Aa
Blood levels too high
My husband has been to the doctor's for blood work a few times over the last couple of years for cholesterol with very high numbers, which medication never made better and results would be Gout. Recently, on the urgency of his mother and myself, we begged him to request blood work for Thyroid after determining all his other symptoms pointed that direction. Results, Triglycerides=2000, Cholesterol=640, THS=300 (yes this correct). Two weeks after blood work doctor's still had no respons with results so after being very persistant they tell him they had to run a Free T4 because they were so shocked with the results and didn't believe they were accurate. Free T4= .11. Doctor's sent him home with thyroid meds and said come back in 3 months for follow up. Is it just me, or are these numbers deadly? especially after 2 years. Last year Triglycerides=1000, cholesterol=400 and they refused thyroid check because he didn't have it. He is very weak and tired and very edgy. His "Gout" is worse than it's ever been and now he's acquired white raised wart like spots all over hands and arms. Which doctor just says take benadryl for.
A) If indeed the TSH is three hundred (which is extremely, extremely high by any reference range standard you could find out there) and you also put the decimal point in the correct spot and the free T4 is only point 11... according to a reference range I got from a lab, which has the low end of normal at point 58, then that is not a normal number and it sounds to me if the lab numbers were accurate ones (if their lab equipment was working properly) like that doctor is a quack and should be reported to the licensing board.
B) They like the HDL higher than that nowadays, since it's believed to fight bad cholesterol. Of course this would only one tiny piece of the pie of attacking the problem.
C) The reason I asked about if he had been diagnosed with a specific type, was I was going to suggest talking to the doctor about something one of my parents took that was supposed to help with triglycerides- gemfibrozil, but found some info that led me to ask about type (see private message).
D) What number(s) was/were a little off of the liver function and was it high or low? (Did you get copies of lab results)
E) Probably didn't then
F) It sounds like it was the wrong medication for your husband and they need to work with him on this & part of trying to get to the right medicine is determining what exactly is the situation, not just giving a generalized conclusion that is obvious to even a lay person.
G) HDL didn't go up at all eating the pistachios? This lack of improvement with diet must be very disheartening for you guys.
H) I'm Glad he's still excercising- that's great!
I &J) Did the doctor take a sample of synovial fluid from a joint during a flare up to try to confirm a diagnosis of gout?
K) Sounds like the doctor was incorrect about it being an allergy and your husband may need to see a dermatologist who knows pathology about the lesions.
B) They like the HDL higher than that nowadays, since it's believed to fight bad cholesterol. Of course this would only one tiny piece of the pie of attacking the problem.
C) The reason I asked about if he had been diagnosed with a specific type, was I was going to suggest talking to the doctor about something one of my parents took that was supposed to help with triglycerides- gemfibrozil, but found some info that led me to ask about type (see private message).
D) What number(s) was/were a little off of the liver function and was it high or low? (Did you get copies of lab results)
E) Probably didn't then
F) It sounds like it was the wrong medication for your husband and they need to work with him on this & part of trying to get to the right medicine is determining what exactly is the situation, not just giving a generalized conclusion that is obvious to even a lay person.
G) HDL didn't go up at all eating the pistachios? This lack of improvement with diet must be very disheartening for you guys.
H) I'm Glad he's still excercising- that's great!
I &J) Did the doctor take a sample of synovial fluid from a joint during a flare up to try to confirm a diagnosis of gout?
K) Sounds like the doctor was incorrect about it being an allergy and your husband may need to see a dermatologist who knows pathology about the lesions.
Yes,
I assume he is taking medication for thyroid and also for cholesterol and tryglycerides, so fibrates are good to reduce trygl.
Jesus
I assume he is taking medication for thyroid and also for cholesterol and tryglycerides, so fibrates are good to reduce trygl.
Jesus
1) So are you saying in addition to meds for thyroid issue?
2) Husband agrees, doctor disagrees
3) I misunderstood husband. bloodwork is once a month
and I agree he needs a new doctor unfortunately he has no insurance and already has paid hundreds for bloodwork and 2 appointments. Thanks for all this good information, at least we have an idea of what to ask and look for if this doctor doesnt.
2) Husband agrees, doctor disagrees
3) I misunderstood husband. bloodwork is once a month
and I agree he needs a new doctor unfortunately he has no insurance and already has paid hundreds for bloodwork and 2 appointments. Thanks for all this good information, at least we have an idea of what to ask and look for if this doctor doesnt.
