Posts by Karen Alvarez40

Maria Fisher46 said:Basically, since we already covered the thyroid hormone levels and those urine tests you did, my previous advice still stands completely.

I’m more than happy to upload the results from my extra tests if you think that would help.
I was hoping you could take a look at these and give me your thoughts: https://ibb.co/pQVgWH7 and https://ibb.co/DtyS9Wg

Thanks!

Maria Fisher46 said:Look, generally speaking, besides checking those thyroid hormone levels and doing the urinalysis—which are already done—my previous advice still stands. Also, if that hemangioma was first spotted on an abdominal MRI over a year ago, you really ought to get another scan just to make sure it hasn't grown. Usually, they stay the same size, but it's better to be safe.

Given everything else that showed up in the tests, I’d strongly suggest seeing an internist.

Of course, there's a lot we can't see through a forum post, like what the past medical records actually look like. For example, does this person have a history of anemia? How long has it been going on? Is the level steady, or is it dropping? We just don't know.

But yeah, bottom line: an internal medicine specialist needs to take a look.

Thanks a ton.
Can you recommend a good hospital in Washington, D.C. with solid internists?

Hi there,

Thanks for getting back to me so fast.
As far as alcohol goes, he doesn't really touch it—maybe a tiny bit of red wine maybe twice a year at most.
He stays away from soda too, but he drinks tons of water and tea, and occasionally takes some magnesium supplements.

We actually had a urine test done, but I totally forgot to snap a photo of it: https://ibb.co/ZXNX8zW

His thyroid was checked back in June along with an internal medicine workup, and everything looked steady (TSH: 3.39 mU/L 0.38-5.33, fT3 4.4 pmol/L 3.2-6.2 and fT4 9.1 pmol/L 8.0-16.3).

Early last year, he had an abdominal ultrasound: the liver looks normal in size and structure, though they did spot a small 20mm hemangioma. The gallbladder showed no issues in the lumen and the walls look fine. Pancreas is normal size and texture. No dilation found in the bile ducts. Kidneys look good—normal size and thickness, and no signs of kidney stones. Adrenal glands look clear. No ascites or aortic aneurysms detected. Spleen looks normal. Bladder is full and shows no abnormalities.

Basically, even then, after his physical, they sent him off for more testing, but it turned out to be a total nothingburger. The final word was that it was just from working out. Still, we’re pretty worried and really want to get to the bottom of this, but we're stuck on where to go next.
When you mention a clinical exam and a deep-dive conversation, which specialist are you thinking of? An internist, a GI doctor, or someone else entirely?

Thanks again.

Hey everyone,

Can someone take a look at these results and let me know if I should be heading to a specialist for more testing? It’s for a guy in his mid-thirties who stays pretty active—mostly running. These labs came back during a routine physical. His resting heart rate is sitting at about 40 bpm. He was diagnosed with hypothyroidism two years ago and is currently managing it with Euthyrox 25 mcg along with 100 mcg of selenium. No steroid use or crazy supplements here. Diet-wise, he's pretty dialed in—lots of complex carbs, low-fat cottage cheese, veggies, fruit, nuts, and honey. Lately, he's actually been cutting back on meat and fats.

Do you think this is just what happens when you're an athlete, or could we be looking at something more serious?

https://ibb.co/KXv7Xbx

Hey there,

Quick question—how long does a white referral stay valid?

Thanks!

Maria Fisher46 said:I think it’s totally doable, but honestly, doctors can't seem to agree on it. It really all boils down to how high that ANA titer is sitting.

Ugh, they totally left out the titer level. No clue why they'd do that. Just super frustrating!

Maria Fisher46 said:It’s totally possible that your thyroid is the culprit behind those elevated transaminase levels. Honestly, even Athyrazol itself could be causing the spike.

The results finally landed in my inbox. Everything is back within the normal range again, except for my ALP, which hit 175 (anything under 119 is considered normal). But hey, even that is trending down—it was sitting at 201 before! It’s been two and a half months now, and I haven't broken character once; I've been sticking to a strict liver diet this entire time.

Do you guys think there's any point in digging deeper or doing more work on this?
I'm heading to the gastroenterologist in a couple of days with this massive mountain of test results, so we'll see what the doc actually makes of the whole mess.

