Author Topic: Lab Values and the possibillities  (Read 892 times)

Tivia

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Lab Values and the possibillities
« on: September 22, 2012, 12:31:57 PM »
Ok so I went to the doctor thursday, my lymph nodes under my left jaw have been sore a little and slightly larger. This has been going off and on for a while now, also the side of my tongue on that side hurts. Anywho I am worried about ya know lymphoma, dr is like naw wont be that, prob just irritation. I am hoping he is right because the lab work they did came back with some funky values. For all you lacb tech junkies out there ..

here goes...GAD Glutamic acid decarboxylase..65 AB..ref range >30 is normal

C-peptide..0.77 ref range for normal 0.80-3.10

Thyroglobulin AB...39.8 ref range normal is 2.0-35.0

Thyroid-stimulating immunoglobulin..87% baseline ..whatever that means

Insulin serum.. <2 

Cortisol .. 8.1

TSH..0.38 RANGE 0.34-4.82 ? Is that the new values?

T4..9.5 range 4.5-13.9

A/C Ratio..40.2 ref range is <30.0

urine creat 203.2 MG/DL

HGBA1C.. 4.7...4.2-6.5 REF RANGE

CBC Looked fine cept for eosinophils...5.10% ref range is 0.90-2.90%

Also thyroid ultrasound came back with two bilateral nodules

In conclusion he said , I have the start of autoimmune diabetes, that graves disease may be flaring...although honestly I feel hypo not hyper.. and that there is some inflammatory reaction going on in my body...well duh! He wants my thyroid removed surgically I am afraid of that..what if it kicks off more problems with the SjS?


I should prb mention I have UC and have had it since a kid, have graves dx'd in 2006 and I think hashis also, SjS dx'd last month, and the rheumy is testing for poss lupus. Other than that breast surgery for precancerous lesions in the ducts in 2000 and the usual fibroids, cysts, and some funky arterial problem with my uterus
« Last Edit: September 22, 2012, 12:40:36 PM by Tivia »
Sjogrens, UCTD with Lupus and Scleroderma symptoms, Ulcerative Colitis, Graves Disease, Severe Gerd and failing pancreas/biliary system . Poss ANA 1:640 speckled , nerve damage in legs feet and hands, fibro, Restasis, evoxac, creon, prilosec, plaquenil, apriso, canassa, prednisione

Iwantmylifeback

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Re: Lab Values and the possibillities
« Reply #1 on: September 22, 2012, 02:39:15 PM »
Lab results can mean so many different things in us.  One test I never see in this forum is a cancer marker. I have family history of ovarian ca. I have had hysterectomy at 22.  We do a yearly cancer marker. This is a good baseline test that will hopefully indicate any tumeros activity at a very early stage.
Your A1C looks great do not see why he thinks early diabetis. Your. Graves could be causing a lot of your issues. My daughter used radioactivity to kill
 hers.  Maybe with nodules surgery would be safer??
I feel even blowing your nose can start a flare! Just do what you feel is the right thing for you! Good luck with this!

Tivia

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Re: Lab Values and the possibillities
« Reply #2 on: September 22, 2012, 02:59:57 PM »
Well he said over 30 is indicative of early kidney damage. Now I do go a lot and its clear sometimes no color but cloudy. The problem with me is I dont know when I have to go, I cant feel the urge anymore.
Sjogrens, UCTD with Lupus and Scleroderma symptoms, Ulcerative Colitis, Graves Disease, Severe Gerd and failing pancreas/biliary system . Poss ANA 1:640 speckled , nerve damage in legs feet and hands, fibro, Restasis, evoxac, creon, prilosec, plaquenil, apriso, canassa, prednisione

mambo

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Re: Lab Values and the possibillities
« Reply #3 on: September 22, 2012, 04:22:22 PM »
You were diagnosed with T1 diabetes based on your positive GAD antibody test.  Your C-Peptide is also low at 0.88, indicating that you don't produce much insulin.  Could be T1 or T1.5.  Are you doing some kind of low-carb diet -- your HbA1c is good at 4.7.  However, it's apparent you're leaking protein in your urine, based on your AC ratio:  your urine Albumin is high.  Your BG could be skyrocketing on occasion.  Are you perhaps anemic?

