Ok, Nobody probably knows anything about this but here goes

I have had low albumin levels and an decreasing Anion Gap.  I was wondering if anyone knew the relationship of these proteins to the thyroid and the levels of free t4 specifically.  My labs are strange, with the free t4 being low but also the  tsh being low, I have been racking my brain trying to figure out what the heck is wrong and I think it could be pituitary, thyroid, or if my low albumin levels explain my low freet4, I just might be crazy!  or something else....

I tried to find stuff on how albumin levels affect these hormones since our thyroid hormones are bound by this and another protein, which I already forgot, but I can only find literature saying it affects the total t4 in the body... anybody out there have a clue as to how it relates and what a low albumin and low anion gap could possibly suggest?

[Barb135]

A quick search for low albumin turned up some causes of  low albumin (hypoalbuminemia), which include, but are not limited to liver disease, malabsorption, malnutrition, late pregnancy.

In the body, T4 binds to proteins which renders the T4 unusable; that's why we say to test for Free T4, which is the amount of T4 that is not bound to proteins, and is available for conversion to T3.  Albumin is one of the proteins that binds to T4, rendering it unusable.  

You might want to ask for further testing to insure proper liver function.  

[jenniferk86]

What would that include I may have already had those tests done

[Barb135]

Alanine aminotransferase (ALT) and aspartate aminotransferase (AST), which are liver enzymes,  are 2 tests used to check liver function.  I'm sure there are others; you might want to research it.

[jenniferk86]

Yep, I did, and I've had three labs that are normal in those.... Yep I  should be on mystery diagnosis. Actually I need better health coverage and to go to a few specialists and peoole who will actually pay attention and listen to me. any one know anybody good? I will travel at this point.

[jenniferk86]

I did come across something that said it could mean there are antibodies in the system, maybe I actually do have hashis I will know soon.....

[Mom2four85]

I do know Cleveland Clinic has a free health program in the state of ohio and a financial assistance program for most other states if you fit the criteria.

Here's the info
http://my.clevelandclinic.org/Documents/Patients/Financial_Assistance_App_0809.pdf

I'm not sure about Mayo Clinic, but I did read someone said they do have similar programs, so a quick call to their clinic may help.

CC and Mayo I've been told are the 2 leading places in the US that find unusual disorders and diseases =)

[jenniferk86]

Thank you. I'm just afraid they are gonna tell me I'm a hypochondriac ! Lol. They should have a test for that too!

[Barb135]

Have you been tested for antibodies?  Either thyroid or others?  

[jenniferk86]

I should know the results today just got tested for anti bodies for the first time, that should explain it, I'm hoping that's my answer.

[jenniferk86]

Oh and how do you test for mal absorption, I think I could have that if the symptoms of that are being tolerant of everything. I can be shot up with narcotics that would tranquilize a horse, that I have never been given and be completely coherent.

[jenniferk86]

Well antibodies 12  but the ref. Range is <35 so my thyroid is perfect then right? My free t4  1.0   tsh .98  free t3 3.4  up since taking 25mg of levo. Were free t4 .8  (.8-1.8),  tsh  1.0(.4-4.0)  free t3  3.5 (2.3-4.2)  all same ref.   Any thoughts?

[medicmommy]

When you had your liver panel done, did they also check for hepatitis C? You can have liver labs in the upper end of the range and have an infection with few symptoms for many years. Often, it is a near-silent disease until your liver begins to fail (takes years). I ask this because pain meds (and everything else) are metabolized in the liver. An the liver affects albumin levels. Liver dysfunction affects every body system including kidneys, thyroid and the pancreas. Many people who have become infected have no idea how it happened because it is only spread from blood to blood. -Just a thought...~MM

[Barb135]

Which antibodies were tested?  Was it TPOab or TGab?  You need them both to test for Hashimoto's, as some of us have TPOab, some have TGab and some have both....

[goolarra]

My thoughts are still on the pituitary.  I'd do as Barb suggested and test whichever thyroid antibodies weren't tested at the same time as some pituitary testing.  Or have you done that already and haven't gotten the results yet?

[jenniferk86]

Tpoab was 12 the others were 0

[jenniferk86]

I had tpoab done and ata, is there more?

[SassySharon]

Hope you get some answers soon!  You know I am pulling for you!!  I forgot to ask you, Did you have your prolactin levels ran??  I know mine were not abnormal when I actually had a pituitary tumor, but that was me.  Most people would show some abnormality in the testing results.  If yours came out in the norm level you may still not know, but if it came back in the abnormal level then that could point to an issue there.          

[jenniferk86]

No, he didn't think it was necessary, said its prob dry skin or something.also just recently developed what feels like a bruise on the midline of the underside of my jaw.it is the size of my thumb approximately just feels like some one punched me there. Its not swollen but since this pain,i have been feeling much worse,i missed work for the post two days.