Aa
Please help me determine my lab results?
For some background info, I've been symptomatic for around 2 months now, which started almost 2 weeks after I had to terminate a pregnancy at 11 weeks. The symptoms do tend to come and go but I haven't felt like myself since September, before all of this started. Since these issues occurred right after my pregnancy, I assume that the pregnancy either caused the thyroid problem or worsened an existing problem that I had no idea I even had. I have an appointment with an endocrinologist but the earliest they could get me in is Jan. 11, so until then I would really like some opinions on my lab results.
An ultrasound on my thyroid determined that I have one small nodule on the right lobe of my thyroid, measuring exactly 10 mm. My lab results state that it is a "small, hypoechoic nodule. No other nodules were revealed." Since it is too small to do a biopsy now, they will have to check it again in about 6 months for growth. I'm wondering if goiters are a common early sign of hyperthyroidism?
T3 Tot result: 179 (Range 87-178)
Thyroglobulin Antibody result: <1.8 (Range 0.0-4.0)
TSH: 0.52 (Range 0.34-5.60)
T4: 1.47 (Couldn't find the sheet for this one so I do not know the range, but the dr told me I was slightly above normal on this one as well.)
At this point, I do not know if I have Grave's, postpartum thyroiditis, etc. The dr at internal medicine where I was tested only told me she believes the symptoms may be due to the small goiter, however, I am in the early stages. One of my biggest complaints is that I am having eye issues and my face has become extremely puffy. My eyes are puffy, red, and swollen and have been since the start of my symptoms. I'm seeing an eye doctor tomorrow as I'm terrified that I'm in the beginning stages of thyroid eye disease. Based upon my lab results, does it seem likely that I'm in the early stages of Grave's disease, or could all these symptoms really be because of my small goiter? This is all very confusing for me and I hate that I have to wait for answers until January. :/
An ultrasound on my thyroid determined that I have one small nodule on the right lobe of my thyroid, measuring exactly 10 mm. My lab results state that it is a "small, hypoechoic nodule. No other nodules were revealed." Since it is too small to do a biopsy now, they will have to check it again in about 6 months for growth. I'm wondering if goiters are a common early sign of hyperthyroidism?
T3 Tot result: 179 (Range 87-178)
Thyroglobulin Antibody result: <1.8 (Range 0.0-4.0)
TSH: 0.52 (Range 0.34-5.60)
T4: 1.47 (Couldn't find the sheet for this one so I do not know the range, but the dr told me I was slightly above normal on this one as well.)
At this point, I do not know if I have Grave's, postpartum thyroiditis, etc. The dr at internal medicine where I was tested only told me she believes the symptoms may be due to the small goiter, however, I am in the early stages. One of my biggest complaints is that I am having eye issues and my face has become extremely puffy. My eyes are puffy, red, and swollen and have been since the start of my symptoms. I'm seeing an eye doctor tomorrow as I'm terrified that I'm in the beginning stages of thyroid eye disease. Based upon my lab results, does it seem likely that I'm in the early stages of Grave's disease, or could all these symptoms really be because of my small goiter? This is all very confusing for me and I hate that I have to wait for answers until January. :/
You have to have all the antibodies tested. TPOab and TGab are associated with Hashi's. Only one has to be elevated to confirm, so both have to be tested to rule out. TPOab is actually the more common one associated with Hashi's. If they were only going to test one, they picked the wrong one.
TSI is associated with Graves'. And, yes, this one is necessary, too.
I feel that labs are getting very sloppy. It's not just labs; it's imaging centers, too. Reports use a lot of discrimination values, so in the end, you don't know what your result really was. As a snapshot test, it's not that important...a "less-than" or "greater-than" value is fine. However, if you have a series of tests over time and want to compare, it's almost impossible.
TSI is associated with Graves'. And, yes, this one is necessary, too.
I feel that labs are getting very sloppy. It's not just labs; it's imaging centers, too. Reports use a lot of discrimination values, so in the end, you don't know what your result really was. As a snapshot test, it's not that important...a "less-than" or "greater-than" value is fine. However, if you have a series of tests over time and want to compare, it's almost impossible.
You originally posted your TGab result as "less-than 1.8". Was it "less-than 1.8" or "1.8"? If it's "less-than 1.8", then the lab is using discrimination values, and your result could be anywhere from zero to 1.8. Either way, no, I wouldn't call your TGab elevated. Bear in mind that those of us with Hashi's often have antibody counts in the high hundreds, or even thousands, on diagnosis.
