Thyroid Update — May 2011

I finally had the next appointment with my endocrinologist.  I was supposed to have it in March, but I put it off until hubby’s new job provided health insurance on May 1st, then I had to postpone it again a couple week’s ago because I was too sick to go get blood work in time for the appointment.  Sheesh!

I don’t have my lab results this time…for some reason they didn’t send them to me.  I’ll have to get a copy from the doctor’s office the next time I go.  He did mention that my levels looked good.  My liver profile looked a little high, but he wasn’t concerned based on my age.

I also had an ultrasound and the two nodules are shrinking a little bit!  That’s the first time they’ve changed at all!

Basically, he ended up leaving all my medication the same and told me to come back in September.  Thank goodness the lab sheet will only require 2-3 vials of blood instead of the 9 vials they took this last time!  And no fasting!  Yay!

Thyroid Results–November 2010

I finally had a chance to compare the lab report from my November blood work and endocrinologist appointment.  Everything looked good, though he did skip a lot of areas he normally tested.

All within normal levels:

• TSH: 0.42 mIU/L — down from August test results of 1.90 mIU/L — normal is 0.40-4.50 mIU/L
• T4 Free: 1.4 ng/dL — up from August test results of 1.2 ng/dL — normal is 0.8-1.8 ng/dL
• T3 Total: 160 ng/dL — down from August test results of 173 ng/dL — normal is 76-181 ng/dL

Everything was in range this time, but I was surprised to see he didn’t test my T4 Total this time since it’s usually out of range.  In August it was out of range by 2.2 mcg/dL.

I told him about some circulation issues and that I wasn’t sure when they started so I wanted to eliminate the Inderol as a cause, though I’m pretty sure it’s due to my knee and hip issues.  He decided to wean me off of it to see if that helps.  If it doesn’t, then I’ll know it’s not the Inderol.  So now I’m taking 20 mg in the morning, and 10 mg in the afternoon and evening.  We’ll see what happens!

He also wanted me to lower my Tapazole dose from 5 mg every other day to 5 mg three days a week.  My vitamin D3 has been increased from 2,000 units to up to 5,000 units per day, though I’m taking 4,000 units per day because they are 2,000 unit pills.  Other than that everything else is the same.

New Thyroid Results

It’s blood work and endocrinologist appointment time again!  This time for some reason the doctor didn’t request extensive lab work like he usually does.  Only three vials this time instead of his normal six to eight.  That’s fine by me!

All within normal levels:

• TSH: 1.90 mIU/L — up from February’s results of 0.84 mIU/L — normal is 0.40-4.50 mIU/L
• T4 Free: 1.2 ng/dL — up from February’s results of 1.0 ng/dL — normal is 0.8-1.8 ng/dL
• T3 Free: 279 pg/dL — down from February’s results of 330 pg/dL — normal is 230-420 pg/dL
• T3 Total: 173 ng/dL — up from February’s results of 167 ng/dL — normal is 76-181 ng/dL
• Thyroglobulin Antibodies: <20 IU/mL — same as February’s results — normal is <20 IU/mL
• Thyroid Peroxidase Antibodies: <10 IU/mL — same as February’s results — normal is <35 IU/mL
• TSI: 105% — up from February’s results of 96% — normal is <=125 % baseline

Out of range results:

• T4 Total: 14.7 mcg/dL — up from February’s results of 13.7 mcg/dL — normal is 4.5-12.5 mcg/dL

My endocrinologist wasn’t concerned with the out of range result because it’s pretty normal for me and is actually elevated more due to the birth control pills I take to regulate my cycle.  So it’s expected to be out of range.  I talked to my gynecologist about getting an endometrial ablation.  He said he could do it, but that it doesn’t mean it will stop my cycles completely, which means I could still be on birth control pills anyway.  *sigh*  I’m still considering doing it anyway, but I’d like a little more time to think about it.  So it seems my endocrinologist will just have to deal with the slightly elevated T4 Total results for now!

In the meanwhile, I’ve been told to continue with my vitamins and the Inderol 3 times a day.  He also wants me to reduce my Tapazole from 5mg a day to 5 mg every other day.  My next appointment and blood work will be in November.  He’s requested more tests on the lab sheet this time so we’ll see how many vials that will be then!

Hyperthyroid Issues

Usually I do pretty well with my thyroid since I’m monitored closely by my endocrinologist.  Yesterday though I had to take my Inderol medication a couple of hours early because my heart was racing and I couldn’t seem to slow it down.  I was fine in a couple of hours.  The Inderol seems to work pretty good for that, too, though I take it for tremors.  I suppose its all the same thing.

I’m already a little shaky this morning, but my morning dose probably hasn’t kicked in yet.  Not sure if it means I need more Inderol to control my symptoms, or if it means something else is going on and I need an adjustment on Tapazole, my thyroid medication.

I guess we’ll see how it goes today.  I’m going to make sure to bring my meds with me today just in case I need them early again!

What My Endocrinologist Said

Finally!  I’m going to talk about what my endocrinologist said at my appointment the other day.

But first I had an ultrasound of my neck.  I have two nodules that have been there for years.  I’m not sure what size they’ve been at all the previous ultrasound appointments because I really haven’t been paying too much attention.  I should have been writing down the dimensions, but I didn’t.  So I have nothing to compare this year’s ultrasound with, but I will try to keep up with it from now on.  I should get another one next year.

This time my nodules were 0.9 and 1.1 (I think they were in cm).  Apparently that is just fine because no one mentioned anything was wrong with them.  For the most part they seem to just stay there not growing…or so they say.  We will see the next time I get an ultrasound and compare the results!