If you were diagnosed with Grave's, then you know that depending on medication and dose, you could become hyper or hypothyroid.  At your TSH level, you should feel ok but symptoms do not always track TSH.  You have Grave's, T1 diabetes, and Sjogren's ... all autoimmune.  I would not agree to removing your thyroid at this stage.  Since you have 3 autoimmune conditions and possibly more, I would think about going gluten/dairy-free and also nightshade-free, if you can.  But I would first go see an endocrinologist who specializes in T1 diabetes.  You may not need to go on insulin immediately, as you may have a honeymoon period where you can manage your BG for a while.  I may also think about seeing a nephrologist to make sure no damage is done to your kidneys.


DragonflyC

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Re: Lab Values and the possibillities
« Reply #4 on: September 23, 2012, 08:32:26 AM »
I can't answer most of your questions, but those are not the new values for TSH. "Normal" is now between .5 and 2.5 (you can find the info here http://www.thyroidtoday.com/TTLibrary/current/AACE%20Newsletter.pdf), so you do look a little hyper. But interpreting TSH depends on the individual. For some, .38 is fine while for others it's not. For some 4.0 is fine (I'm a mess at that level, personally).

Labs are only meaningful when combined with an analysis of a patient's symptoms, so it really all depends on what you're feeling and experiencing, as well as what these numbers say.

SJS, Hashimoto's, Raynaud's
Plaquenil, Evoxac, Restasis, Levoxyl, fish oil supplements, Vitamin D, NSAIDs, prednisone when flaring
Tested positive for SS-A ( > 8 ) and ANA (>1:640)

Visit me at http://sjogrensstyle.com for ideas about living well despite autoimmune disease.

Tivia

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Re: Lab Values and the possibillities
« Reply #5 on: September 23, 2012, 09:35:01 AM »
You were diagnosed with T1 diabetes based on your positive GAD antibody test.  Your C-Peptide is also low at 0.88, indicating that you don't produce much insulin.  Could be T1 or T1.5.  Are you doing some kind of low-carb diet -- your HbA1c is good at 4.7.  However, it's apparent you're leaking protein in your urine, based on your AC ratio:  your urine Albumin is high.  Your BG could be skyrocketing on occasion.  Are you perhaps anemic?

If you were diagnosed with Grave's, then you know that depending on medication and dose, you could become hyper or hypothyroid.  At your TSH level, you should feel ok but symptoms do not always track TSH.  You have Grave's, T1 diabetes, and Sjogren's ... all autoimmune.  I would not agree to removing your thyroid at this stage.  Since you have 3 autoimmune conditions and possibly more, I would think about going gluten/dairy-free and also nightshade-free, if you can.  But I would first go see an endocrinologist who specializes in T1 diabetes.  You may not need to go on insulin immediately, as you may have a honeymoon period where you can manage your BG for a while.  I may also think about seeing a nephrologist to make sure no damage is done to your kidneys.

I know for years I have felt I was diabetic, my father was so I know what a lot of the signs are. The doctors only ever did a stick test, and I asked for more indepth testing but ws told I was fine. My fasting BG when I wake up is between 81 and 89, which sounds good right, 2 hours after breakfast its between 111 and 145 I think it depends on what I have eaten.

I am so scared and there are not specialists any where around here, some days I am so weak shaky and feeling like Im going into a coma..I dont know what illness is causing it. The kidney problem I have harped at my dr. for a while about too. I told him something is wrong here, my urine output dont match my intake, and yet its pale and cloudy.

Wow like graves, UC, sjogrens wasnt enough..now this. And I am not able to get the help I need here, so it will be a downward spiral into another complication or AI illness. There is no preventive health care system in this backwoods place.
Sjogrens, UCTD with Lupus and Scleroderma symptoms, Ulcerative Colitis, Graves Disease, Severe Gerd and failing pancreas/biliary system . Poss ANA 1:640 speckled , nerve damage in legs feet and hands, fibro, Restasis, evoxac, creon, prilosec, plaquenil, apriso, canassa, prednisione

mambo

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Re: Lab Values and the possibillities
« Reply #6 on: September 23, 2012, 11:18:36 PM »
Your BG control so far seems to be good.  You may be able to stay off insulin for a while by eating somewhat low carb, under ~75g of net carbs per day.  Your A1c, however, could be a bit understated if you're anemic.

