Lucian and Abnormal Blood Test Results 4/27/09

Ok so I got a call from Lucian’s doctor today while I was at work wanting me to call them back asap about his blood work.
So I did just that. She wouldn’t get into full detail whit me about everything so I asked the questions I could add plus I was trying to work and talk. So your probably asking what was abnormal. Well Lucian had a pretty good amount of blood work done on Friday with his dilation to test for various things.
I will tell you the name of each test and explain it the best way I can.
1)T.4 test…Total T4 and free T4 are two separate tests that can help the doctor evaluate thyroid function. The total T4 test has been used for many years to help diagnose hyper- and hypothyroidism. It is a useful test but can be affected by the amount of protein available in the blood to bind to the hormone. The free T4 test is a newer test that is not affected by protein levels. Since free T4 is the active form of thyroxine, it is thought by many to be a more accurate reflection of thyroid hormone function and, in most cases, its use has replaced that of the total T4. Whichever thyroxine measurement is ordered, it is usually ordered along with or following a TSH test. This helps the doctor to determine whether the thyroid hormone feedback system is functioning as it should, and the results of the tests help to distinguish between different causes of hyper- and hypothyroidism. Sometimes a T3 test will also be ordered to give the doctor additional diagnostic information. In the United States, newborns are commonly screened for T4 levels as well as TSH concentrations to check for congenital hypothyroidism, which can cause mental retardation if left untreated.A total T4 or free T4 test is primarily ordered in response to an abnormal TSH test result. Sometimes the T4 will be ordered along with a TSH to give the doctor a more complete evaluation of the adequacy of the thyroid hormone feedback system. These tests are usually ordered when a patient has symptoms of hyper- or hypothyroidism. Sometimes they are ordered as screening tests during routine blood testing, but expert opinions vary on who can benefit from screening and at what age to begin. In patients with known thyroid disorders, the TSH and sometimes T4 are ordered at intervals to monitor the effectiveness of treatment. In pregnant women with thyroid disorders, the doctor is likely to order thyroid testing early and late in the pregnancy and for a time period following delivery to monitor the mother and baby. Thyroid hormone screening is commonly performed on newborns in the United States as part of newborn screening programs.
In general, high free or total T4 results may indicate an overactive thyroid gland (hyperthyroidism), and low free or total T4 results may indicate an underactive thyroid gland (hypothyroidism). The test results alone are not diagnostic but will prompt the doctor to perform additional testing to investigate the cause of the excess or deficiency. Both decreased and increased T4 results are associated with a variety of temporary and chronic thyroid conditions. Low T4 results in conjunction with a low TSH level or high T4 results along with a high TSH may indicate a pituitary gland condition. Lucians t.4 test was NORMAL
Next test C.B.C…The complete blood count (CBC) is one of the most commonly ordered blood tests. The complete blood count is the calculation of the cellular (formed elements) of blood. These calculations are generally determined by special machines that analyze the different components of blood in less than a minute.

A major portion of the complete blood count is the measure of the concentration of white blood cells, red blood cells, and platelets in the blood. Lucian’s was NOT NORMAL. His white blood cell count was off. Noraml is between 6-17.5 and his is at a 3.53
Next thing they want to do a lead screen because he has not had one done yet.
The next test is called a T.S.H TEST…A thyroid-stimulating hormone (TSH) blood test is used to check for thyroid gland problems. TSH is produced when the hypothalamus releases a substance called thyrotropin-releasing hormone (TRH). TRH then triggers the pituitary gland to release TSH. TSH causes the thyroid gland to make two hormones: triiodothyronine (T3) and thyroxine (T4). T3 and T4 help control your body’s metabolism.

Triiodothyronine (T3) and thyroxine (T4) are needed for normal growth of the brain, especially during the first 3 years of life. A baby whose thyroid gland does not make enough thyroid hormone (congenital hypothyroidism) may, in severe cases, be mentally retarded. Older children also need thyroid hormones to grow and develop normally.

