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    Honorary Soulcyster rue28's Avatar
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    Default Blood work - what does it mean???

    I just got some blood work back from my Dr. and some of the stuff is out of range...I was hoping that someone here could help me to understand what it means:

    Carbon Dioxide - 19 (range: 21-33)

    T3 - 195 (range: 60-181)
    T4 - 13.6 (range: 4.5-12.5)
    TSH - 2.36 (NORMAL, range: 0.4-5.5)

    Sex Hormone Binding Globulin - 267 (range: 17-120)

    I have no idea what implications the low carbon dioxide has but I know that the T3, T4, and TSH have to do with thyroid. Beyond that, I have no idea. I don't know what the SHBG means either but it sure looks awfully high to me .

    I'm feeling really depressed because my gyno just told me a few weeks ago that she felt an unusually large cyst on one of my ovaries and that's why I got my bloodwork in the first place, to forward it from my RE to my gyno.

    If someone could help I would really appreciate it.
    Amanda *34*
    DH: Rupert *35*
    Thomasina, Newt, & Lucky (our 3 kitties) & Splash (our Golden Retriever)

    Dx with PCOS 10/2001

    Currently taking:
    NOTHING! I just quit BCP because it was making me a psycho.

  2. #2
    Registered User JessicaE's Avatar
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    I'm sorry for the bad news, Rue. Hopefully, though, this will help them figure out what's going on in your body and get it corrected.

    I don't know about the carbon dioxide or SHBG.

    Your thyroid results (T3 and T4) show that you are very slightly hyperthyroid, although your body is not working extra hard to produce that excess hormone. There are a number of things that can cause you to go hyperthyroid:

    * a nodule on your thyroid
    * Grave's Disease
    * a "burnout phase" of Hashimoto's Thyroiditis, which is normally characterized by low thyroid (hypothyroid), but can go high for a period of time when your thyroid is "spilling" hormones into your bloodstream

    They'll probably want to do some more tests on you to find out exactly what's causing this. Possible a radioactive iodine uptake test, where you ingest the iodine and they measure how much your thyroid soaks up. I have also had thyroid ultrasounds.

    Good luck, I hope it turns out to be a simple fix.
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    Honorary Soulcyster rue28's Avatar
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    Thanks Jessica.

    I called my Dr. this morning and spoke with the nurse who said that the Dr. had reviewed my results and was not planning any further follow-up. I've always thought that my Dr. is very thorough but I am surprised that she was not concerned about these results. She did the blood work in the first place because my results have been very sporatic since I met her. When I started going to her she even referred me to a specialist for Thyroid problems who said that there was nothing wrong with my Thyroid. I am sort of confused right now because I feel like I've been here before but was told it was nothing...I guess I'll just give the results to my gyno and see what she has to say about them. That'll be Dr. #3 who has reviewed my situation. It's harder for a borderline problem to slip past 3 doctors than it is for 1 doctor.

    Congrats on your son! How exciting .
    Amanda *34*
    DH: Rupert *35*
    Thomasina, Newt, & Lucky (our 3 kitties) & Splash (our Golden Retriever)

    Dx with PCOS 10/2001

    Currently taking:
    NOTHING! I just quit BCP because it was making me a psycho.

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    RIP Momma shenacat's Avatar
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    I have no idea why they tested your CO2, but SHBG that is high usually correlates with high levels of estrogen. So congratulations, you're estrogen dominant like most women w/pcos. This means you have your own unhealthy level of androgens floating around in your body.

    This could be why your thyroid results are abnormal. With both T3 and T4 high and out of range, I'm surprised to see a TSH that is that *low*. It should be under 1 with the other numbers that high. This smacks to me as early thyroid disease, or subclinical hypothyroidism.

    High estrogen stresses the thyroid. If you don't do something to get that estrogen under control, your thyroid (from what I can see so far) is going to flunk at some point.

    Have you had any abnormal symptoms?

    Fatigue? (Needing to sleep in the middle of the day...)
    Abnormal eye strain/hurting?
    Tightness in neck/shoulders?
    Heart racing?

    Sometimes it's hard to pinpoint symptoms because we've felt them all our lives, or think they are due to other things.

    I'd want to follow up on those thyroid results maybe in six months, earlier if you are feeling ill.

    Are you on birth control pills...?

     

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    Honorary Soulcyster rue28's Avatar
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    Shenacat,

    Thanks for the response! I am on birth control pills (Yasmin). I have been worried about my thyroid since I was diagnosed with PCOS and had slightly elevated numbers. I have had 3 or 4 weird test results, sometimes conflicting (can't remember exactly what they actual numbers were right now), and actually went to an endocrinologist who specializes in the thyroid. He said that I didn't have a problem but my RE has been following up with tests every 3-6 months to see how my thyroid is doing. I'm really surprised that she didn't consider my results to be concerning.

    I didn't know that high SHGB can damage your thyroid! Now I am really worried! Is my number average for PCOSers or really high? Besides, I thought that the Pill was supposed to control stuff like that!?!

