What Does This Blood Report Indicate?

Posted on Tue, 24 Nov 2015

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Tue, 24 Nov 2015 Answered on

Tue, 15 Dec 2015 Last reviewed on

Question : I have been experiencing major nervousness, rapid heartbeat, sweaty hands, anxiety, insomnia, difficulty sleeping and increased appetite without weight gain. The worse symptom of all is by early afternoon i cant keep my head up, i get double vision, lighthead and extreme fatigue(indescribable). My ultrasound came back with a small hypoechoic collid cyst measuring 3mm. Blood work was repeated and came back as elevated thyroid.

TSH .94
Free t4 25
Free t3 4.8

Can you give me some feedback on these findings? Diagnosis and treatment

Thank you in advance,
XXXXXXX

Answered by Dr. Shehzad Topiwala (32 minutes later)

Brief Answer:
Thyroid

Detailed Answer:
I understand what you are asking.

1 Your thyroid ultrasound does not have worrisome features

2 You do have symptoms suggestive of an over active thyroid condition called hyperthyroidism.

When I see someone like you in my practice, I typically order the following tests in addition to a detailed physical examination:

CBC
Electrolytes
Calcium
HbA1c
Liver function tests
Kidney function tests
TSH
Total T3
Total T4
T3 resin uptake
25 hydroxy Vitamin D
Plasma Free Metanephrines
Prolactin
8 am Serum Cortisol

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

Follow up: Dr. Shehzad Topiwala (4 minutes later)

What is the treatment plan? How ling for me to feel myself again?

Answered by Dr. Shehzad Topiwala (12 hours later)

Brief Answer:
Follow up

Detailed Answer:
Treatment will depend on the cause found.

For example if you truly have hyperthyroidism then the reason for that needs to be determined too. If it is from the pituitary then surgery is an option , otherwise there are medications too.

There is an uncommon condition called Pheochromocytoma which also causes symptoms similar to the one you are reporting. The test above called Plasma Free Metanephrines checks for that.
The treatment for that is often surgical

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