So Confused...apparently I don't have a thyroid problem...

[pipsal]

I got these test results for my thyroid - I had to ask for everything other than TSH. Have numerous symptoms, but they could be from a number of conditions I guess.

Anyway, I was sent for a thyroid ultrasound also at my request as I have a fullness/irritation in neck/throat and they always thought I had a goiter - according to the ultrasound I don't have a goiter/enlarged thyroid...I just have 2 nodules, 1 on each side of it.

Thyroid Stimulating Hormone 2.5 mU/L (0.40-4.00)
free Thyroxine (fT4) 20 pmol/L (10-20)
free T3 5.7 pmol/L (2.8-6.8)
+ Anti-Thyroglobulin Ab 76 U/mL (<60)
+ Anti-Thyroid Peroxidase Ab 100 U/mL (<60)
"This antibody pattern suggests an underlying autoimmune inflammatory process. eg Graves' and Hashimoto's." - this was on the report printout

Anyway, apparently I don't have any problems with my thyroid at all. Its all perfectly fine, and there will not be any follow up tests etc required. I don't know if they need to check the nodules on the thyroid to see if they are cancerous or not? And even though the lab has indicated that I may have Graves/Hashimotos because of the antibodies, apparently I don't have either. I *MAY* at some point develop Hashimotos - could be next week, could be 30yrs time, could be never they said (they being GP and an Endocronologist).

When I went to the Endo he didn't even discuss my thyroid results until I asked him - he continues to stick with the Poly-Cystic Ovarian /hormone diagnosis for me (similar symptoms). Yet my hormone levels have been perfectly low for 8yrs or more now...but he said that some people are more sensitive than others and get symptoms even if their levels were in the normal range. I don't understand how this can be so for hormone levels, but not for thyroid....I asked this and he went bright red and deflected the conversation saying thyroid tests were much more accurate??

I really don't want to have a thyroid problem obviously, but I need to be sure it can be ruled out totally and I am very confused with all of this.... Is there anyone out there that needs treatment with these levels?

[redheadaussie]

You sound just like me! I had years, over 15 years of having symptoms and a nice TSH of around 2 all the time only to be told, you are normal!
Well, anti-bodies 'chomped' on me and I ended up without a thyroid and 15 miserable wasted years of life.
  I was always low on iron levels too, still am. Alot of the time I was tested I was getting the same result as you with the 'concurrent infection/inflammatory disease' report. ( I am an Aussie too, BTW)  I have Hashimoto's.
Mild lymphocytosis means your body is fighting either an infection or an inflammatory disease. Often people will have that without realising they are fighting a virus or a cold. BUT it can also be indicative of an antibody issue.

I am having a bad tired brain fog day, and would like to say more, but will leave it for now till I am fresher!
Cheers

[pipsal]

Thanks for your replies. The rest of my blood test results are as follows. My Prolactin looked ok, but something is out with my Adrenal Plasma ACTH - apparently that is pretty normal as its a very sensitive test, I just have to get it done again in 9mths when I go back to the Endo.

The only thing they are going to check is my Red Cell count - have to get that done in 3mths. I was also put on iron supplement (again). When I pointed out that I always have 'mild lymphocytosis' they looked back at my results (I get tests done at least every 6mths for the hormones/FBC) and they are always up a bit - does this mean something?

My sugar was up a bit on this test - I have had Glucose Tolerance Test done in the past and it was marginally elevated, they said it was slight insulin resistance (but that could be from excessive weight).

My problem is that my very trusted GP since childhood doesn't appear concerned, and my endocrinologist of 8yrs isn't either - they just seem to  be going with the status quo, but I don't think status quo is good enough if things continue to progress in case it is something else. Who else do I go to? I need the GP to write a referral to a specialist....I am in Australia btw if anyone knows of anyone they can recommend in Queensland.

Full Blood Examination
+ Red Cell Count 5.5 (3.6-5.2)
+ Lymphocytes 4.3 (1.1-4.0)
"Mild lymphocytosis"

Erythrocyte Sedimentation Rate 11 mm/hr (1-20)

Serum Chemistry - Fasting
- Bicarb 23mmol/L (25-33)
+ Gluc 6.3mmol/L (3-6)
+ Urate 0.37 mmol/L (0.14-0.35)
+ GGT 50 U/L (0-45)

Adrenal Studies
- Plasma ACTH <5 ng/L (5-50)

Serum Cortisol (collected 9.13am)
510 nmol/L (220-660)

Prolactin 8 ug/L (<20)
Testosterone 1.6 nmol/L (0.3-2.8)
free Testosterone 1.4 pmol/L (0.2-13.0)
Sex Hormone Binding Globulin 104 nmol/L (18-114)

Iron Studies
-Serum Iron 8 umol/L (10-33)
+++Transferrin IBC 107 umol/L (45-70)
-- Transferrin Saturation 7% (16-50)
Serum Ferritin Assay 64 ug/L (15-290)
"The iron pattern suggests, but is not diagnostic of suboptimal iron status. The serum iron may be falsely lower and the ferritin may be misleadingly elevated into the normal range by concurrent infection/inflammatory disease."

