Labs don't support symptoms

Hi shelly, I wonder if you can help me. After seeing my Endrcinologist recently,he said I had Mild Hyperthyroidism,my blood results are at the bottom of this post if you can read them,I am also from the UK.

The reason I'm asking you is because I suffer chronic Stomack problems daily,to the stage where the pain is becoming unbearable.

i also do not understand the thyroid at all,it's so complicated .

Hi Shelly, thank you so much for your advice. I really appreciate it.

I am going to schedule some time with an endrocinogist sometime this month, and I'll be sure to ask about Addison's Disease. I looked up Addison's Disease after your message, and it's interesting that the "Addison's crisis" sounds a lot like that episode I had. 

I do think that I've been tested for diabetes and my blood sugar always seems to be in the normal range - the most recent A1C measurement showed 5.1.

I have had a few blood tests that show slightly high calcium (I am out of town at the moment so I don't have the numbers in front of me.). Do you think that that could indicate anything?

Allison

Hello Aharp:

I also feel from what you said you fit Addison's Disease more.  A1C of 5.1 is awesome!  Under 7.0 is the guideline.

Addison's is a cortisol problem (too low) and the adrenal gland makes that.  The adrenal gland sits on top of each  kidney. It causes all kinds of pain, esp. bone pain, back problems etc...It is also know for Gastro-intestinal problems. The late USA Pres. John F. Kennedy had it. It can be treated. Also when you see the Endocrinologist have him do a 24 hour urine, blood cortisol levels also, and calcium levels. Mineral panel check.

Your urine should only have minor "trace" levels of cortisol and calcium, and other things like sugar, urea, protein, creatinine, etc...if you are having too much it will show in the 24 hour urine.

Many people with thyroid disease can also have an adrenal problem. Sometimes it can be from a growth on the adrenal gland or the gland has changes in it do to the disease. Sometimes it can be a family trait.

They can do an ultrasound of the parathyroid gland as it sits on the corners of the thyroid  gland. The Parathyroid makes calcium and it can also change from a growth or undiagnosed thyroid disease.  So ask for an Ultrasound as they can see if it is enlarged, measure size, etc...

Keep me posted on how it goes,

Shelly

Hello Norma:

I was able to read your results. I will explain as follows:

TSH is 0.86 and normal range is 0.45 to 4.50, so since it is at the low end of the scale they call it Hyper (too much hormone),  when it is on that side of the scale. If it was 5.0 you would be HYPO or too little hormone!  They are opposite of each other.

It says as a note under your TSH if you are taking T4?  If you were on T4 name is Thyroxine 4 a hormone made by the thyroid. So if you were taking T4 it would be too much.

Now we have thyroid glands that sit on top of our trachea (Windpipe) and it makes a total of 4 hormones. For our conversation we will focus on T3 Liothyronine and T4 Thyroxine.

A thyroid produces the hormones and you normally do not know or feel anything. It also works with a gland in our brains called the Pituitary. The Pit. Gland says to the thyroid make more T4 and it does, except for some reason it can make too much.  Our bodies have to be just right not too much or too little. So if you have too much (HYPER) you will see symptoms like: feeling HOT, feeling anxious,  losing weight fast, sweating, insomnia, loose bowels and even Irritable bowels sydrome, anxiety, thyroid eye or bulging eyes, headches, muscle aches. There are more but these are common.

It can be hard to digest food well as the thyroid is making the metabolism run too fast. A normal thyroid take T4 and converts it into T3 which is the useable hormone in our bodies. When it makes too much you can lose weight so fast and if your bowels and tummy are under constant movement, it makes it go fast through you almost like you have food poisioning.  Some people have it very bad and need meds for the tummy.

There are 4 smaller glands on top of the thyroid and they are called the parathyroid glands. They make calcium.  They regulate the level in the body, your calcium is 2.36 normal should be 8.6 to 10.3 and you are low in that.

Low calcium causes muscle pains and problems in the body. It can be replaced by taking calcium tablets.