    As far as symptoms go, I feel like I'm having hot flashes all the time. I told my RE and all she said was, "hmmm?" I can't think why that would be". I have also been having a lot of muscle and lower back achs for the last three weeks. Originally, it started during my period behind my knee and since I had just flown to England and back in the course of 4 days, I was worried that it was deep leg thrombosis. Eventhough I sometimes get achy thighs during my period, I discounted that as a possible cause since it was lower on my leg than normal. Now that my period has been over for a week, I continue to have achy muscles and pain in my lower back. Now I also have pains in weird places like my fingers, my arms, etc. To be honest, these pains aren't anywhere near being incopacitating, but they are uncomfortable! I've been considering going to my GP and wonder if this is related to my wacky test results.

    Thanks again for your response! I hope I get to the bottom of this soon!
    Amanda *34*
    DH: Rupert *35*
    Thomasina, Newt, & Lucky (our 3 kitties) & Splash (our Golden Retriever)

    Dx with PCOS 10/2001

    Currently taking:
    NOTHING! I just quit BCP because it was making me a psycho.

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    RIP Momma shenacat's Avatar
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    It's not really the SHBG that damages the thyroid, it's that high SHBG points to high estrogen which stresses the thyroid and can hurt it. You can't know what your estrogen level really is without testing.

    The only way I know of really lowering that estrogen is to start on glucophage or a similar insulin-sensitizing medication; but the problem is some of us are estrogen dominant because our progesterone is LOW, that is why I am going to suggest you get your progesterone levels tested on a cycle to see if you ARE low. If you are, simply supplementing may be an answer.

    Hot flashes are hormonal; before I was dx'd I'd get them but it would not be a routine thing. They'd crop up and last for a few weeks and then go away again for months. Hot flashing can be a sign of hyperthyroid, or a sign of hormone imbalance (a need for estrogen or progesterone). The chronic pains you experience sound similar to pains I had before I went on thyroid medication. Hypothyroidism causes all body parts to hurt and ache.

    The increased PMS you describe can be attributed to low progesterone as well.

    I'd recommend getting those tests I mentioned above if you can, you need to figure out what's going on if you want to fix it! Good luck with the doctors.

    Edited to mention: most of these tests will be useless to you if you have them done while on birth control pills. I'd suggest going off them and testing your thyroid again within 2 weeks, 5 weeks, and 9 weeks of quitting to see how your thyroid is effected; then do a cycle where they test your progesterone. They caught my thyroid disease after I quit bcps and my thyroid went insane; on bcps my thyroid was slightly hyper.

     

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    Honorary Soulcyster rue28's Avatar
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    Dear Shenacat,

    Thanks for your reply. It's all so complicated! I will bring everything up with my RE the next time I see her. Should be within the next 3 months. In the meantime, I'll wait and see what my Gyn says. Maybe she'll request the tests that you've suggested. To make matters worse, my insurance is going to change in October and neither my Gyn nor RE are covered by my new plan...uggghhh!
    Amanda *34*
    DH: Rupert *35*
    Thomasina, Newt, & Lucky (our 3 kitties) & Splash (our Golden Retriever)

    Dx with PCOS 10/2001

    Currently taking:
    NOTHING! I just quit BCP because it was making me a psycho.

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    RIP Momma shenacat's Avatar
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    You'll likely have to *insist* that your doctor perform those tests. Doctors can be extremely dull at times and prefer doing nothing to doing something unless the patient is in a life-threatening situation. I actually had a doctor tell me once that he couldn't treat me unless I was dying from my condition and I obviously wasn't, so he could do nothing for me. :|

     

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    Google Junkie nobimbo's Avatar
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    I found this the other day (was researching because I have been getting hot flashes, too:

    http://www.wdxcyber.com/nmood12.htm


    Hot Flashes - Causes Other Than Menopause
    Frederick R. Jelovsek MD
    "I am a 32 year old female. Throughout the last year, I've developed "night sweats". I have them sporadically about once a month. I know this is a common occurrence with menopause, but I'm only 32! I also know that I could be starting menopause early. However, are there other conditions that would cause night sweats? Is there a way to prevent them? Thanks a bunch. ". J.S.

    The quick answer to this is that at a frequency of once a month, night sweats are not very likely due to a disease process or menopause or even perimenopause. Also at that frequency, I would not suggest going to extreme means to try to stop them other than some of the simple suggestions below.

    In the mind of many women, hot flashes are only associated with low estrogens but that is not true. It may surprise you that men have hot flashes too. They can get them if undergoing treatment for prostrate cancer using anti-testosterone therapy, using thermal blankets and from alcohol, hot liquids and other substances. Both estrogen and testosterone seem to protect against frequent hot flashes. If either of those hormones are withdrawn after one's body is used to them, a rapid increase in skin temperature due to dilatation of the skin blood vessels can occur very frequently. While these hormones protect from frequent hot flashes, many other events and ingested substances can also cause the skin vessels to rapidly dilate and release heat.

    What exactly is a hot flash?
    Characteristically, a hot flash (also called hot flush) is a sudden feeling of warmth and often a breakout of sweating usually confined to the upper half of the body (chest and up), neck, face and head. There is an intense feeling of heat and the face head and neck can turn red. When they occur at night, they are called "night sweats". It can be difficult to distinguish them from a low grade fever such as that seen with the flu, a cold, a urinary tract infection or a more serious cause of fever such as tuberculosis or cancer. Fevers usually cause the sweating to last longer than the typical few seconds or few minutes that hot flashes last. Non fever caused hot flashes can occur rarely or every few minutes.