My first reaction is to change doctor!!!
1) Check medication that he is taking, as ChatterAlly pointed out, fibrates are the most effective medicament for tryglicerides, if he is not on them.. is another reason to change doctor.
2) The spots in the hands can be Xanthomas (google it)
3) 3 months can be an standard time for cholesterol evolution, but definitely NOT for thyroids evolution.
4) If he has not gotten, a Thyroids echography is advisable.
5) I think that Vitamin D and PTH levels should also be measure.
6) In case of extreme need, there is a sort of dialysis that extract cholesterol from the blood.
I think that he really need a good specialist.
Jesus
1) Check medication that he is taking, as ChatterAlly pointed out, fibrates are the most effective medicament for tryglicerides, if he is not on them.. is another reason to change doctor.
2) The spots in the hands can be Xanthomas (google it)
3) 3 months can be an standard time for cholesterol evolution, but definitely NOT for thyroids evolution.
4) If he has not gotten, a Thyroids echography is advisable.
5) I think that Vitamin D and PTH levels should also be measure.
6) In case of extreme need, there is a sort of dialysis that extract cholesterol from the blood.
I think that he really need a good specialist.
Jesus
Trigs can be that high. Last year they were over 2100. I was put on Tricor and in March they were down to 525. I was tested again after properly fasting and my numbers were still a bit high, so a statin was ordered in addition to the Tricor. I will be tested again to see what effect the combination of meds has. Take care, Ally
COMMUNITY LEADER
Just a quick thought, you need to request a more accurate lipid test. The fact that his report shows his LDL as tri's too high to calculate means they are using a test that calculates the LDL based on the level of his tri's. He needs the test that actually measures his HDL, LDL and TGL's, it's the only way he'll know for sure what his lipid profile is.
Jon
Jon
Yes, the high Cholesterol/Triglycerides combination could be caused by Familial combined Hyperlipidemia, but to find out he would need genetic testing.
Sorry TSH, yes. and not sure about the Gout being Gout but it is severe pain he says. I did look up information on Hyperlipidemia and there is information about swelling symptoms that could mean he has Hyperlipidemia but not sure since the Gout was not technically diagnosed just assumed by the doctor. Just saw the doctor who gave him the thyroid meds and sent him home.
A) They refused thyroid check because they decided he had no signs of a thyroid problem so they told him it was not needed.
B) HDL=41 and LDL says tri results too high to get accurate results
C)Has not been diagnosed with anything except high cholesterol.
D)They told him it was little off but nothing to worry about
E)Don't know
F)Yes last year and with medication and exercise=slightly elevated instead
G)All of the above, last year.....did not help
H)Yes
I)No to trophi but has not been treating gout but takes apple cider vinegar. Doctor never checked it out because it was not active at time of bloodwork
J)Don't believe Uric acid has been checked
K)No, doctor thinks its an allergic reaction and told him to take the benadryl for two weeks......no results
B) HDL=41 and LDL says tri results too high to get accurate results
C)Has not been diagnosed with anything except high cholesterol.
D)They told him it was little off but nothing to worry about
E)Don't know
F)Yes last year and with medication and exercise=slightly elevated instead
G)All of the above, last year.....did not help
H)Yes
I)No to trophi but has not been treating gout but takes apple cider vinegar. Doctor never checked it out because it was not active at time of bloodwork
J)Don't believe Uric acid has been checked
K)No, doctor thinks its an allergic reaction and told him to take the benadryl for two weeks......no results
While lifestyle changes I would guess would be unlikely to be sufficient for such an elevation, I imagine you would agree that not only does the underlying cause need to be determined to hopefully figure out which, if any, medication regime might be helpful for this patient to bring his numbers down (since lgraywolf said "which medication never made better"), but this problem should be attacked from every known direction, including dietary and excercise.
Shouldn't that be TSH instead of THS? And why did you put the word Gout in " ". Does that mean you are not sure? However if he has acute gout, he'll know it. The pain in the joints is just unbearable. If your husbands Cholesterol and Triglycerides levels are as high as you report them to be, there is nothing he can do, but see a doctor asap to determine the cause - no nutritional changes and amount of exercise can change that.
I am putting letters (A,B,C, etc.) beside my questions for more ease of you answering them- hope I don't overwhelm you!
The way I see what you are saying, your husband has two different issues in the lipids and the thyroid.