When I finally saw the doctor it was an hour after my appointment.  He’s an excellent doctor and I love the staff, but sometimes they get a little behind.  This time they were short some nurses so it messed up the schedule a bit.  That’s alright because I wasn’t in a rush and brought one of my textbooks to read while waiting.

The nurse weighed me…I was like 131 or something.  I don’t really pay too much attention to that because I’m finally at a normal weight after being underweight all my life (except for three times when I actually gained weight–after graduating from basic training, and during each of my pregnancies at 9-months–though they were still less than I am now)!  I also told her about how tired I’ve been lately, and seem to not sleep well or when I do I still feel tired in the morning.

The doctor came in and told me I get an A+ for my lab results even though there are some elevated levels, they’ve all gone down since the last appointment.

I asked about the parathyroid results that were low on the lab report.  He said not to worry about it because all my other results look good.  Apparently from my research the parathyroid regulates the calcium and has something to do with vitamin D, but mostly calcium.  My calcium results were really good so there’s not reason to worry about the parathyroid at this time.  He’ll continue to measure my calcium results as usual so we’ll know if it does become a problem in the future.

Then we discussed why I’m so tired all the time.  Usually you would automatically think it’s because I have an auto-immune disease that can cause fatigue, insomnia, etc.  But I’ve had it for almost 9 years now and other than normal sleepiness, I really haven’t had much of a problem.

He seems to think it has to do with me beginning to have side-effects from the birth control pills I take to regulate and decrease my menstrual cycles.  I’ve been taking them for about 8 years now because I had abnormal cycles after my last pregnancy, and then several years ago I switched to the pills that let me go every 3 months.  I don’t need them for anything else because I had my tubes tied the day after I had Project #2.

We knew the birth control pills were elevating some of my thyroid levels so that has always been factored in, but now that it may also be effecting my sleep, I have to consider getting off of them.  He suggested I talk to my gynecologist about getting an endometrial ablation to stop my cycles and get off the birth control pills.  This was something I had already discussed with my gynecologist in the past so it shouldn’t be a problem to get him to do it.  I know I’ll be happy to have that taken care of and over with!

Other than that everything looked fine and I should continue to take all my medication and vitamins as he previously prescribed.  I’ll be seeing him again in August.

Partial Lab Results

Yesterday I received a copy of the partial lab results from my blood work from Wednesday.

It’s good and bad, but not horribly bad so far.

Those areas with normal levels include:

HDL Cholesterol, Triglycerides, Cholesterol/HDLC Ratio, Glucose, Nitrogen, Creatinine, Sodium, Potassium, Chloride, Carbon Dioxide, Calcium, Magnesium, Phosphate, Uric Acid, Hepatic Function Panel, CBC (White Blood Cell Count, Red Blood Cell Count, etc.).

See why I don’t need to see my primary doctor unless there is something wrong?  My endocrinologist runs too many enough tests that I’d know if something is wrong before I even started feeling bad!

The areas that are out of range include:

• Total Cholesterol — normal range between 125-200 mg/dL.  Mine is 206, which is high, but not I’m going to drop dead of a heart attack tomorrow enormously high!
• LDL Cholesterol — normal range should be <130 mg/dL.  Mine is 136.  Again high, but not extreme.
• T4 (Thyroxine), Total — normal range is between 4.5-12.5 mcg/dL.  Mine is currently at 13.7, which is better than the last time.

The last time I had my cholesterol checked it was November 2008.  At that time it was a lot higher with my Total Cholesterol at 254 and my LDL at 177!

OUCH!

So it has gone down significantly!  I’m very pleased about that, especially since I haven’t been taking any medication and I’ve been basically eating the same, which has been rather good overall.

My previous T4 (Thyroxine), Total levels were (these have to do with my thyroid–generally the higher they are, the more hyper my thyroid is, though I’ll need the other test ranges, too):

• November 2009 = 14.5
• July 2009 = 13.2
• November 2008 = 11.7 (in range)

I’m still missing from this lab report:

• TSH, 3rd Generation
• T4, Free
• T3, Free
• T3, Total
• Thyroglobulin Antibodies
• Thyroid Peroxidase Antibodies
• TSI (Thyroid Stimulating Immunoglobulin)
• Vitamin B12
• Folate

All except the last two have to do with my thyroid.  I’ll do a post another time with explanations regarding Graves’ Disease and the lab tests required to keep track of it.

Is anyone else dealing with a thyroid issue?

Do you keep track of your lab results?

They Drained My Blood!

I had to get blood work again today and as usual it’s not very pleasant, but not too bad either.  I’ve been having it done every 3-6 months due to an auto-immune disease I developed during my last pregnancy in 2001.

I have a hyperthyroid disease called Graves Disease.

Luckily for me, it can be controlled by medication.  Unluckily for me, it requires constant supervision by an endocrinologist, which includes appointments and blood work every 3-6 months plus ultrasounds about every year to check the nodules on my thyroid (I have two).

I have to say that I have an excellent endocrinologist, which not everyone can say.  But he is very protective over his patients to the point of going overboard with the lab sheet!

This is what is being done with the blood I had drawn today:

1. Basic Metabolic Panel
2. Liver Profile
3. Lipid Profile
4. Phosphorus
5. Magnesium
6. Uric Acid
7. CBC w/Auto Diff
8. Albumin/Creatinine Ratio
9. T4
10. Free T4
11. T3 Total
12. Free T3
13. TSH
14. Vitamin B-12
15. RBC Folate
16. TPO-Anti.
17. Thyroglobulin-Anti.
18. Thyroid Stim. Imm./TSI
19. Intact PTH

Yes, that’s right 19 tests!  That was 6 vials of blood taken (2 small and 4 large) and a urine sample!

You’d think I would be ready for a burger when I was finished!