    No one knows exactly what the physiologic cause is for hot flashes but the beginning trigger is probably increased heat (or blood flow) in the heat regulatory area of the brain. The brain, sensing an increased body temperature, releases chemicals that cause the skin blood vessels to dilate so the heat can be released. Apparently estrogens and testosterone allow the body to have a higher tolerance for changes in core body temperature. In other words, normally a body might tolerate a change in 1.5 degrees C. before dilating the blood vessels whereas in the absence of the sex hormones, the blood vessels are triggered to dilate at a change of only 0.8 degrees C. (1). This means that anything increasing core body heat or even just the heat of increased blood flow at the brain's heat regulatory center will cause a hot flash. The hot flash will last or keep repeating as long as needed to dissipate the increased heat. Even women who are menopausal can reduce by almost 50% the number of night sweats by dropping the evening bedroom temperature a few degrees cooler.



    Can foods or drinks cause a hot flash?
    Definitely yes. Almost everyone should be familiar with how a meal containing hot pepper (capsaicin) can cause a rapid out break of a hot sweat. In this case, the capsaicin directly stimulates nerve endings that affect and dilate the brain blood vessels. Alcohol, other food additives and just eating a large meal itself can cause hot flashes. The truth is that we do not know all the different foods and additives and other ingested substances that can trigger this reaction.

    Many prescription drugs such as anti-hypertensives and mood altering drugs such as anti-depressants or anti-anxiety medications can also cause hot flashes. Each prescription drug you are taking should be checked to see if hot flashes or night sweats are a known side effect. Over-the-counter medications and supplements should also be examined for their side effect profile.



    What other conditions or circumstances can cause hot flashes that are not "menopausal"?
    Many systemic conditions can also produce flushing such as carcinoid syndrome, systemic mast cell disease, pheochromocytoma, medullary carcinoma of the thyroid, pancreatic islet-cell tumors, renal cell carcinoma, hyperthyroidism, neurological flushing, emotional flushing, and spinal cord injury (2). These conditions are thought to secrete chemicals into the blood stream that can stimulate the nerves or blood vessels of the brain.

    By far, the most common cause of hot flashes is a stress reaction that causes epinephrine and norepinephrine release into the blood stream. This in turn causes increased blood flow and thus increased heat. A hot flash may ensue to get rid of the heat. The trigger can even occur during deep REM sleep (presumably from dreaming). The next most common cause of a hot flash is just simply that the body is too warm. This can happen at night with thermal blankets or by just sitting with a portable computer on your lap for awhile. We have radiant heat panels at our house that overshoot the thermostat and often cause our family to have night sweats when they come on.



    How can I know if the hot flashes mean I am menopausal?
    We know that women have hot flashes in the decade before menopause. They certainly are not as frequent as during the menopause but we cannot predict them and cannot know for sure if they are due to low estrogen at the moment. When we measure estrogens or measure FSH, the brain hormone that becomes elevated when the ovaries finally fail, they are usually in normal ranges. If you are still having normal, regular menses, then asking the doctor to request blood studies for menopause is not likely to yield results. The doctor should check the TSH level for hyperthyroidism however. Alternatively, if your menses are irregular, you should ask you doctor to check for possible menopause or low estrogen state. Remember that smoking can lower blood estrogens; thus women who smoke will have more hot flashes in the perimenopausal period.



    What can be done to lessen or stop hot flashes or night sweats that are not due to low estrogens?
    First of all, I would say that if hot flashes or night sweats are less than once a week, you might just ignore them. They are not harmful and at that frequency, they do not usually represent a disease process. If they are more frequent, you might try the following:

    For night sweats:
    Avoid any foods, alcohol or caffeine within 3 hours of going to bed
    Avoid exercise, hot liquids or smoking within 3 hours of going to bed
    Drop the evening thermostat by about two or three degrees without adding more covers
    Wear light bed clothing
    If you feel stressed out from daily work or family events, take at least an hour before bedtime for some relaxation activity ( if you cannot "afford" an hour before bedtime to do this, there's your answer)

    For daytime hot flashes:
    Examine and try to avoid individual triggers (i.e., strong emotions, caffeine, alcohol, cayenne, occlusive clothing, heat).
    Use fans during the day.
    Wear clothing made of natural (i.e., cotton) materials.
    Practice deep, slow abdominal breathing, taking six to eight breaths per minute: Practice 15 minutes in the morning and evening, and use this technique in conjunction with "premonitions" of hot flashes. This can produce a 50% decrease in hot flash frequency.
    Exercise or walk, swim, dance or bicycle every day for 30+ minutes but not within 3 hours of bedtime

    If the above measures are not successful to stop night sweats and hot flashes almost entirely, then you should see your doctor to be evaluated for menopause or thyroid disease as well as other possible conditions.
    dx pcos 1984, type II diabetes 2001, also hypertension
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