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Dr. Brims
Dr. Brims, U.S. Licensed Physician
Category: Health
Satisfied Customers: 9053
Experience:  U.S. Licensed Physician, general surgery and internal medicine experience
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My TSH is 28.54; T4 free is L10...what does this mean?

Resolved Question:

My TSH is 28.54; T4 free is L10...what does this mean?
Submitted: 1 year ago.
Category: Health
Expert:  Dr. Brims replied 1 year ago.

Dr Brims :

Hello, welcome to the site! My name isXXXXX and I will try to assist you with your medical question, and any medical information you seek

Dr Brims :

Do you have any other medical conditions?

Dr Brims :

Do you take any medication?

Customer:

Not that i know of. I recently had 3 cancerous polyps removed from my colon but thank goodness they did not turn into cancer! My Gamma GT is elevated currently ...at a reading of H53

Customer:

The only medication I take on a regular basis is Levothyroxin...and I have had 2 sinus operations to remove polyps and blockage. Sometimes use novanex ...and flush

Dr Brims :

Okay, your TSH is high, which indicates your thyroid is low, and this means you need a higher dose of levothyroxine

Customer:

I have been quite healthy most of my life.

Dr Brims :

Ok

Customer:

I am already taking 200 mcg levothyroxin....what level do you recommend?

Dr Brims :

You should ask your doctor to start you on 300 mcg a day

Customer:

I have been suffering from anxiety lately -which is new to me. Not normally a symptom of 'low' thyroid is it?

Dr Brims :

No, that is not a symptom of hyperthyroidism

Customer:

Could be hormonal changes...what about the Gamma GT reading of 53...is this really high?

Dr Brims :

It is slightly high, 45 is usually the normal upper limit

Customer:

hmm...causes?

Dr Brims :

It could be due to gall stones, that is the most likely cause

Dr Brims :

But any obstruction in the biliary tract can cause an elevation in GGT

Dr Brims :

To narrow down the cause, you would need liver function tests like ALT and AST

Dr Brims :

ANd bilirubin

Customer:

would it cause nausea, fatigue, and dizziness?








it cause nausea and
Dr Brims :

It may cause nausea, not fatigue or dizziness

Customer:

These were my recent blood tests - any input in regards XXXXX XXXXX overall picture - the asterisks on the differential?

Customer:























































































































































































Hematology

WBC


5.8


4.0 - 11.0


10*9/L


RBC


4.47


3.50 - 5.00


10*12/L


Hemoglobin


143


115 - 160


g/L


Hematocrit


0.42


0.35 - 0.47


L/L


MCV


93


80 - 100


fL


MCH


32.0


27.0 - 34.0


pg


MCHC


344


315 - 365


g/L


Platelet Count


275


150 - 400


10*9/L

Differential

Neutrophils


2.8


2.0 - 8.0


10*9/L


Lymphocytes


2.2


1.0 - 4.0


10*9/L


Monocytes


0.5


< 0.9


10*9/L


Eosinophils


0.3


< 0.8


10*9/L


Basophils


0.1


< 0.3


10*9/L


Granulocytes Immature


0.0


< 0.2


10*9/L


Mono Test


Negative

Biochemical Investigation of Anemias

Ferritin


28


> 14


ug/L


Interpretation:
<15 ug/L-diagnostic of iron deficiency
15-49 ug/L-probable iron deficiency
50-100 ug/L-possible iron deficiency
>100 ug/L-iron deficiency unlikely. If result
is persistently >1000 ug/L, consider
test for iron overload (transferrin
saturation).
General Chemistry

Glucose Fasting


5.3


3.6 - 5.5


mmol/L


- Hours After Meal


10.0


h pc


- Specimen Drawn


0755


h


Creatinine


78


45 - 90


umol/L


Estimated GFR


67


> 59


mL/min/1.73sq.m

Note: eGFR based on serum creatinine, age and gender. This
result within reference interval. Diet, drugs and
clinical state may also affect: see
www.healthservices.gov.bc.ca/msp/protoguides/gps/ckd.pdf

Alkaline Phosphatase


57


35 - 120


U/L


Gamma GT


H


53


< 31


U/L


ALT


20


< 36


U/L

Thyroid Function

TSH


H


28.54


0.30 - 5.50


mU/L


T4 Free


L


10


11 - 22


pmol/L

Dr Brims :

These tests indicate you have hypothyroidism

Dr Brims :

They do not indicate any other condition

Dr Brims :

an increase in GGT can also be due to drinking alcohol, but as I said earlier, more liver function tests would be required to determine the cause

Dr Brims :

Are you there?

Customer:

yes.

Customer:

So overall, it looks ok, other than the GGT and thyroid?

Dr Brims :

Yes, those are the only 2 abnormal findings

Customer:

We have been indulging in wine more often ..too many events...if I stop the silliness will it fix itself if this is the problem?

Dr Brims :

If you stop drinking the GGT will likely return to normal

Customer:

Perfect. That is what I shall do, and have further tests for the liver just to be sure. I will also get a stronger dose of thyroid medication. One more question - will the thyroid change as hormonal changes happen? Not yet in menopause.

Dr Brims :

No, the thyroid should not changes with hormonal changes

Customer:

Perhaps it is the additional stress I have been under...

Dr Brims :

It may just be the thyroid gland is failing

Customer:

Ok. Anything else I can do to have a healthier thyroid? (hypo for 30 years)

Dr Brims :

No, the thyroid gland will not respond to anything but iodine, which is present in just about everything we eat

Customer:

Ok. Thank you so much, you have been very helpful!

Dr Brims :

You're very welcome

Dr Brims :

I am glad I could help

Dr Brims :

If you have any questions in the future, you may request me by starting your questions with "Dr Brims" and I will answer

Dr Brims :

If you still have questions on this topic, please feel free to ask

Dr Brims :

If not, you may click a rating button to end this session

Customer:

Thank you, XXXXX XXXXX!

Dr Brims :

You're welcome

Dr Brims :

Are you still there?

Dr. Brims, U.S. Licensed Physician
Category: Health
Satisfied Customers: 9053
Experience: U.S. Licensed Physician, general surgery and internal medicine experience
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