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What does my blood test report indicate?

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Posted on Wed, 7 Jun 2017
Question: Hi, I would like some help with my blood test results as my doctor has not been able to help. I have a multinodular goiter with 6 nodules, the largest is 5cmx2cm. I am particularly concerned about the high FT4 (while FT3 is below optimal level), high PTH (my niece has hyperparathyroidism), low vitamin D, high CRP and ESR, high insulin, and high IgA. Do you have any suggestions on what could cause these results. My symptoms include chronic diarhhea and occasional constipation, abdominal pain, fluid retention, extremely irregular periods, fatigue with trouble sleeping, frequent headaches, occasional dizzyness, bone and joint pains, and weight gain. Most of these only showed up in the last few months after the goiter was found. My saliva cortisol results are also on the very low end of the range. I have attached my bood test results.
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Answered by Dr. Mirjeta Guni (34 minutes later)
Brief Answer:
Further investigations needed:

Detailed Answer:
Hello and thank you for asking,
I have gone carefully through your concern.
First of all the nodular goiter should be explored further to rule out a malignant nature to one of them, i would recommend: scintiscan of the thyroid gland, calcitonin (tumor marker) and a fine needle aspiration to the cold nodule that will result in scintiscan.
High parathormone level may be suggestive for parathyroid adenoma, but as calcium level is within the normal ranges first the vitD should be corrected. In rare cases (4%) parathyroid adenoma may be associated with normal calcium levels.
I would also suggest to check Chromogranine A, for chronic Diarrhea and abdominal pain.
The insuline level is high due to overweight.
The adrenal gland should be explored further (as the saliva cortisol tends to be low) with cortisol at 8.00 am and 16 PM.

Will be a pleasure to suggest you further after the above results.
Kind regards,
Dr.mirjeta


Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Answered by
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Dr. Mirjeta Guni

Endocrinologist

Practicing since :2006

Answered : 2375 Questions

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What does my blood test report indicate?

Brief Answer: Further investigations needed: Detailed Answer: Hello and thank you for asking, I have gone carefully through your concern. First of all the nodular goiter should be explored further to rule out a malignant nature to one of them, i would recommend: scintiscan of the thyroid gland, calcitonin (tumor marker) and a fine needle aspiration to the cold nodule that will result in scintiscan. High parathormone level may be suggestive for parathyroid adenoma, but as calcium level is within the normal ranges first the vitD should be corrected. In rare cases (4%) parathyroid adenoma may be associated with normal calcium levels. I would also suggest to check Chromogranine A, for chronic Diarrhea and abdominal pain. The insuline level is high due to overweight. The adrenal gland should be explored further (as the saliva cortisol tends to be low) with cortisol at 8.00 am and 16 PM. Will be a pleasure to suggest you further after the above results. Kind regards, Dr.mirjeta