

I don't know of any prescription drugs for hair loss, but I do know members have tried OTC supplements, etc. with positive results.  I'm sure there are many questions in the archives if you want to search, or you could post a new question specific to hair loss and supplements to get members' suggestions.

You should have vitamin levels checked as well as some deficiencies seem to accompany hypo quite frequently...D, B12, selenium, magnesium, etc.  

Once your thyroid levels are adjusted properly, you hair loss will reverse.

I seriously doubt that you will suffer any permanent damage from being undertreated.  You're not going to feel your best, however.  So, I'd suggest you pre-interview doctors to save yourself some time in finding a good one..  You can do that over the phone (through a nurse, usually), or I faxed out a questionnaire.  I thought the questionnaire worked really well, because in addition to getting info on the doctors treatment practices, etc., it brought out doctors who weren't offended by patient input and were willing to take a minute to address patient concerns.  If you want any suggestions on questions, let us know.  

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Avatar universal
I agree that I'll need to find another DR.  Do you think a PCP would be able to help with Thyroid questions if I go in with my results?  I have very limited choices for endo's with my insurance.  I was really expecting more from a specialist than what I got.  I'm afraid I'll have to weed through Dr.'s and in the mean time will permanently lose my hair.  Has anyone had an RX prescribed for hair loss?  Could some of the vitamin deficiency cause it, and if I start taking a multivitamin, will it reverse? I'm also wondering if under-managed hypothyroid can cause damage as I try to find a Dr. who can/will help.
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Avatar universal
Your FT4 is a little on the low side.  It has to go up quite a bit to get to midpoint.  Unfortunately, your T3 is a total T3, not a free T3, so it doesn't yield nearly as much useful information.  I think your endo was dismissive if he sent you away without an increase since you are still having symptoms.  If I were you, I'd ask my doctor about increasing my levo a little.  Then, I'd want to re-test in 4-5 weeks, re-evaluate symptoms and make sure he orders FREE T3 this time.  With FT3 and FT4 together, it's a lot easier to spot a conversion problem and see if you might benefit from adding some T3 to your meds.

If your doctor isn't listening to and treating your symptoms, you might have to find a new doctor.  
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Avatar universal
Sorry, I did forget to include some of the other thyroid results. I posted the things that were out of range. But here are the TSH, T3, T4.

Triiodothyronine (T3) 112                        71-180 ng/dL
T4,Free(Direct)         1.32                       0.82-1.77 ng/dL
TSH                         2.020               0.450-4.500 uIU/mL

There are about 60 things they tested on me and 6 that were abnormal high/low.  Some things were at the lowest/highest threshold, but not "abnormal". I just felt the Endo. was dismissive about the results.  

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Avatar universal
I just want to add that FT3, FT4 and TSH do not have to be out of range for you to be hypo.  Many of us find FT4 has to be at least midrange and FT3 upper third of range before we're symptom-free.  Just being "in range" is not enough.
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649848 tn?1534633700
COMMUNITY LEADER
I don't see any actual thyroid hormone tests in your list.  Those would include TSH, Free T3 and Free T4.  Your TGab indicates that you might have Hashimoto's Thyroiditis (that's the only actual thyroid test you posted).  

Yes, all your other tests could be off, due to thyroid problems, but without the actual tests I listed above, it's really impossible to tell because other things could cause those tests to be off, as well.  

In regards to the gluten free diet -- there's no scientific proof that it does anything for thyroid issues.  The only reason one would need to go g/f is if they have celiac or a wheat allergy, etc.

Additionally, detox's are not normally needed, as long as your organs are functioning properly.  That's what they are for - to clean garbage from your system.  
Helpful - 0
1756321 tn?1547095325
Yes well that is just a small bit of info lol.  Optimal levels of vitamin D for autoimmune thyroid conditions should be around 80 - 100ng/mL. Worth taking a multi vitamin too.  Not sure about the centrum brand to be honest but i know it is popular.  I forgot to add the link to Dr Cabot's book. :)

http://www.amazon.com/Your-Thyroid-Problems-Solved-Solutions/dp/0975743643
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Avatar universal
That is a lot of info to process :) but definitely "thank you" for all the references! I've seen several articles about changing to the gluten/dairy free diet, too. My Ca, and K levels are normal, but the Vit D is 32.4 in a 32-100 range. Not sure about the other electrolyte/vitamin levels, but it probably wouldn't hurt to add a multivitamin(Centrum Silver?) each day. The endo did add a RX for Spirinolactone for hair loss(the diuretic is supposed to help get my diastolic below 90).
Helpful - 0
1756321 tn?1547095325
Higher neutrophils can be due to thyroiditis.  Higher haemocrit levels can be due to macrocytosis (deficiency of B6, B12, folic acid, or hypothyroidism).  Abnormal cholesterol levels can be due to not enough thyroid hormone -  thyroid hormone is necessary for the healthy metabolism of cholesterol. Low lymphocytes can be due to lacking nutrients which means the body starts to use its own resources to generate energy. This in turn causes the white blood cells in the body to be depleted.  Hypothyroidism can cause low stomach acid (stomach acid is needed for nutrient absorption).

An electrolytes imbalance such as magnesium, potassium or calcium can cause high blood pressure. Sodium has been recently found to not affect blood pressure. In some people, vitamin B12 deficiency can cause high blood pressure. Vitamin D deficiency is also noted to cause high blood pressure.  These 5 vitamins/minerals are commonly found to be low with hypothyroidism.

As for your "normal" thyroid results, i found a good article that you will relate to...

"Doctors don't know, having never been taught and apparently not caring enough to learn, that thyroid tests also aren't worth spit. Synthroid and levothyroxine make the blood test normal, but not the patient. Patients continue to gain weight, lose hair, wonder why their brains don't work, and on, and on--unnecessarily dragging through life not knowing where to turn for help." >>> http://www.healthiertalk.com/we-are-seriously-doomed-4120

Just to add information from a good book called Your Thyroid Problems Solved by Dr Sandra Cabot:

Patient results:

Free T3 = 1.1 pmol/L (2.5 - 6.0)
Free T4 = 23 pmol/L (8.0 - 22.0)
TSH = 2.0 mIU/L
Anti thyroglobulin antibodies = 80
Anti microsomal antibodies = 1200 (now called thyroperoxidase antibodies - TPOAb)

Patient prescribed T3 (brand name tertroxin) 20mcg three times a day, T4 100mcg a day, selenium (Dr Cabot recommends 200mcg daily), gluten and dairy free diet, bowel and liver detox.

Three months later:

Free T3 = 5.0 pmol/L (2.5 - 6.0)
Free T4 = 16 pmol/L (8.0 - 22.0)
TSH = 1.9mIU/L
Anti thyroglobulin antibodies = 40
Anti microsomal antibodies = 350

High neurophils >>>
http://www.nlm.nih.gov/medlineplus/ency/article/003657.htm

Cholesterol reduction >>>
http://www.drgregemerson.com/fact-file/cholesterol-reduction

Haemocrit >>>
http://www.medicinenet.com/hematocrit/page3.htm

Blood count >>>
http://www.drkaslow.com/html/blood_cell_counts.html

Causes of Lymphocytopenia >>>
http://www.ehow.com/about_5073504_causes-lymphocytopenia.html#ixzz1VOfrG2pV.

Blood pressure meds are fat fertilizer >>> http://www.selfgrowth.com/articles/Blood_Pressure_Meds_are_Fat_Fertilizer.html



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649848 tn?1534633700
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