You need to slow down the thyroid, and they have a medication called Carbimazole and you should see an Endocrinologist who knows the thyroid gland.  It may be mild on paper but it can make you feel bad so you need to see the doctor and also see a gastro-intestinal doctor who could exam you and the give you a med for it. So please talk with your GP and ask for a referal to the above doctors.

Any more questions just ask,

Shelly

Hi again, Shelly,

Thank you so much for your replies. I ended up going back through my labs, and I found two that show some abnormal results for cortisol, but at the time I remember I was told it was all normal:

10/13 - 

- Cortisol 0 min - 6.3 ug/dl (low)

- Cortisol 30 min - 19.5 ug/dl (low)

- Cortisol 60 min - 28.2 ug/dl

1/16 - 

- Cortisol 0 min - 8.7 ug/dl (low)

- Cortisol 30 min - 23.3 ug/dl (low)

- Cortisol 60 min - 27.8 ug/dl

I also looked back through some labs and found another report for PTH which was also in the 20s, which like you said might indicate that the parathyroid is not the issue...

I have taken corticosteroids before (many times) for urgent inflammatory conditions over the years and it does not seem to "cure" my illness, so I'm not sure if that is counterindicative of Addison's.

If you have any thoughts on these cortisol numbers, please let me know. 

Thank you!

I also had a 24 hour urine test from a while ago (2010) that showed some abnormal results:

Hypercalciuria - 360 (normal is < 200)

borderline hyperoxaluria - 45 (normal is 20 - 40)

high urine ph - 6.7 (normal is 5.8 - 6.2)

moderate caox stone risk - 8.86 (normal is 6 - 10)

extreme cap stone risk - 4.78 (normal is 0.5 - 2)

creatinine 24 hour high - 28.2 (normal female is 15 - 20) 200)="" borderline="" hyperoxaluria="" -="" 45="" (normal="" is="" 20="" -="" 40)="" high="" urine="" ph="" -="" 6.7="" (normal="" is="" 5.8="" -="" 6.2)="" moderate="" caox="" stone="" risk="" -="" 8.86="" (normal="" is="" 6="" -="" 10)="" extreme="" cap="" stone="" risk="" -="" 4.78="" (normal="" is="" 0.5="" -="" 2)="" creatinine="" 24="" hour="" high="" -="" 28.2="" (normal="" female="" is="" 15="" -="">

borderline hyperoxaluria - 45 (normal is 20 - 40)

high urine ph - 6.7 (normal is 5.8 - 6.2)

moderate caox stone risk - 8.86 (normal is 6 - 10)

extreme cap stone risk - 4.78 (normal is 0.5 - 2)

creatinine 24 hour high - 28.2 (normal female is 15 - 20)>

Hello Aharp:

I do have some extra thoughts on your levels above.  I assume these are timed blood draws? 

Normal blood cortisol levels are 2.3 to 19.4 and should not be lower than this range. Usually a morning cortisol level may be the highest and later ones with-in normal ranges.  Was this done with a Dexamethasone tablet test?

Steriods- such as Prednisone can cause a problem with your cortisol levels as they reduce inflammation well, they also shut off your own body for a time.  In some cases, it can bother the adrenal glands and if you are on them more than 7 days, it can take a while for the adrenal gland to work as it should. Longterm use of steriods can also cause a brittle bone disease to happen. It can not be reversed. Please avoid steriods unless it is for Asthma or a matter of life & death.  they do harmful things when taken long term.

Each of your blood draws looks like you are too low and then goes high, so it does not seem stable to me.

I think you show symptoms of Addison's Disease and since many of the cortisol readings are low, this should be investigated by an Endocrinologist.

Regards,

Shelly

Hello Aharp:

This is not good. Have you had a kidney stone?  Some people do make high calcium and have a tendency to get stones.  They are extremely painful.

In any event you need to have an exam and even an MRI or CAT scan done to image the kidneys and adrenal glands.

I still feel you fit a lot with Addison's Disease.  Your levels should be updated on a 24 hour urine since this was 2010.

Regards,

Shelly

Oh Shelly,thank you so much for all of that.  I won't pretend I understand it all,but it has taught me a bit more.