With a TSH of 300 rather than 3.0 for example, which would be in normal range, and a free T4 of only point 11, your pituitary is trying desperately with enormous amounts of thyroid stimulating hormone to stimulate your husband's thyroid....
A) what did you mean by "they refused thyroid check because he didn't have it."? Are you saying he has no thyroid?
May I suggest with the way your husband is feeling, a three month interval before checking on the levels again after prescribing thyroid medication is unacceptable and you need to shop for a better endocrinologist? The thyroid is important in metabolism, and not having the synthetic hormone the doctor prescribed in proper balance in his body can affect many aspects of your husband's well-being.
The other issue is your husbands cholesterol and triglycerides.
B) What is is LDL and what is his HDL?
The triglycerides are obviously extremely high and this can be a high risk, because triglycerides help form plaque in blood vessels and you definitely don't want that! Triglycerides come from certain foods. Also, if he is not getting enough dietary fat, triglycerides, according to a website I looked at, are produced by the liver. I know heredity can play a factor in some individuals for their high cholesterol... I believe this was the case with my grandma, who had peripheral vascular disease.
C) Has your husband been diagnosed specifically regarding his lipid issues (for example, have they said he has Type IV hyperlipoproteinemia; has he been told he is a Type IIb patient)?
D) Have they taken a look at his liver function?
E) Have they tested any other endocrine function besides thyroid?
F) Has he cut out foods that raise triglycerides, such as sugar, saturated fat, and dairy?
G) Is he eating things known to help with cholesterol- like oatmeal for example? Is he eating pistachios, which have been shown to raise the HDL (good cholesterol that's supposed to fight the LDL- bad cholesterol)? Is he getting a buttery spread with plant sterols in it known to help with cholesterol?
H) Is he exercising at least a half hour five times a week to try to raise his good cholesterol?
I) Does the doctor say the raised white spots are tophi? If so, does this mean he is not treating the "gout"?
J) Is his uric acid high and his joints having painful attacks that he has been diagnosed with gout?
K) Does the doctor feel the raised white wart like spots are an allergic reaction that he feels benadryl is the answer for? If it is an allergy, has any doctor tried to determine the cause so the cause can be avoided?
The way I see what you are saying, your husband has two different issues in the lipids and the thyroid.
With a TSH of 300 rather than 3.0 for example, which would be in normal range, and a free T4 of only point 11, your pituitary is trying desperately with enormous amounts of thyroid stimulating hormone to stimulate your husband's thyroid....
A) what did you mean by "they refused thyroid check because he didn't have it."? Are you saying he has no thyroid?
May I suggest with the way your husband is feeling, a three month interval before checking on the levels again after prescribing thyroid medication is unacceptable and you need to shop for a better endocrinologist? The thyroid is important in metabolism, and not having the synthetic hormone the doctor prescribed in proper balance in his body can affect many aspects of your husband's well-being.
The other issue is your husbands cholesterol and triglycerides.
B) What is is LDL and what is his HDL?
The triglycerides are obviously extremely high and this can be a high risk, because triglycerides help form plaque in blood vessels and you definitely don't want that! Triglycerides come from certain foods. Also, if he is not getting enough dietary fat, triglycerides, according to a website I looked at, are produced by the liver. I know heredity can play a factor in some individuals for their high cholesterol... I believe this was the case with my grandma, who had peripheral vascular disease.
C) Has your husband been diagnosed specifically regarding his lipid issues (for example, have they said he has Type IV hyperlipoproteinemia; has he been told he is a Type IIb patient)?
D) Have they taken a look at his liver function?
E) Have they tested any other endocrine function besides thyroid?
F) Has he cut out foods that raise triglycerides, such as sugar, saturated fat, and dairy?
G) Is he eating things known to help with cholesterol- like oatmeal for example? Is he eating pistachios, which have been shown to raise the HDL (good cholesterol that's supposed to fight the LDL- bad cholesterol)? Is he getting a buttery spread with plant sterols in it known to help with cholesterol?
H) Is he exercising at least a half hour five times a week to try to raise his good cholesterol?
I) Does the doctor say the raised white spots are tophi? If so, does this mean he is not treating the "gout"?
J) Is his uric acid high and his joints having painful attacks that he has been diagnosed with gout?
K) Does the doctor feel the raised white wart like spots are an allergic reaction that he feels benadryl is the answer for? If it is an allergy, has any doctor tried to determine the cause so the cause can be avoided?
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