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What Do My Blood Test Reports Indicate?

Posted on Tue, 3 Nov 2015

Question: Good evening. I have had TFTs taken as part of cardiology profile and results came back with a TSH of 5.4 and normal T3 and T4. Is this subclinical hypothyroidism ? I have another result of ALT of 74 and other LFT normal. Could these be linked? What could be the cause please? Generally well apart from paroxysmal AF. Thanks

Sorry TSH was 6.2 NOT 5.4 Thanks

Answered by Dr. Shehzad Topiwala (43 minutes later)

Brief Answer:
Thyroid

Detailed Answer:
yes sub clinical hypothyroidism is a possibility. There are other potential reasons too such as reducers from something called thyroid it's which is a type of bruising of the thyroid gland. Another possible cause is recovery from 'non thyroidal illness ' meaning whenever someone is really sick and recovery follows the thyroid lab picture can look like this. The elevated liver enzyme seems unrelated. I suggest you check blood levels of thyroid auto antibodies such as anti TPO and anti Thyroglobulin

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Shehzad Topiwala (12 minutes later)

Thanks this result was a few weeks after cardioversion in ER for paroxysmal AF

Was concerned raised ALT could be cancer. Strange all other LFTs were fine including AST. Can I conclude you aren't overly concerned? Will order the other bloods thx

Answered by Dr. Shehzad Topiwala (6 hours later)

Brief Answer:
Follow up

Detailed Answer:
I see.

There is a good chance the TSH may normalise couple months later, particularly if the antibody test results are negative.

Regarding the raised the ALT, it will require investigation. For example, fat accumulation in the liver is one cause of liver enzyme elevation, as is hepatitis profile. Yes I agree it is unusual for ALT alone to rise with normal AST and other liver function tests. I suggest you see a gastro enterologist who will have the opportunity to examine you thoroughly and order appropriate tests.

I just re-read my first response to you and noticed an auto-correct typographical error Apologies.

Incorrect:There are other potential reasons too such as reducers from something called thyroid it's which is a type of bruising of the thyroid gland.

Correct: There are other potential reasons too such as recovery from something called Thyroiditis, which is a type of bruising of the thyroid gland.

Thyroid matters too can be complex, so it would be worthwhile for you to consult an endocrinologist in-person.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Shehzad Topiwala (6 hours later)

Thanks. I am overweight 6 foot 2 and 16 stone. Thought it may be a bit of fatty liver. If it were something lie carcinoma would the blood results be more deranged? Thanks

Answered by Dr. Shehzad Topiwala (29 hours later)

Brief Answer:
Second follow up

Detailed Answer:
Fatty liver is a likely reason. An ultrasound of the liver can aid in making the diagnosis of Fatty Liver.

Another useful test is the hepatitis profile. Carcinoma is very uncommon though. As recommended above, please seek a comprehensive work-up for this through a qualified Gastro enterologist

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Shehzad Topiwala (22 hours later)

Thanks. Just had the repeat 4 month tests back. ALT now 47 with other LFT normal. TSH 13 with normal T3 and T4.

Thanks

Answered by Dr. Shehzad Topiwala (3 hours later)

Brief Answer:
Third follow up

Detailed Answer:
The TSH is climbing. As recommended above, thyroid auto antibody levels in the blood will give an ideas as to whether or not you are likely to progress towards further worsening of thyroid function.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Shehzad Topiwala (1 hour later)

Thanks. The GP said he didn't think antibodies were necessary and to start levothyrixine immediately despite being a asymptomatic. I have requested test regardless and should have results in a day or so. Shall I wait until then until medicating and come back to you with results?

I wouldn't be a pituitary adenoma would it?

Thanks Guy

Answered by Dr. Shehzad Topiwala (40 hours later)

Brief Answer:
Fourth follow up

Detailed Answer:
Pituitary adenoma is extremely unlikely.

Exact diagnosis and treatment decisions regarding your thyroid require the opportunity to examine you. Since this is not possible through this forum, I am sorry I am unable to give you precise step by step guidance as would be the case in an in-person consultation.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Shehzad Topiwala (8 minutes later)

Thanks. Should have results of antibody tests back today. Will keep you posted. Thanks

Answered by Dr. Shehzad Topiwala (1 hour later)

Brief Answer:
Fifth follow up

Detailed Answer:
Best wishes

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar