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What Are The Findings And Required Treatment From The Blood Work?

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Posted on Fri, 20 Dec 2013
Question: I was diagnosed with an overactive thyroid during a hospital visit. I posted the images of the blood work. I don't understand why my family doctor didn't treat it, by looking at the blood work is it just not bad enough? he didn't say or explain anything to me.
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Answered by Dr. Shehzad Topiwala (1 hour later)
Brief Answer: You likely have a slightly overactive thyroid Detailed Answer: Your TSH is low. The free T4 is within normal limits though. Were you taking any steroids like prednisone/hydrocortisone/dexamethasone or opioid pain killers like hydrocodone, at the time this blood sample was taken? Because these agents can lower the TSH without there being a real problem with the thyroid. It only makes the blood test look like that. Similarly, if you were in the hospital under some stressful condition or illness, your thyroid labs can look like that temporarily and it often spontaneously resolves i.e. the blood tests look normal upon retesting a couple month later. However, it is possible you have a slightly over active thyroid too. But this may not necessarily merit treatment right away unless it is causing an irregular heart beat or angina-like chest pains, or osteoporosis. This link describes potential symptoms from this condition: WWW.WWWW.WW A comprehensive work up includes repeat testing for TSH Free T4 total T4 Total T3 T3 resin uptake prolactin (to rule out the rare possibility of a pituitary problem) If this reveals similar results as the first one and you have symptoms suggestive of thyroid overactivity then further tests like the following may be necessary before embarking upon treatment options that include medication, radiation or surgery. Ultrasound of the thyroid Radio iodine uptake and scan
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Shehzad Topiwala (20 minutes later)
Actually I believe I was taking a type of steroid. Im on a lot of medicine for being 31 . Im on heart meds for fast heart rate, blood pressure meds for high blood pressure, lexapro, clonzapam and ritalin. I had an older script of phentermine I shouldn't have taken. I took it the few days before I ended up in the hospital. Im 145 pounds I just wanted to be thinner so I took the phentermine. ..I know I shouldn't have
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Dr. Shehzad Topiwala

Endocrinologist

Practicing since :2001

Answered : 1663 Questions

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What Are The Findings And Required Treatment From The Blood Work?

Brief Answer: You likely have a slightly overactive thyroid Detailed Answer: Your TSH is low. The free T4 is within normal limits though. Were you taking any steroids like prednisone/hydrocortisone/dexamethasone or opioid pain killers like hydrocodone, at the time this blood sample was taken? Because these agents can lower the TSH without there being a real problem with the thyroid. It only makes the blood test look like that. Similarly, if you were in the hospital under some stressful condition or illness, your thyroid labs can look like that temporarily and it often spontaneously resolves i.e. the blood tests look normal upon retesting a couple month later. However, it is possible you have a slightly over active thyroid too. But this may not necessarily merit treatment right away unless it is causing an irregular heart beat or angina-like chest pains, or osteoporosis. This link describes potential symptoms from this condition: WWW.WWWW.WW A comprehensive work up includes repeat testing for TSH Free T4 total T4 Total T3 T3 resin uptake prolactin (to rule out the rare possibility of a pituitary problem) If this reveals similar results as the first one and you have symptoms suggestive of thyroid overactivity then further tests like the following may be necessary before embarking upon treatment options that include medication, radiation or surgery. Ultrasound of the thyroid Radio iodine uptake and scan