Help with diagnosis?

[Rachel4426]

I have been going through blood tests for over a year trying to find a cause for my macrocytosis!  After my genereal physician and now hematologist number 2, we are still looking for answers.  He suspects hyperthyroidim and I was hoping someone could help me and give me another opinion.

Here are my latest test results.

T4 total 12.7
T-Uptake .73
Free Thyroxin In 9.3
TSH, High Sensitive 4.272


Other abnormal results include MCV 103.2
RBC 3.76
Hct 38.8
MPV 6.5
Retic Count 2.5
Retic Absolute .0940

Any thoughts on the thyroid?  Can hyperthyroidism cause macrocytosis???  Any help would be greatly appreciated!

[Rachel4426]

How do you convince the doc that 300 is too low (my previous was 276).  
I had a MMA test and it came back normal. I think it came back normal because my G.P had me on B12 supplements (1000 mcg a day) for 5 days before my MMA test.  Would this have caused my MMA test to fall this quickly?

When I metnioned that I thought B12 may be the problem to my new hematologist, he just shook his head like it wasn't the problem.

I suppose if no one will believe me that I FEEL  B12 is a problem, I will just start taking them again :)  Advocate for your own health right?!?  I hear that Jarrow is a good brand and that Methyl is better than Cyano.  Do you take oral supplements or injections?

It also looks by this last test result that Thyroid is a problem too!  Auto-Immune problems do run in my family!  I will make sure to look into that farther too!

Thanks for all of your help!!!

[Barb135]

Your levels are too low -- mine was 258 @ diagnosis.  Just because it's in range, doesn't mean it's good enough for you.

Well, I think Japan's levels are more reasonable, because even when my levels got to 500, it wasn't enough.  It wasn't until I got over 700 that it really made a difference.  The range my lab uses is 200-1100; my latest level was 735 - I'd like to get it higher.  

Make sure you get TSH, FT3, FT4 and antibody tests done, if you get sent to an endo.  Try to get them anyway.  

[Rachel4426]

Thanks for the info Barb!

My doc's have tested b12 Folate and ferritin.  Al have come back within range.  The 2 b12 tests came back 276, and the latest 300.  I doubt I could get a diagnosis of a b12 deficiency with those scores since the referance range in the US is 200-900.  Now if I was in Japan, their low end range begins at 500!  

Chances are when I go back to the hematologist in July, he will recommed an endocrinologist.  Which means more tests, but maybe we are headed in the right direction...  This has certainly been a long road!

[Barb135]

Macrocytosis is enlarged red blood cells.  To my knowledge being hyper does not cause it.  Here's a tidbit that helps explain it a bit.

http://www.mayoclinic.com/health/macrocytosis/an01287

Two things I know (there are others) that cause macrocytosis are alcoholism and pernicious anemia (vitamin B12 deficiency).  No, I'm not an alcoholic, but I do have pernicious anemia and one doctor several years ago insisted that I had to be an alcoholic because (according to him) that's the *only* thing that causes macrocytosis.  I do have a drink now and then, occasionally, even more than I should, but, as a test to prove to him that I wasn't alcoholic, I actually went for months with not even a sniff of alcohol and when my blood tests came back the same, the doctor actually accused me of "cheating"/lying to him ........with a doctor like that, I couldn't win!!  

It was another 3-4 yrs before my doctor (not the same one) finally sent me for a B12 test and my levels were rock bottom; I was dx'd with pernicious anemia and started on B12 shots - did wonders for my fatigue and exhaustion, as well as the tingling/numbness in my hands and feet; however, because I had pernicious anemia that went untreated for so many years, I have permanent damage.  

It was actually over a year after the pernicious anemia dx, that I got my hypo dx, then almost another year before I got the Hashi dx.  

Regarding the reference ranges -- labs use different methods to analyze samples, so the reference range depends on the analysis method; therefore, these ranges must come from your own lab report.

That said -- the AACE has made a recommendation regarding the TSH; their recommended range is 0.3-3.0, so in view of that your result would indicate hypo, but without knowing the range for the FT4, it's impossible to say.  Having an FT3 result would make it even easier for us to help you.  

[Rachel4426]

After looking at past tests, I think the range for the TSH is probably .350-5.5 uIU/ml (mine is 4.272 still not finding anything about the others :(

[Rachel4426]

Sorry about the spelling!  lol Guess I should have read before I posted!  

[Rachel4426]

Hello!

Thanks for responding!  Unfortunately there are no range values listed on these results.  THe only think it says is that my
T4 Total Thyroxine at 12.7 is High
and T-Uptake  as .73 is low.

I don't see the doc again about these results for 5 more weeks!  UGH!  Just tired of searhing with no answers.

THanks for your help!

[Super_sally888]

Hi,

you need to give the reference range for your labs.

I think your levels are indicating  hypo (low) thyroid rather than Hypo.

Am not sure if hypo can cuase macrocytosis.  However, I think it may be wise to try treating the hypothyroid and seeing if it helps.