[Barb135]

Judging from both the TPOab and TGab, and the nodules, I'd say, almost certainly that you have Hashimoto's.  Your levels of both are elevated; some people have high TPOab, some have high TGab, others have both, like you.  As LazyMoose said - you need to have a TSI done to diagnose Graves Disease; you should be aware that some people have both Graves and Hashimoto's.

Additionally, you should also be aware that TPOab is used to diagnose several other autoimmune diseases, as well as Hashimoto's.  These include, but are not limited to: pernicious anemia, lupus, and RA.  

Because of the level of your FT4, the diarrhea, anxieity, sweating, headaches, etc, I think you really need to have the TSI to check for Graves.  I'd also recommend that you get the Rheumatoid  factor; a vitamin B12 test and top all that off with an ANA (Antinuclear Antibody) test.  You should also get tested for insulin resistance/pre-diabetes, which often goes hand in hand with PCOS and can cause quite a few of your symptoms.

As LM said -- you have the antibodies "chomping" away at your thyroid; it's possible, they are chomping away on other parts of your body as well.  You should also be aware that having one autoimmune disease, raises your chances of having another, or more and symptoms for many of these autoimmune diseases mimic each other.

You said: "As I said before though, these symptoms could be because of a number of things though - is it likely that these could be symptoms of my body reacting 'more sensitively' oto the levels? Or are the antibodies only in very early stages where you wouldn't expect symptoms?"   Your symptoms *could* be from any or all of the issues mentioned, along with probably others.  

In the early stages of an autoimmune disease it's possible for some people not to have symptoms; however, it's also very possible to have symptoms even before the antibody tests are positive.  In your case, however, there are a ton of symptoms and they really do need to be looked into.  With those antibody results, it's a sure thing that you have some type of autoimmune issue - my guess is that thyroid is going to be involved.  

Keep an eye on those thyroid results - TSH, FT3 and FT4.  I would expect them to fluctuate some for a while, then gradually, your TSH rise, while the FT3/FT4 decrease, leaving no question as to whether your there's anything wrong with your thyroid.

[LazyMoose]

PCOS - hopfully someone else will answer in this area, not my thing. I hope adrenals were tested and prolactin levels. You need a complete blood physical for everything. It has been noted that hypo symptoms can arise from antibodies only., but you seem to advanced for that.

[pipsal]

I have a lot of thyroid symptoms - some hypo and some hyper though. I have been diagnosed with PCOS in the past based on hormone levels, menstrual cycle and hairloss alone - but all tests that were not right for that have been better than good for many years, yet the symptoms continue to progress which is why I am trying to find out if something else might be causing it....they diagnosed androgenic alopecia because of the PCOS, yet to be 80% bald at 30 is not common (people in wig salons have been shocked), and if all seems ok with the hormones, surely there must be something else? It feels like they found one thing to explain the hair and then stuck with it, and maybe it wasn't the only thing...

Some Symptoms:
Extensive diffuse hair thinning/loss - has progressed over last 10yrs (I'm only 30 and have to wear a wig now as I have less hair than a baby - lost 80% - my part is about 6 inches wide, but it is that thin all over the head), hair that I do have is dry/frizzy
Irregular/often non-existant menstrual cycle...yet had a cycle beginning of this year that lasted over a month and I had to go on meds to stop it.
Nails are paper thin and split/peel constantly - can barely grow them to the tip of my finger.
Very sensitive/dry skin
Always tired/lethargic - can't wait until I can get home and have a sleep
Increase in sweating - often sweat beads on face/scalp even if in airconditioning / feeling the heat more?
Overweight - gain it very easily and have a lot of trouble loosing any no matter what I do.
Chronic sinus and throat infections over past 4 yrs or so
Hoarse voice/clearing throat all the time (but I am a teacher...)
Anxiety - difficulty breathing when anxious (only last couple of years)
Often get muscle cramps during night, swelling around ankles when sitting or standing for too long
General pain/aches in back, legs, arms, shoulders - daily, varying degree
Difficulty concentrating/more forgetful than I used to be
Chronic headaches/migraines
Frequent diahrea (was told i have irritable bowel syndrome)

As I said before though, these symptoms could be because of a number of things though - is it likely that these could be symptoms of my body reacting 'more sensitively' oto the levels? Or are the antibodies only in very early stages where you wouldn't expect symptoms?

[LazyMoose]

Anti-Thyroid Peroxidase Ab 100 U/mL (<60)
"This antibody pattern suggests an underlying autoimmune inflammatory
disease process. eg Graves' and Hashimoto's."

-High TPO is usually Hashimotos, but can also be Graves. TSI test is used to test for Graves only. Antibodies do not go away. Some do take very low doses of thyroid med when tested positive for antibodies, but with normal looking labs. These people usually have symptoms as well.

You need to keep an eye on these labs and repeat them according to how you feel.

"I really don't want to have a thyroid problem obviously"  - Antibodies are munching away at it right now, in time it will be more obvious.  Fullness, irritation in neck is a sign or it could be acid reflux.

You do not mention any main thyroid disease symptoms, have none yet?