Recent Blood Test

[guavas]

Hi, i've done recent blood test, firstly i've diagnosed with hypo from 3 months without no reason and i'm now on 75mcg euthyrox and still feel symptoms of hypo, anyway i've also done Parathyroid Hormone (PTH) because i've found high calcium level in blood test and it's in High normal range, so firstly i need an advice about my dose of euthyrox, then what to do about Parathyroid ? and what is relationship

of being hypo and high range of PTH at the same time ?

TSH 2.283 uIU/ml (0.48 - 4.17)

Free T3 2.82pg/ml (2.3 - 5.3)

Free T4 1.28ng/dL (0.83 - 1.43)

Parathyroid Hormone (PTH) 51.3pg/mL (9 - 52)

also i've did AST,ALT,Bilirubin (Total) & (Direct)

ALT(SGPT) 60 U/L (0 - 15)

AST(SGOT) 41 U/L (0 - 50)

Bilirubin (Total) 0.63 mg/dL (0.2-1)

Bilirubin (Direct) 0.14mg/dl (Up To 0.2)

also CBC attached.

Thanks!

[Clutter]

Syst3mErr0r,

You are a little undermedicated on 75mcg to have TSH 2.283. Ask your GP to increase dose to 75mcg/100mcg alternate days.

The goal of Levothyroxine is to restore the patient to euthyroid status. For most patients that will be when TSH is 0.48 - 1.0 with FT4 in the upper range. FT4 needs to be in the upper range in order that sufficient T3 is converted. Read Treatment Options in thyroiduk.org.uk/tuk/about_... Email [e-mail] if you would like a copy of the Pulse article to show your GP. The Thyroid UK office opens on 3rd January.

Low haemoglobin and haematocrit can indicate anaemia. Ask your GP to check ferritin, iron, B12 and folate.

Mild normocytic normochromic anaemia google.co.uk/search?q=mild+...

Elevated eosinophils indicates mild eosinophilia google.co.uk/search?client=...

There are 4 x parathyroid glands which control calcium levels. They are not related to the thyroid gland and there is no connection between hypothyroidism and high or low PTH. High PTH and high calcium can indicate primary hyperparathyroidism. This is usually due to a benign tumour on one or more of the glands secreting hormone. Treatment, if primary hyperparathyroidism is confirmed, is usually surgery to remove the affected parathyroid glands. Currently PTH is within range so it would be sensible to monitor PTH, calcium and phophorus levels in a couple of months.

ALT is elevated and indicates liver inflammation or injury. I would see your GP about the result. google.co.uk/search?client=...

[guavas in reply to Clutter]

Clutter,

Thank you for reply.

i will visit doctor on 1/1/2018 , i will discuss with doctor about increasing the dosage and also talk about my condition

actually really i'm very confusing about my condition now, because the lymph-nodes in my neck is swollen but swollen like that you have infection or having flu, also my thyroid gland is swollen like there is infection and there is also pain when pressing on it , there is no pain when i pressing on lymph-nodes in my neck, i don't think it's cancer because the swollen of all gland like i have infection (normal swollen) , so really i'm very confusing.

[Clutter in reply to guavas]

Syst3mErr0r,

If you have autoimmune thyroiditis (Hashimoto's) thyroid gland may be swollen due to a lymphocyte infiltration. Have thyroid peroxidase or thyroglobulin antibodies been tested? If not, ask your GP to do blood tests. Stop pressing and prodding it as you will make it more bruised and tender.

[guavas in reply to Clutter]

Clutter,

already did Antithyroglobulin (Anti TG) Abs & Antimicrobial Ab (Anti TPO) two times the first one was in 30/9/2017

and the result is

Antithyroglobulin (Anti TG) Abs < 15.0 U/mL (Up to 60)

Antimicrosomal Ab (Anti TPO) < 0.1 IU/ml (Up to 5.6)

The second one was in 26/12/2017

Antithyroglobulin (Anti TG) Abs 0.5 IU/ml (Less Than 4.1)

Antimicrosomal Ab (Anti TPO) 0.1 IU/ml (Up To 5.6)

[Clutter in reply to guavas]

Syst3mErr0r,

Thyroid antibodies are negative for autoimmune thyroiditis (Hashimoto's). Some people are sero negative for Hashimoto's but have it confirmed by ultrasound scan. If thyroid is swollen you may want to ask to be referred for an ultrasound scan but I would wait as the swollen lymph nodes indicate infection which may also be affecting your thyroid.

[guavas in reply to Clutter]

Clutter,

my lymph-nodes is swollen before i was diagnosed with hypo , it's swollen In conjunction with thyroid gland , some days lymph-nodes become a little bit swollen also thyroid gland become a little bit swollen in conjunction with it at the same time, i mean the swollen process is in conjunction.

[Clutter in reply to guavas]

Syst3mErr)r,

Discuss it with your GP as you may have a virus affecting your thyroid and lymph nodes.

[guavas in reply to Clutter]

Clutter,

Exactly what i expected , also there is some symptoms like Night fever, desire for vomiting, and shortness of breath and many , like you have a very bad flu , symptoms come from time to time , anyway i will discuss this with endo.

Thank you.

[guavas in reply to Clutter]

Clutter,

my endo told me that i have to not worry about PTH , because it's in "normal range" , so what should i do ? , what about waiting for 6 weeks and retest for PTH and Calcium ?

[Clutter in reply to guavas]

Syst3mErr0r,

Your PTH is almost top of range. You say calcium is high too so I would wait 6-8 weeks and retest PTH and Calcium together.

[guavas in reply to Clutter]

Hi Clutter,

Done. i did all blood tests again after 5 weeks.

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