TGab tells you nothing whatsoever about your thyroid function. We can have antibodies for years or decades before they damage the thyroid enough to cause out-of-range labs and symptoms. All antibodies really tell you is that you have the potential to develop thyroid disease. FT3, FT4 and TSH (if it's reliable in your case), tell you if your thyroid function is normal or not. The general rule of FT4 is that it should be about midrange. We don't have your range, but 1.47 is a little above most ranges' midpoints. FT3 should be in the upper half of the range. Yours is total T3, but you can see that it is above range, which could be making you feel hyper. However, your TSH is not suppressed, which would indicate that your pituitary is pretty happy with your levels.
Thyroid eye disease typically goes with Graves', not Hashi's or postpartum.
A nodule is a small overgrowth of thyroid tissue, you can't usually see a nodule. As you can see, yours is only 10 mm. A goiter is an inflamed, swollen thyroid. It can be visible if it's big enough to distort the neck. If your thyroid was reported on U/S as normal in size, you don't have a goiter.
TGab tells you nothing whatsoever about your thyroid function. We can have antibodies for years or decades before they damage the thyroid enough to cause out-of-range labs and symptoms. All antibodies really tell you is that you have the potential to develop thyroid disease. FT3, FT4 and TSH (if it's reliable in your case), tell you if your thyroid function is normal or not. The general rule of FT4 is that it should be about midrange. We don't have your range, but 1.47 is a little above most ranges' midpoints. FT3 should be in the upper half of the range. Yours is total T3, but you can see that it is above range, which could be making you feel hyper. However, your TSH is not suppressed, which would indicate that your pituitary is pretty happy with your levels.
Thyroid eye disease typically goes with Graves', not Hashi's or postpartum.
A nodule is a small overgrowth of thyroid tissue, you can't usually see a nodule. As you can see, yours is only 10 mm. A goiter is an inflamed, swollen thyroid. It can be visible if it's big enough to distort the neck. If your thyroid was reported on U/S as normal in size, you don't have a goiter.
1 Comments
The report had the less than sign before the 1.8, so that means it could be anywhere from 0-1.8? I suppose that's a good sign, would it be necessary to complete other antibodies test such as immunoglobulin?
First of all, unless your U/S report contained other information that you didn't post, a thyroid nodule is different from goiter. A nodule is a small overgrowth of thyroid tissue and extremely common. A goiter is the overall swelling of the thyroid. It's not necessarily a warning sign of hyperthyroidism.
Your total T3 is above range, but FREE T3 is a much more informative test. FT4 does look a little high in the range, but not above most ranges. Ranges vary lab to lab and have to come from you own lab report.
Your doctor should test TSI (thyroid stimulating immunoglobulin), which would tell you if you have Graves' or not. TPOab (thyroid peroxidase antibodies) should also be tested. They can be elevated with both postpartum thyroiditis and Hashimoto's thyroiditis.
A goiter is not the cause, but the result, of thyroid disease. Once again, did the U/S report mention a goiter (enlarged thyroid)?
Your total T3 is above range, but FREE T3 is a much more informative test. FT4 does look a little high in the range, but not above most ranges. Ranges vary lab to lab and have to come from you own lab report.
Your doctor should test TSI (thyroid stimulating immunoglobulin), which would tell you if you have Graves' or not. TPOab (thyroid peroxidase antibodies) should also be tested. They can be elevated with both postpartum thyroiditis and Hashimoto's thyroiditis.
A goiter is not the cause, but the result, of thyroid disease. Once again, did the U/S report mention a goiter (enlarged thyroid)?
2 Comments
Oops, I thought goiter was the same as a nodule. When I asked one of my doctors she told me they are they same thing. I have no reports of an enlarged thyroid. When the ultrasound was performed they told me it appeared "normal" in size, but who knows? I still think i'm in the early stages of whatever this is...which is also my biggest fear; that this is going to get worse. I've heard about the other antibodies tests so I'll have to ask my endocrinologist about them. It's driving me crazy not knowing what this is. Do my antibodies seem slightly elevated to you?
Let me rephrase that to make more sense; since my thyroglobulin result is at 1.8, does that mean it is slightly elevated? Would it be at a 0 if I had normal thyroid function?
Have an Answer?
You are reading content posted in the Thyroid Disorders Community
We tapped the CDC for information on what you need to know about radiation exposure
Endocrinologist Mark Lupo, MD, answers 10 questions about thyroid disorders and how to treat them
A list of national and international resources and hotlines to help connect you to needed health and medical services.
Herpes sores blister, then burst, scab and heal.
Herpes spreads by oral, vaginal and anal sex.
STIs are the most common cause of genital sores.
