Help Needed - Labs results v Symptoms

[Guest guest]

We have a close friend, 61 year old female, who we are concerned about. She has

been on Levothyroxine for 20 years.

She is suffering from fatigue, breathless on exertion, pale skin including lips.

She has abdominal weight gain despite diet –barrel body, thin arms and legs.

Bruises easily. Loss of muscle despite exercise/ slow recovery after exercise.

Muscle and joints ache.

Dry skin, hair, eyes and mouth, dry brittle nails. Hair loss, croaky voice,

purple eye bags.

Basal temperature avg 35 Cold all the time. Headaches, migraine, light sensitive

and intolerant to sun. Brain fog, chronic sinus and earache. Blood pressure

fluctuates.

Was blood tested by Dr who said all were normal!!! Except she was HYPER and

reduced her Levothyroxine. Blood tests for thyroid were see-sawing for 4 years

and Levo has been raised and lowered. It was at 150ug but is now at 100ug and

she feels awful.

We suggested she ask her Dr for copies of the results, and here they are. She

hadn't been told of the kidney damage and neither have further test been

suggested!

Free triiodothyronine level 4.1 pmol/L (3.8 – 6.0)

Thyroid Function Test

Serum TSH Level 0.01 mIU/L (0.35 – 3.5)

Serum Free T4 Level 19 pmol/L (8 – 21)

Specimen Description EDTA Whole Blood

FBC

WBCs 5.4 10*9/L (4.0 – 11.0)

RBCs 4.55 10*9/L (3.9 – 5.6)

HB 13.0 g/dL (11.5 – 16.4)

Heamatocrit 0.382 (0.37 – 0.47)

MCV 84 fL (80 – 100)

MCH 28.6 pg (27 – 32)

Platelet count 233 10*9/L (150 – 400)

Neutrophil count 3.05 10*9/L (2 – 7.5)

Lymphocyte count 1.86 10*9/L (1.1 – 3.5)

Monocyte count 0.33 10*9/L (0.2 – 0.8)

Eosinophil count 0.15 10*9/L (0.00 – 0.40)

Basophil count 0.01 10*9/L (0.00 – 0.10)

Liver Function Test

Serum total bilirubin level 4 umol/L (0 – 22)

Serum Total Protein 67 g/L (63 – 82)

Serum Albumin 38 g/L (35 – 50)

Serum Globulin 29 g/L (21 – 35)

Alk Phos 113 u/L (38 – 126)

ALT/SGPT serum level 31 u/L (0 – 50)

Serum Gamma GT level 19 u/L (0 – 60)

Bone profile

Serum Calcium 2.4 mmol/L (2.1 – 2.6)

Corrected serum calcium level 2.45 mmol/L (2.1 – 2.6)

Serum inorganic phosphate 0.96 mmol/L (0.8 – 1.45)

Urea and Electrolytes

Serum sodium 138 mmol/L (134 -145)

Serum Potassium 3.9 mmol/L (3.6 – 5.0)

Serum bicarbonate 25 mmol/L (22 – 30)

Serum Urea level 6.2 mmol/L (1.7 – 7.1)

Serum Creatinine 60 umol/L (55 – 125)

GFR Calculated abbreviated MDRD 88 ml/min/1.73*2

Comment note

Mildly decreased GFR- Stage 2 CKD if kidney damage confirmed.

The diagnosis of Stage 2 chronic kidney disease requires the presence of kidney

damage for 3 months or greater, manifest by pathological abnormalities of the

kidney, abnormalities in the composition of urine such as haematuria or

proteinuria, or abnormalities in imaging tests.

Serum Ferritin 69 ug/L (23 – 300)

Plasma Glucose level 4.9 mmol/L (3.5 – 7.8)

Lab 21 Thyroid Test 29/09/2010

Free T3 4.6 pmol/L (3.0 – 6.2)

Free T4 19.7 pmol/L (12 – 22)

TSH 0.01 mIU/L (0.04 – 4.0)

TgAb 27.2IU/ml (less than 60)

We would appreciate any help in casting some light on the difference between her

symptoms and her lab results.

Many thanks

Ian