If you have good insurance, I'd go see a nephrologist on your own to see your kidneys are ok.  Your Microalbumin seems to be around 82, which is outside the range.  Are you leaking protein or glucose in your urine?  Your urinalysis should have those results.  How's your serum BUN and Creatinine? 

Even though you may not have specialists in your area, you can take good care of yourself by becoming knowledgeable about your condition.  Usually, the most diabling condition is UC, which you seem to have under control.  That's terrific.  I think for UC, Sjogren's, and Grave's, being gluten and dairy-free helps reduce symptoms. 

Autoimmune conditions come in clusters.  Seldom you end up with just one condition.  I am officially Sjogren's so far but have symptoms of Hashimoto's, Raynaud's as well as what looks to be T1.5 diabetes, lupus and RA.  Make sure to come and ask qustions here.  We're all here for support.  Many of us are willing to listen, help and answer questions, if we can.  Take good care and stay positive.

Tivia

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Re: Lab Values and the possibillities
« Reply #7 on: September 24, 2012, 08:40:47 AM »
Your BG control so far seems to be good.  You may be able to stay off insulin for a while by eating somewhat low carb, under ~75g of net carbs per day.  Your A1c, however, could be a bit understated if you're anemic.

If you have good insurance, I'd go see a nephrologist on your own to see your kidneys are ok.  Your Microalbumin seems to be around 82, which is outside the range.  Are you leaking protein or glucose in your urine?  Your urinalysis should have those results.  How's your serum BUN and Creatinine? 

Even though you may not have specialists in your area, you can take good care of yourself by becoming knowledgeable about your condition.  Usually, the most diabling condition is UC, which you seem to have under control.  That's terrific.  I think for UC, Sjogren's, and Grave's, being gluten and dairy-free helps reduce symptoms. 

Autoimmune conditions come in clusters.  Seldom you end up with just one condition.  I am officially Sjogren's so far but have symptoms of Hashimoto's, Raynaud's as well as what looks to be T1.5 diabetes, lupus and RA.  Make sure to come and ask qustions here.  We're all here for support.  Many of us are willing to listen, help and answer questions, if we can.  Take good care and stay positive.


Hi Thanks for the info, the endo I saw that did the bloodwork said I have type1.5 diabetes I have the antibodies, its just a matter of months to maybe a year till I am insulin dependent. I think its happening now, I am testing positive for some ketones in my urine. My feet are tingly, I get tremendous drops in blood sugar over a period of an hour, I had readings of 120, 137,84,62 in fifteen min testings. I feel absolutely awful, like I am going to slowly pass out. And I am peeing like every 15 min. barely eating cause I have no appetite. Could starting evoxac have caused the diabetes to come on sooner?
Sjogrens, UCTD with Lupus and Scleroderma symptoms, Ulcerative Colitis, Graves Disease, Severe Gerd and failing pancreas/biliary system . Poss ANA 1:640 speckled , nerve damage in legs feet and hands, fibro, Restasis, evoxac, creon, prilosec, plaquenil, apriso, canassa, prednisione

mambo

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Re: Lab Values and the possibillities
« Reply #8 on: September 25, 2012, 11:08:08 PM »
Well, ketones shouldn't be an issue since you're not injecting insulin.  Are you on a very low carb diet?  If so, that's understandable but ketones shouldn't be in your urine when you're not taking insulin and eating normally.  If your feet are tingly, it's neuropathy.  In your case, it's neuropathy caused by diabetes and Sjogren's and other autoimmune diseases you may have.  Sjogren's contribution to neuropathy is typically mild; most neurologists think it's diabetic neuropathy that's the real culprit.  I'm not so sure, however, since I also have cosiderable neuropathy and I had it when I was diagnosed with diabetes only 3 years ago.  My endo was surprised by it. 

Those are pretty severe BG drops.  You might want to mention that to your endo and say that you're anemic so HbA1c might not be accurate.  I hope you have a good PCP who's coordinating all this, else this could get a bit overwhelming.  If your neuropathy is severe, you might consider taking alpha lipoic acid.  Since you have multiple autoimmune issues, you might also wanna look into alternative therapies.  I don't know what people think about low-dose naltrexone (LDN), but I'm looking into it.  Most doctors only prescribe standard medications and are not familiar with alternative options such as gluten and dairy free diets and LDN.