hello Butterfly,I hope that you are felling better have a supper day

Waves, I still think you would make a great doctor, you are so knowledgable!

I am feeling better. I don't have fever any more. My throat is still sore but my voice has come back and my cough sounds more like a normal cough as opposed to a choking goose. I taught my daughter school yesterday morning and cooked chicken spaghetti last night. So I have resumed some of my normal day to day activities, which feels good. I'm hoping to kick the last of it in the next couple of days. I'm still drinking lots of water. And hot chocolate.

Waves, I so appreciate your input on this matter as my mind is swirling. Yesterday in the mail I got another piece to this puzzle.

OK, in 2009 my TSH was 1.24.

pdoc ordered bloodwork which was drawn on 11/26/12. CBC, Hepatic Fuction Panel, BUN, Creatinine, Valproic Acid, Lithium, all normal. Only thing out of norms is that TSH is 4.96.

pdoc tells me to see endo, his schedule had a cancellation, and I was seen 3 days later. They drew blood on that day 11/29/2012.

Then remember I got the phone call Monday that Dr. BXXXXXX is not going to do any treatment at this time. Let's schedule an appt in 6 months.

Well yesterday in the mail I got a copy of the bloodwork that that endo's office did. It shows my TSH as 1.86.

Is this possible? That my thyroid went from 4.96 to 1.86 in 3 days? I mean how does that happen? I have double & triple checked and I'm looking at both lab copies right now and this is what they say. Mr. Butterfly looked at them with me last night and we're certain this is what they say.

If it is helpful the endo's bloodwork results also has T4 1.14, T3 166, Thyroid Peroxidase (TPO) Ab 7 which are all in the normal ranges.

So I guess I take it all back about endo being a jerk. If nurse on the phone would have just explained that my TSH was 1.86 I would have understood him not treating me with thyroid hormone, b/c that's under 3. I just don't understand such a high fluctuation in 3 days.

I am still glad that I have the appt set up with the internist. Maybe she can retest and tell me what it is. My appt is Jan 2nd. Although if there is this much variation day to day then what is the point of even getting TSH tested?

I'm soooooo confused.

Oh I forgot to say waves, my dad had a benign tumor on his thyroid and as a result had his thyroid removed. 2 of his sisters have thyroid trouble but my mom is unclear as to what kind, they still have theirs.

Thank you katmae, I am so far. In 15 minutes I'm leaving to take the children shopping so they can buy my husband something for Christmas. This should be interesting. Hope you have a great day!!!!

have fun with the kids,I do most of my shopping on line,as I have bad panic attacks, and this makes it not so fun for me

Dear Butterfly

I think a doctor's life would like stress me out too much. I couldn't handle compsci... not sure I could do medical. At one time, I was more sure but it was not an option. we'll never know. I like to read though.

Thanks for the clarifications on timing of tests, and results etc. In light of your most recent post here's what I think regarding the TSH changes.

The first, simplest and most likely explanation is that the 4.96 value was a lab error. Typically the values must be transcribed by a human at least once, maybe more times. Suppose your ACTUAL result was 1.96. Considering that the 1 and the 4 are adjacent keys on a numeric keypad, it would be very easy to get 4.96 from 1.96. Furthermore, some folks handwrite 1's such that others confuse them as 4's. So a legibility is yet another possibility. 1.96 would be a very good match for the 1.86 reading obtained from the draw at the endo's 3 days later. Values normally do fluctuate a small amount, and methodologies/results vary between labs anyway, so i'd not expect an exact match. Now, if there were significant differences in the T4 and T3 also, then the error may have been that a sample got switched with someone else's during the testing or reporting process - occasionally happens). Here i have identified 3 distinct but possible lab errors that would explain this "crazy" value.

Second explanation (unlikely*) - TSH shot up temporarily due to your contraction of this clearly very bad infection ... immune system reactions can cause all sorts of things to go "out of whack" temporarily.