This test may be done at the same time as tests to measure T3 and T4. * Find out whether the thyroid gland is working properly.
o An underactive thyroid gland (hypothyroidism) can cause symptoms such as weight gain, tiredness, dry skin, constipation, a feeling of being too cold, or frequent menstrual periods.
o An overactive thyroid (hyperthyroidism) can cause symptoms such as weight loss, rapid heart rate, nervousness, diarrhea, a feeling of being too hot, or irregular menstrual periods.
* Find the cause of an underactive thyroid gland (hypothyroidism). TSH levels can help determine whether hypothyroidism is due to a damaged thyroid gland or some other cause (such as a problem with the pituitary gland or the hypothalamus).
* Keep track of treatment with thyroid replacement medicine for people who have hypothyroidism.
* Keep track of thyroid gland function in people who are being treated for hyperthyroidism. This treatment may include antithyroid medicine, surgery, or radiation therapy.
* Double-check the diagnosis of an underactive thyroid gland in a newborn (congenital hypothyroidism).
High TSH levels may be caused by:

* An underactive thyroid (hypothyroidism). Hashimoto’s thyroiditis is the most common cause of primary hypothyroidism.
* A pituitary gland tumor that is making too much TSH. This is uncommon.
* Not taking enough thyroid hormone medicine for treatment of an underactive thyroid gland.

Low values

Low TSH levels may be caused by:

* An overactive thyroid gland (hyperthyroidism). Causes of hyperthyroidism include Graves’ disease, a type of goiter (toxic multinodular goiter), or a noncancerous (benign) tumor called a toxic nodule.
* Damage to the pituitary gland that prevents it from making TSH (a condition called secondary hypothyroidism).
* Taking too much thyroid medicine for treatment of an underactive thyroid gland.
* Pregnancy during the first trimester.
What Affects the Test

Reasons you may not be able to have the test or why the results may not be helpful include:

* Taking medicine, such as corticosteroids, levodopa, heparin, dopamine, lithium (such as Carbolith or Duralith), methimazole (Tapazole), and propylthiouracil.
* Having had a recent X-ray with iodine dye or test using radioactive materials.
(* Having severe stress or a long-term (chronic) illness.) I am hoping this test is wrong because lucian has kind of had a long term chronic illness. He has been through so much. But this test was high for his age so they are referring us to a Endocrinologist. To explain a little better What is the endocrine system?
The endocrine system is a complex group of glands. Glands are organs that make hormones. These are substances that help to control activities in your body. Different types of hormones control reproduction, metabolism (food burning and waste elimination), and growth and development. Hormones also control the way you respond to your surroundings, and they help to provide the proper amount of energy and nutrition your body needs to function. The glands that make up the endocrine system include the thyroid, parathyroid, pancreas, ovaries, testes, adrenal, pituitary and hypothalamus.

What is an endocrinologist?
An endocrinologist is a specially trained doctor. Endocrinologists diagnose diseases that affect your glands. They know how to treat conditions that are often complex and involve many systems within your body. Your primary care doctor refers you to an endocrinologist when you have a problem with your endocrine system.

What do endocrinologists do?
Endocrinologists are trained to diagnose and treat hormone imbalances and problems by helping to restore the normal balance of hormones in your system. They take care of many conditions including:

* diabetes
* thyroid diseases
* metabolic disorders
* over or under production of hormones
* menopause
* osteoporosis
* hypertension
* cholesterol (lipid) disorders
* infertility
* lack of growth (short stature)
* cancers of the endocrine glands

Endocrinologists also conduct basic research to learn the way glands work, and clinical research to learn the best methods to treat patients with a hormone imbalance. Through research, endocrinologists develop new drugs and treatments for hormone problems.

What type of medical training do endocrinologists receive?
Endocrinologists finish four years of medical school and then spend three or four years in an internship and residency program. These specialty programs cover internal medicine, pediatrics, or obstetrics and gynecology. They spend two or three more years learning how to diagnose and treat hormone conditions. Overall, an endocrinologist’s training will take more than 10 years.

What are the most common endocrine diseases and disorders?
Diseases and disorders of the endocrine system can be grouped into several different areas. Some endocrinologists focus on one or two endocrine system diseases, such as diabetes, pediatric disorders, thyroid, or reproductive and menstrual disorders. Others work in all areas of endocrinology. The major areas of endocrinology are described below.