I emailed my Endocrinologist secretary before Christmas ,because I thought there maybe a typing error in hyperparathyroidism /hyPOparathyroidism and she said she would check with the Endo,but she never got back to me,so I emailed her again this morning,and she replied with it was a typing error,and I have mild hyPOparathyroidism,can you believe that.  So I assume that changes a few things or probably makes more sense to you.

I am at the moment on 100mg of Thyroxide,now I don't know if that's right or not?   I have also asked to see my first Endocrinologist who first found out I had an Underactive thyroid,and that was there fault for giving me Amidrone after a heart attack.  Nearly all the health issues I have are due to bad care.

But the thyroid being a main organ,it has to work right,and I suffer severely with Stomack pain daily,and I know it could have somthing to do with my thyroid,but God is it difficult to understand,which if doctors done there job I wouldn't have to.    That just leaves me with sorry for the rant,and if you could advise me on what I need to do now that I've found out it is hyPOparathyroidism I would be eternally grateful. Thank you so much.

Hello Norma:

Okay that makes sense to me, Hypoparathyroidism, is a mouthful to say!  I saw your calcium is low right away. You should have the doctor advise you but you need replacement calcium.

As I said before, we must be "Just Right" not too low or too high. Go to a phramacy or chemist shop and ask for calcium tablets as they are sold over the counter. You may only need one tablet a day. It comes in different doses or you can buy a very good multivitamin that contains calcium and take one each day.

You need to get up to 8.6 and you are at 2.3 and it may take a month to get it to come back.  You can see if your doctor recommends a replacement calcium tablets also.

I would say that you may want to take 25% less of the Thyroxide as your TSH is 0.86 and it would be better at 1.0 -3.5 or so.  You would feel better. Of course you may and should consult your doctor for that, but I recommed that.

Ah doctors, LOL,  are too busy and hardly have 10 mins per patient.  I have no problems helping and explaining so please ask me, if I am getting through to you.

The thyroid is a very important Gland and it does a lot of things in our body, it regulates our periods, it makes us have energy, it regulates our metabolism, it helps with our weight, it helps with our body temp's and our heart rate.  We only have 1 thyroid gland and no back up gland so we need to stay well and find the right dose of meds if needed.

Any questions, just ask.

XO Shelly

We use different calcium units in the rest of the world. 2.3 is 9.2 US. Multiply by four to convert. No one alive has Ca of 2.3 in US units.

Firstly I'd like to say thank you Shelly,sorry it's took me so long to reply,but I've been so busy.

Now I notice the post below talking about different countries use different Calsium levels,so firstly I think I did tell you I come from the UK.

And secondly I can't really understand what that person is talking about.

But I for one am sincere grateful for your help,and if in the future I need a question answered,be sure I'll be back.  Thanks.

Hi ed,I am from the UK so could you be a bit more precise in your post.?

Sure, if your calcium is 2.3 and your from the UK it's in the normal range. Our range runs from about 2.2 - 2.6. In the US the range is about 8.8 - 10.4.

We use mmol/l units the US use mg/dl. To convert UK units to US multiply by 4. Thus your calcium of 2.3 is 9.2 in US units. So no need to get it up. It's already OK.

Hello Ed:

Oh thanks for that I in the USA and am using our USA scale. I wrote this down now. Will keep that handy.

Shelly

Hello Norma:

As I am in the USA, I did not realise that your using a different scale and way of determing your calcium.  Ed is correct your calcium would be 9.2 in my country. That is okay!

We use different measurements ways.  Most of our ways are similar and this way doing the calcium is different.  I was unaware of the testing methood so in my country your calcium would be measured in mg's. 

I thought it looked strange at 2.3.

Anyway, you are okay in Calcium, and let's keep it that way, LOL. Keep taking your medication as directed  or you can ask the doctor about reducing the thyroxide by a small amount so your TSH may come up.

Regards,

Shelly

Thank you all the same shelly.

Right ed,Lets start again, your saying if your Calsium is between 2.2-2.6 that's normal. So why is my Endocrinologist telling me I have mild hyPOparathyroidism . I'll put my latest blood results on if I can and I would sincerely appreciate your opinion . 