Third explanation (unlikely*) - Thyroid pathology may present with fluctuations in some cases, especially at onset of thyroid dysfunction.

Fourth explanation (unlikely*) - changes in foods and meds can affect thyroid hormone levels.

* the reason i say the other explanations are unlikely is because it typically takes a while for changes to occur. I can't be sure of this but 3 days seems like a ridiculously small amount of time for such a drastic change. When I was retested due to abnormal TSH i was told to wait at least 6 weeks.

You do well to keep your thyroid monitored given your dad's history. I think the endo should have called you to explain his choice, and allow you to ask questions. Now, while I don't think there's anything to worry about, you should have had opportunity to ask the doctor questions about the previous lab value. I think it is a good idea to see the internist, to get the benefit of a doctor's consultation on all this. Mention your dad's history to her also.

But until then, I would sit back, relax and have yourself one of those chocomintylicious drinks you wrote us about!



~ waves ~

p.s. I'm really glad to hear you're starting to feel better!!! great news!

OK so not a doctor. Done with that. Nurse practitioner? or nurse maybe? Come on, drug rep at the least? [smirk] Just joking around, I'll stop giving you a hard time now. You truly are a wealth of knowledge!

Thank you for your reply. I just hung up with the lab who says that they no longer have blood samples from 11/26 so it can't be re-run. I asked her if they keep any handwritten records and she said no. So I guess internist will just have to order again and 3rd time will be the charm. I'll keep y'all posted.

Oh and yeah, when I went to endo appt. I brought a copy of the results with me for my file there. Why didn't the nurse who called me back mention anything about the drastic change in numbers in 3 days? You would think his office would have noticed that. I take that back. Doctor's offices are so busy these days, I doubt they compared them. But, seeing as how that was the whole reason I went there in the first place, I would have thought they would have. Who knows.

Waves I think that you would have made a good teacher,doctor,scientist,and etc.,and etc. I would have liked to contribute my skills to society also. It's to bad that we have these mountains(mental health issues) that we have to deal with. I look at these people and say,"I wish that I could have done something like that".

I hope that my writing was correct. I'm heart broken over the kids that got killed in Connecticut today. BF

Dear Steve

thanks for the compliments. i know what you mean about our mountains. i could see you working for NASA or something with the passion you have for astronomy. myself, i have had to face the great green monster when it comes to personal achievements and others.

~ waves ~

ROFL nahhh. you gave me a chuckle. especially with the drug rep!! LOL!!! you know, if i had a car, i could do the rep thing. except that i met a few - sitting in my doctors waiting room. they work dog hours. and you know they are often caught between the devil and the deep blue sea. they don't advise based on their knowledge... they are there to pitch, and occasionally must avoid giving information the drug company has found out... Zyprexa lawsuits come to mind.

i would have actually liked to have done neuroscience or pharmacology ... i almost applied for a neuroscience program at one point but it would not have been realistic by that time (inadequate prereqs, no funds). in undergrad studies, i started out as a chem major and it was only by my own furious stubbornness in reaction to some "bad treatment" i received/perceived, that i didn't end up as one. first i boycotted class, and then egregiously failed the first semester by flying home on the day of the final instead of "risking a low grade" by taking it. (no, i wasn't full of myself or anything.) and that was that. shot myself in the foot. i was not even manic at the time. i was just used to getting good grades... saw things very black and white. If i didn't try, it secretly didn't count. Alas, it publicly did - put my GPA in a total hole and destroyed my shot at a scholarship and honors! Life's lessons... and chemistry was no more.

-------------------

It was a good idea to call the lab. Too bad they didn't have the samples - they might have re-tested for free.

Who knows what the deal was with the endo. They may have ordered the redraw specifically due to the high TSH. if that was your first anomalous reading, when they got the normal result they probably figured, lab error, and thought no more of it. but yeah, how nice to leave us patients in the dark huh.

i hope the internist is more communicative. it didn't sound like you particularly liked that endo. good luck and keep getting better.

hope you had a good day shopping with the kids.

~ waves ~