Diabetes
Patients with diabetes have too much sugar in their blood. Recent studies have found that controlling blood sugar helps prevent serious problems that can be caused by diabetes. These can include problems with the eyes, kidneys and nerves, which can lead to blindness, dialysis, or amputation. Endocrinologists treat diabetes with diet and medications, including insulin. They also work closely with patients to control blood sugar and monitor them so they can prevent health problems.

Thyroid
Patients with thyroid conditions often have problems with their energy levels. They may also have problems with muscle strength, emotions, weight control, and tolerating heat or cold. Endocrinologists treat patients with too much or too little thyroid hormone (conditions respectively caused by either an overactive or underactive thyroid). They help patients reach a hormone balance by replacing or blocking thyroid hormone. Endocrinologists also receive special training to manage patients with thyroid nodules or thyroid cancer, and enlarged thyroid glands.

Bone
Osteomalacia (rickets), which causes bones to soften, and osteoporosis are bone diseases that endocrinologists diagnose and treat. Osteoporosis is a disease that weakens your skeleton. Certain hormones act to protect bone tissue. When hormone levels are abnormal, bones can lose calcium and weaken. Menopause, in women, and loss of testicle function, in men, and aging may put you at risk for bone fractures. Endocrinologists treat other disorders that can affect bones, such as too much parathyroid hormone and long term use of steroids like prednisone.

Reproduction/Infertility
About one in ten American couples are infertile. Endocrine research has helped thousands of couples to have children. Endocrinologists diagnose and treat hormone imbalances that can cause infertility, and also assess and treat patients with reproductive problems. They work with patients who need hormone replacement. Problems treated by endocrinologists specializing in reproductive endocrinology include menopause symptoms, irregular periods, endometriosis, polycystic ovary syndrome (PCOS), premenstrual syndrome, and impotence.

Obesity and Overweight
Endocrinologists treat patients who are overweight or obese, sometimes because of metabolic and hormonal problems. When someone is obese they have too much body fat. Thyroid, adrenal, ovarian, and pituitary disorders can cause obesity. Endocrinologists also identify factors linked with obesity, such as insulin resistance and genetic problems.

Pituitary Gland
The pituitary is often called the master gland of the body because it controls other glands. The pituitary makes several important hormones. Over – or under – production of pituitary hormones can cause a hormone imbalance that can lead to infertility, menstrual disorders, growth disorders (acromegaly or short stature) and too much cortisol production (Cushing’s syndrome). Endocrinologists control these conditions with medications and refer patients who need surgery.

Growth
Children and adults can have effects from not making enough growth hormone. Pediatric endocrinologists treat children who suffer from endocrine problems that cause short stature and other growth disorders. Adults with growth hormone deficiency can experience emotional distress and fatigue. Safe and effective growth hormone replacement therapy is available for people with growth hormone imbalance.

Hypertension
Hypertension is high blood pressure, and it is a risk factor for heart disease. Up to 10% of people have hypertension because of too much aldosterone, a hormone produced in the adrenal glands. About half of these cases are caused by growths that can be removed with surgery. Conditions such as the metabolic syndrome or a rare adrenal growth called a pheochromocytoma also may cause a hormone imbalance that leads to hypertension. These conditions also can be treated successfully.

Lipid Disorders
Patients with lipid disorders have trouble maintaining normal levels of body fats. One of the most common lipid disorders is hyperlipidemia – high levels of total cholesterol, low-density lipoprotein cholesterol (known as “bad” cholesterol), and/or triglycerides in the blood. High levels of these fats are linked to heart (coronary) disease, strokes, and peripheral vascular disease (problems with circulation in the legs). Endocrinologists are trained to detect factors that may be related to lipid disorders, such as hypothyroidism (a hormone imbalance caused by thyroid conditions), drug use (such as steroids), or genetic or metabolic conditions. Lipid disorders can be found in several conditions that require special management, including the metabolic syndrome, polycystic ovary syndrome (PCOS), and obesity. Special diets, exercise, and medications may be prescribed to manage hyperlipidemia and other lipid disorders. So in a nut shell this is what I have been studying all night. Hoping for the best. I have to have him in first thing int he morning and I ma glad I am off tomorrow. Also Travis’s grandma has surgery tomorrow morning please pray for her. Please pray for the surgeons and team of medical staff that they will be guided by god and take good care of her I love her so much.