Only way to know if you're hypoparathyroid is to test parathyroid hormone level. Has endo done that?

How is that done,by blood tests,or ct scan. He tells me nothing apart from I'm keeping an eye on you.

Blood test.

Hello Norma:

Ask your doctor to test via blood your Parathyroid Hormone (PTH) it is a special blood test.

That way you can be sure of a proper diagnosis.

Shelly

ed,you sure are a person of few words.

Hello shelly, I don't really get what blood test your really referring to here.

Are you saying just the usual blood test,which here is usually just TSH level,or do you mean,just test the (PTH) I told you I find it soooooo complicating lol.   So can you detail it to me a bit more clearly.

sorry if I sound stupid,but this is really important to me to get it right.

I suffer chronic Stomack pain,so I'm trying to get to the problem which I believe can have a great deal to do with the thyroid.

Thanks again shelly.

Hello Norma:

No problem ask any questions you have.  I am refering to a special blood test for Hypoparathyroidism, a condition of the Parathyroid gland. The Parathyroid glands sit at the corners of the thyroid.  They make calcium and regulate your level in your body.

The special  test is called PTH or Parathyroid hormone level test. This way you can be sure that something is either wrong or not wrong with the gland. This is a special test that was not done in your other blood work. It is not the TSH!

What is your symptoms with your stomach?  Are you having loose bowels? Do you have sharp pain? Tell me what it is that is bothering you.

XO Shelly

Hi shelly,Sorry to be such a pain,so to speak.

Firstly I'll just remind you I'm from the UK,and obviously each country does things differently,but having said that,all our body parts work the same.lol

For sometime now I have chronic Stomack pain,I've been down the road of IBS,food intolerance ,allergies,there now starting MRI scans for nerve pain.

But the pain is getting more severe,especially towards the end of the day,I usually go the toilet 3-4times a day,but each time I go the pain gets worse.

Now back to the thyroid,I'm not very well up on this,I've tried but I find it so complicated,but I do know my Stomack pain can be due to the thyroid,I don't hold my Endocrinologist in very high regard,because of mistakes he keeps making ,example a letter to say I had mild hyperparathyroidism ,then I checked it out,and I had to email his secretary to see if he'd made a mistake,and she sends back yes it's hyPOparathyroidism ,so really I don't know what it is until I see him in Febuary,which I asked for my appointment to be brought forward because I'm not happy,with not knowing about my health.  I would probably have gone with the flow,but I'm getting to the end of my tether with my Stomack pain.Someone else on here once told me,

(when I just had an Underactive thyroid ) that here in the UK they only do TSH,and she wrote me some other bloods to ask for,and my doctor let me have them,so if there's another test,like the one you mention that I know I've never had done I'll ask him for it when I see him Thursday,How on earth can they come to a conclusion of hyperparathyroidism /hyPOparathyroidism if they haven't tested for it. This word just keeps getting longer,and all he says to me is we'll keep an eye on it.HOW?

Sorry for the rant shelly,but our NHS has made that many mistakes with me that I have to question everything now.  Here's a good one I went to see my GP last week because I go the toilet so much,I thought I had a prolapse bowel,he's sending me for a colonoscopy because he's thinking cancer,and that's without even touching me,what a joke,if this was cancer I'd be dead by now,and I'll never have another colonoscopy,because the last one was horrendous .  Rant over.

Hello Norma:

It does not matter that we are in different countries our bodies work the same.

Several conditions can cause abdominal pain and loose bowels or having to go to the bathroom a lot.

#1- Crohn's Disease is an inflammation of the intestinal linings. It can be diagnosed by a Gastroenterologist (a stomach doctor).  It makes you go a lot and causes bad pain in the abdomen.

#2-  Diverticulosis - Little pockets form in the bowel and get feces in there and you have pain.  CAT Scan can see it.  Treatment is antibiotics.

#3- Cancer causes blood in the feces and makes you weak. Your Red Blood cells would be down, in your blood work.  Abnormal cells can be removed via surgery.  Cancer is slow and may not have any pain at all, however you may see loose bowels. They can see the cells on a colonoscopy.  Cancer tends to be a family thing and a gene/DNA tendency to get it. 