Karen Alvarez40 said:My hepatitis results came back today and everything is negative.
Following my GI doctor's advice, I still need to get checked for alpha-1 antitrypsin, antinuclear antibodies, and serum copper. My appointment is at the end of the month, so once I get those done, I'll bring them to him. What exactly are these tests looking for?

Okay, I just got these lab results back too.

Alpha-1-antitrypsin 1.54 g/L (0.90 - 2.00)
Serum Copper 23.5 qmol/L (12.2 - 25.1)

ANA (ENA) IIF homogeneous titer (< 1:100)
dsDNA negative IU/ml ( < 100 neg, 100-120 weak pos, > 120 pos)
histones negative AU/ml
SS-A negative AU/ml
SS-B negative AU/ml
Sm negative AU/ml
U1-RNP negative AU/ml
DNA-topo 1 negative AU/ml
Jo-1 negative AU/ml
CENP-B negative AU/ml

Since the ANA came back homogeneous, and because of my hyperthyroidism diagnosis, I went ahead and had my thyroid antibodies checked out as well:

TgAb 4.8 IU/mL (< 4 IU/mL)
TPOAb 144.3 IU/mL (< 9 IU/mL)
TSH 0.03 mIU/L (0.34 - 5.60)
fT3 4.12 pmol/L (3.84 - 5.99)
fT4 6.61 pmol/L (7.85 - 14.42)

Could an ANA result like this point toward an autoimmune thyroid issue? Also, what other tests should I run to rule out things like Lupus, Rheumatoid Arthritis, or other autoimmune stuff?
And is it actually possible for the thyroid to cause elevated liver enzymes?

I'm still waiting on my liver enzyme numbers to see if they've improved. Honestly, though, I'm on Atazanavir right now, so I'm not holding my breath for much of an improvement.

Maria Fisher46 said:Whether you need to dig deeper into an EBV infection really depends on how you’re actually feeling, what your previous labs looked like, and your overall clinical picture. Honestly, I’d also suggest running markers for viral hepatitis if you haven't already.

My hepatitis results just came back today and everything is negative.
Following my gastroenterologist's advice, I still need to get tested for alpha-1 antitrypsin, antinuclear antibodies, and serum copper. I have my appointment at the end of the month, so I'll bring those results straight to him. Does anyone know what exactly those tests are looking for?

It’s been two months since that "flu" episode (those were basically the only symptoms I had that could possibly link back to mono), and my full blood panel showed these transaminase levels: AST 68, ALT 139, GGT 80, ALP 201, and total bilirubin at 17. It feels like they should have started trending back toward normal by now, right?

Everything else fell within the normal range, except for my red blood cell count, which was slightly elevated at 5.24.

Maria Fisher46 said:We’re missing the actual data needed to figure out what's really going on with the EBV status. Just seeing "EBV IgG" by itself doesn't tell me a thing when you've got four different markers to juggle: VCA IgG, VCA IgM, EA IgG, and EBNA IgG.

The lab only ran exactly what I asked for: EBV IgM and IgG, plus CMV IgM and IgG.
So, are you guys saying I should go back and get more tests? Honestly, I don't get why they didn't just do the whole panel from the jump.

I’ve got a question about mono too.

So, my EBV IgG came back positive at 99.97% and my CMV IgG is at 25, but both IgM tests were negative. What’s the deal with that?
I was sent in for more testing because my liver enzymes are through the roof—some of them are triple the normal limit. Back in mid-February, I was stuck in bed for three days thinking I just had a nasty bout of the flu.

On top of that, I’ve been diagnosed with hyperthyroidism, though my ultrasound and scintigraphy results actually look fine. Is it possible that a past bout of mono totally threw my thyroid out of whack?

Thanks!

Hey there,

I really need some insight on these thyroid hormone results:

T3: 6.39 H
T4: 287.0 H
TSH: 0.01 L

This is my first time ever getting these checked out, and honestly, I have zero clue how far off these numbers are from the normal range. My primary care doctor can't see me until next week, so I'm hoping someone here can shed some light on this.

Thanks!