TSH, Metabolic Panel, CBC

[torozco]

Hi, everyone. I recently saw my doctor as a result of some symptoms I was having including fatigue, shortness of breath, dizziness, migraines and tachycardia.  Dr did an EKG and chest x-ray to rule out heart problem.  Explained he was concerned it may be thyroid related.  Ordered CBC, basic metabolic panel, and TSH level test.  I'm a 26 year old female with no notable prior health history.

After everything I've seen and heard so far, it seems like just testing the TSH level without testing T3 and T4 would not be definitive in determining any sort of a thyroid condition, but I may be misunderstanding how this testing works.

The CBC results were within normal range in all aspects; however, metabolic panel had two numbers that were at the extreme ends of the "normal" spectrum - namely carbon dioxide at 22 and serum calcium at 10.2.

My dr doesn't seem concerned and said we would discuss it at my next visit, but honestly, he's younger than I am and very inexperienced so I'm not really sure if I should be consulting another dr. on this based upon the results I did get.

I've read a number of things that indicate hypercalcemia may indicate a parathyroid problem.  I guess I'm just confused as to whether or not I should be making an appt. with somebody else and if my dr. performed the same tests any of you underwent in being diagnosed with any thyroid and/or parathyroid condition.

Any information you could provide me would be great.  Thank you.

[GravesLady]

LOL, the Internist that diagnosed and treated my thyroid was much younger than me also.  But he was very thorough.  He doesn't practice here anymore.

Do you happen to know what your TSH result and Labs reference range?

Your doctor might be doing  the cascade method, in which most doctors do, unless they have reason for suspect, where they will do the full thyroid panel.  
Physically checking your thyroid (neck) and TSH is enough to tell whether you are hypothyroid, hyperthyroid and something wrong with thyroid like nodule/goiter, or swollen.  If doctor suspects hyperthyroid then FT-4 along with TSH.  Then they work from there if other test are warranted. FTs if warranted, will tell if you are autoimmune and other thyroid or health conditions.  If autoimmune then doctor will do antibodies to confirm.

Serum calcium is usually measured to screen for or monitor bone diseases or calcium-regulation disorders (diseases of the parathyroid gland or kidneys). Normal values range from 8.5 to 10.2 mg/dL. CO2 (carbon dioxide): 20 to 29 mmol/L. However normal value ranges may vary slightly among different laboratories.  So both of yours seem to be normal , therefore doctor is not concerned, which to me is great - good news!


Other health conditions share some of the same symptoms of thyroid, and, what you have described.  For one, MVP - Mitral Valve Prolapse.  This is done by echocardiogram.  The health condition list is just too long to post.

Good Luck and keep searching for reasons.

[torozco]

Thank you for your response.  My TSH level was around 1.7 (normal) so that appeared to be fine.

My lab's reference range for serum calcium was XX (I don't remember the low number) to 10.2 and for carbon dioxide was 22 to XX (I don't remember the high number).  Since I was right on the ends of the spectrum on those two and knowing that different labs use different reference ranges is part of why I wasn't sure if these levels were really "normal".

I hate not knowing what is wrong, but knowing that something isn't right.  I don't anticipate any serious problems, but if there is damage being done that could be prevented as a result of a diagnosis and proper treatment, I don't want to waste any time finding out.  I think I am going to work on finding another physician for care though, just because I don't like feeling like I'm second-guessing a trained professional, which is what I've been doing with this doctor as a result of his age and finding that I do have symptoms but not getting any explanation.  In the scheme of things, it's only been four months since I've been seeing him.  I don't know if things are truly getting worse (headaches, graying hair, fatigue, shorter/lighter periods) or if I'm just noticing them more now.

Anyway - thank you for your time in providing me some additional information on my labs graveslady, it is very appreciated.