#4- IBS- Irritable Bowel Sndrome.  Causes pain and cramping!  Sometimes you may have constiapation and then loose bowels. It can be treated with diet changes and meds.

#5- Appendecitis.  Early symptoms are pain in the right lower side of the abdomen.  May have lot's of bowel movements and pain.  Tender to touch when pressed on.  Treatment is removal of appendix.

Yes I have heard some horror stories of NHS.  You need to be informed and ask for things like blood work and I hope they do it.

It is a good idea for anyone experiencing bowel trouble to get a colonoscopy.  They can see it all, and no guessing! 

So you have to be informed and if you can ask a friend or loved one to your medical appt.  Have them take notes!  I did that when my now late, Father was diagnosed with cancer.  You need extra ears and a note taker if you ask questions. Even though I knew, I wanted someone else to write down what was discussed.

A colonoscopy has to be done under a relaxant medication and the patient has to drink magnesium citrate to make you clean out the bowel.  It can be painful but they can see a lot.

Keep me posted, I care!

Shelly

Hello Shelly,So do you think the best way to determine hyperparathyroidism /hyPOparathyroidism, is a PYH,blood test.

sorry to be such a nuisance, I just want to get it right,as I've got a doctors appointment on Thursday.   Thanks for all your help.

Hello Norma:

Yes, the test is PTH not PYH. " Parathyroid Hormone test".  It will show what the level is.  This will clear up any mistakes in your diagnosis.

Any questions, just ask.

Shelly

Thank you shelly,I don't know what made me put PYH,must have missed the T button,goes to show we can all make a typing error.

Should really read what I type.lol.  Thank you once again.

Hello, I have been struggling with my hormones forever as far as i can remember, i never have had regular periods. last time my periods started to be regular for 3 months in a row was just before i got pregnant with my little one. I am 26 years old i got 5 month baby and i am active and go to gym when find the time and energy at the end of long day.

Last thyroid test i had in 2014 Dr did advise me that it could be under active thyroid but she was rushing to get me out of the door and see her next patient as they do.. so i never have been put on any medication. past few months i been suffering with depression and i got itchy skin all over my body even starting to look like eczema plus i am gaining weight and my skin is pail and dark circles under my eyes, my joints are so sore and i feel horrible.

Last time the test was full panel but this time GP only ordered TSH and results form this weeks test were 2.89 miu/L [0.3 - 5.5] Dr`s comment is its normal and no evidence of primary thyroid disease!

Surely my symptoms should be evidence? 

I am not sure what should i do next? I have another appointment to see GP next week and want to ask him to run full panel test with TSH; Free T4; Free T3; Reverse T3; TPOAb; TgAb but not sure if he will if he only ordered TSH in the first place. 

has any one else been diagnosed with under active thyroid with similar results?

Thank You in advance

 

Hello Crownya:

You should ask for all the tests in your post to me, (TSH, Free T4 Free T3 TPOA, Reverse T3),  and a blood cortisol level. Also Vit D level. and a mineral panel to include calcium, sodium, potassium, iron, ferritin, and B-12.  ViT. D  is special test and takes a week to do. Many of us with thyroid problems are low in Vit D and we can get muscle pain from it being low, feel really awful, etc...

Some doctors go by the TSH only and it is not as reliable in early stages of thyroid disease. Sadly, some know very little about the thyroid, and seeing an Endocrinologist is better but you need a referal.

You have many symptoms of Thyroid disease and the TPOA antibodies test will show if you have an autoimmune disease like I have, called Hashimoto's. 

Hashimoto's is famous for looking good on on the lab tests TSH but inside the gland is being attacked slowly.  It can take so many years to see a change in the labs. That is why the TPOA test is helpful.   It is a bit sneaky like that and a lot of doctor's miss it.  

Also a blood cortisol level can show any problems with your adrenal gland.  A condition that looks like thyroid can share some symptoms is called Cushing's Syndrome. It can cause weight gain and dark eye lids and circles, sleepy a lot, etc...

