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Suffering from anxiety, heavy menstrual period and weight gain. Thyroid test done. Do I have hyperthyroidism?

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General & Family Physician
Practicing since : 1980
Answered : 1 Question
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Hello,

I have an additional question in regard to my thyroid labs. While nothing is out of range, I wanted to get your opinion.

My TSH is .96 mIU/l
T4 total is 6.5 mcg/dl
T3 uptake 35 percent
T4 free is 2.3
My parathyroid is it 55 with a high lab value of 65.

I do have issues gaining weight and suffer w anxiety As well as heavier menstrual periods as of late.

I had a very high vit d 1,25 dihydroxy test come out high of 99 and then 129 on retest yet my calcium and Phos are normal. My normal
Vit d is 36 and all autoimmune tests have come out normal as well as
A ct scan. I also had a thyroid scan which was normal yet noted a heterogenous appearance.


Do you have any insight into what this may be and what is causing the high d 1,25.
This is causing me great stress. Could this be the start of hyperthyroidism? Oh, I also had some tingling and sensations in my right foot.
Posted Mon, 29 Apr 2013 in Thyroid Problem and Hormonal Problems
 
 
Answered by Dr. Rahul Tawde 3 hours later
Hi Dear,
Thanks for writing in. Your thyroid tests are normal. There isn't a hint to suggest hyperthyroidism based on the reports except for a lower TSH. But then T4 is also in the lower half so hyperthyroidism seems unlikely.
As far as high 1,25 dihydroxy D3 levels are concerned it could either be a lab error or due to calcium and vit D supplementation. If both are not the obvious causes, other things like granulomatous conditions or lymphoproliferative disorders may have to be considered. But Vit D levels are far more important than 1,25 dihydroxy D3 levels and in the presence of normal calcium, PTH and vit D levels, a significant disturbance in bone mineral homeostasis seems inlikely. We hardly ever get 1,25 dihydroxy D3 levels checked because its present in such a minute quantity in blood estimation errors are common and its levels acan be normal or high in vit D deficiency states. So it doesn't help much in clinical decision. I wonder what was the indication for getting that test in you.
Hope this helps
Shivaprasad
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Follow-up: Suffering from anxiety, heavy menstrual period and weight gain. Thyroid test done. Do I have hyperthyroidism? 2 hours later
Thank you for your reply. The test was re run and it came
Back higher the second time which concerns me that it was not a lab error.
They did the cat scan to look for granuloma a
Diseases and lymph issues and nothing was
Seen. I'm not sure what else to do to
Rule that out. I've had much bloodwork in regard to autoimmune issues
With nothing showing up. I even had a rpr test.

Do you know what else I can do. My other tests such as CBC and livers are fine too.
I'm not sure where to go from here.
They actually initially ran the test in error instead of a regular vitamin. I only used to take vitamin d on occasion and do not supplement with calcium.

Thank you
 
 
Answered by Dr. Rahul Tawde 18 minutes later
Hi,
I still feel we should ignore the test result and repeat the test by a different method after a couple of months. Two other causes of high 1,25 dihydroxy D3 levels need to be thought about. Obesity and polymorphism or activating mutations in 1 alfa hydroxylase.Serum angiotensin converting enzyme levels can be checked to see if there is any evidence of sarcoidosis. However the bottom line is - any deviation in 1,25-dihydroxy vitamin D3 must always be interpreted in the context of the remaining parameters of the calcium metabolism. The other parameters in your case are normal. High 1,25-dihydroxy vitamin D3 must in fact be associated with suppressed PTH which in your case is near the upper limit of normal. So I don't attach much significance to isolated high 1,25-dihydroxy vitamin D3.
Shivaprasad
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Follow-up: Suffering from anxiety, heavy menstrual period and weight gain. Thyroid test done. Do I have hyperthyroidism? 3 hours later
Thank you. You seem very knowledgeable in this area. I am actually getting and ace and Lyme tests today.

I am also thin so unfortunately that rules out obesity because I would really like a cause for this and one that is more benign of course.

So a low parathyroid is when you have hyper parathyroidism not a high one? I was thinking the high normal could be pushing the 1,25 up?
 
 
Answered by Dr. Rahul Tawde 9 minutes later
No its other way.High 1, 25 D3 should suppress PTH. On the other hand hyper para should be associated with high PTH, high calcium & low phosphate. 1,25 D3 may or may not be high. Its the least important factor in the diagnosis of hyperpara.
Lets wait for the results. I think nothing worrying will come out.
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Follow-up: Suffering from anxiety, heavy menstrual period and weight gain. Thyroid test done. Do I have hyperthyroidism? 2 hours later
I just left the doctor and they said on my ct scan there is minimal left apical scarring. Could this be tb? I also used to smoke and had suspected pneumonia at one point. I'm terrified I have tb now.
 
 
Answered by Dr. Rahul Tawde 3 minutes later
Very unlikely. Could be due to smoking rather than due to tb.Dont worry too much.
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Follow-up: Suffering from anxiety, heavy menstrual period and weight gain. Thyroid test done. Do I have hyperthyroidism? 6 minutes later
I'm just connecting this w the high 1,25 as I read that's a possibility. Is latent tb very dangerous? I hope you're right and that it's due to other reasons bc I'm panicking
 
 
Answered by Dr. Rahul Tawde 3 minutes later
Nothing is proved. Unnecessary panicking wont help.Only active tb is assoc with high 1, 25 d3.
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Follow-up: Suffering from anxiety, heavy menstrual period and weight gain. Thyroid test done. Do I have hyperthyroidism? 7 minutes later
And would the ct scan show active tb? I wish you were my physician
 
 
Answered by Dr. Rahul Tawde 3 minutes later
Presence of symptoms like malaise, wt loss , evening rise of temperature etc. Some radiological features in ct which radiologist will be able to tell you better. Just scarring signifies nothing.
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Follow-up: Suffering from anxiety, heavy menstrual period and weight gain. Thyroid test done. Do I have hyperthyroidism? 9 minutes later
I've had some weight loss or more like I haven't been gaining weight when I've tried to. No cough. Would other blood tests show anything bc I've had a ton of blood work done. I'm going for the tb blood test today. I'm just terrified that I could have passed anything on to my children. Does that happen during pregnancy
 
 
Answered by Dr. Rahul Tawde 6 minutes later
No blood tests wont be able to differentiate. I dont think passing to children in the absence activity is possible but im not an expert in this field.
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Follow-up: Suffering from anxiety, heavy menstrual period and weight gain. Thyroid test done. Do I have hyperthyroidism? 20 hours later
Hello,
I am still waiting for the tb and lyme tests to come back. What else can i do to see if anything lymph node is causing this. I did have the ct scan of the pelvis, ab and chest and bloodwork has been ok so far. Anything else I can do? Should i see a rheumatologist at this point?
 
 
Answered by Dr. Rahul Tawde 52 minutes later
No just wait for the results. Multiple things cant happen at same time. So only one thing can be abnormal. Just wait..
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