If you are in the UK you can ask to be given Levothyroxine under the NICE guidelines a starter dose of Levothyroxine 25mcg  to help you.  If in the USA, ask your doctor for a trial period of Levothyroxine. It take about 6 to 12 weeks to see symptoms go away.

Tell the doctor to test all of the above.  Say how you feel and what symptoms you have and log it down and hand it to him/her.

Regards,

Shelly

Hello Everyone! Thank You for Your replies. I had my Dr`s appointment and got my test results back i will post them at the end of this message. I really do not understand them but will try to search online because i don`t think they are good but my Dr says they are ok... My D Levels seem not normal but here again my Dr is the boss... 

Please if any one can give me some advice that would be great.

Total white blood count 6.47 10*9/L [4.5 - 11.0]

Red blood cell count 4.83 10*12/L [3.8 - 5.8]

Haemoglobin concentration 144 g/L [115.0 - 160.0]

Haematocrit 0.444 [0.36 - 0.47]

Mean cell volume 91.9 fL [80.0 - 100.0]

Mean cell haemoglobin level 29.8 pg [27.0 - 32.0]

Mean cell haemoglobin concentration 324 g/L [300.0 - 350.0]

Platelet count - observation 290 10*9/L [150.0 - 450.0]

Neutrophil count 3.46 10*9/L [2.5 - 7.5]

Lymphocyte count 2.42 10*9/L [1.5 - 3.5]

Monocyte count - observation 0.40 10*9/L [0.2 - 0.8]

Eosinophil count - observation 0.16 10*9/L [0.04 - 0.4]

Basophil count 0.03 10*9/L [0.01 - 0.1]

Total white blood count 6.47 10*9/L [4.5 - 11.0]

Red blood cell count 4.83 10*12/L [3.8 - 5.8]

Haemoglobin concentration 144 g/L [115.0 - 160.0]

Haematocrit 0.444 [0.36 - 0.47]

Mean cell volume 91.9 fL [80.0 - 100.0]

Mean cell haemoglobin level 29.8 pg [27.0 - 32.0]

Mean cell haemoglobin concentration 324 g/L [300.0 - 350.0]

Platelet count - observation 290 10*9/L [150.0 - 450.0]

Neutrophil count 3.46 10*9/L [2.5 - 7.5]

Lymphocyte count 2.42 10*9/L [1.5 - 3.5]

Monocyte count - observation 0.40 10*9/L [0.2 - 0.8]

Eosinophil count - observation 0.16 10*9/L [0.04 - 0.4]

Basophil count 0.03 10*9/L [0.01 - 0.1]

Serum total 25-hydroxy vitamin D level 33 nmol/L [50.0 - 144.0]

 

Hello Crownya:

Your blood work you posted is good. You had a few blood tests some measure the amount of Red bloo cells and white blood cells and platelets and different parts of your blood.

 You had RBC -red blood cells and that count is normal.

WBC- white blood cells are also normal.  They help fight infection and are normal so that is good.

Hemoglobin normal.  That helps carry oxygen around your body. It is normal.

Even the componets of your WBC's lymphocyte, monocyte,and Eosinophils are all normal.

Vit D is a bit low.  So that should be a bit higher and can be replaced by taking Vit D supplements.  I take 2000IU  a day.  So that is all that is a bit off.

All in all, your blood work you listed is okay except for Vit D. Did they do any thyroid tests? 

Regards,

Shelly

Hello ShellyC19 Sorry for such a long delay in reply we been poorly and have taken a while to get up and running with daily things...

These are the orther test results i have got -

Thyroid function test 

Serum TSH level 2.78 miu/L [0.3 - 5.5]

Serum free T4 level 15.1 pmol/L [12.0 - 22.0]

Serum free triiodothyronine level 4.4 pmol/L [3.1 - 6.8]

Hello Crownya:

Sorry for my late reply, I was having trouble with some messages not coming through to me.

TSH level is good and with in range   Also free T4 is okay and so is serum free triodothyronine. 

So these levels look good on paper.  Are you taking any Vitamin D to bring that up? 

Also next time you see the doctor ask for a blood cortisol level to make sure the adrenal glands are okay.

Regards,

Shelly