Doctors Lounge - Endocrinology Answers
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Forum Name: Endocrinology Topics
|tinker3168 - Sat Oct 20, 2007 11:36 pm||
I am sending this in regards to my 19 year old daughter. In the last year she has lost 32 pounds and her blood pressure is higher than usual. She is athletic and had a physical every year for the last 5 years. This is the first year she has had any issues. She is 6"1 and now weighs 156 pounds. Among other symtoms, she is very pale, sometimes clamy and had a problem sleeping for a while. She went to the Doctor and had some lab test done as I thought this issue might be related to a hyperthyroid. Her test results came in and her glucose level shows as 35 mg/dL. (Normal range should be 65-99 mg/Dl). Her
T-4 Free is 1.3 and her TSH is 1.49. In the lab results for the glucose the following message appears:
Red Blood cells were present in the sample upon receipt in the laboratory. The test ordered were performed. The presence of red blood cells has been known to affect the following analytes: Potassium, Glucose, Inorganic Phosphorus, Lactate Dehydrogenase and Iron. Verified by repeat Analysis.
The doctor indicated that the lab results were within normal limits. Should I be concerned with the glucose level and request this test be completed again and if the issue is not related to her thyroid, what else should I have her checked for? I am very concerned. Please help.
|Dr. Chan Lowe - Sun Oct 21, 2007 10:24 pm||
I would be quite concerned about a glucose level of 35. Anything less than 50 is suspicious. There are several other hormonal tests that should be evaluated. Low blood sugars such as this can indicate a hormone deficiency such as a growth hormone deficiency, cortisol deficiency or possibly a hyperinsulin state.
I would recommend she see an endocrinologist for further evaluation. It may be necessary to do a fasting glucose evaluation where the patient is kept without eating to see if the blood sugars drop. The hard part about these types of diseases is that the labs really need to be drawn when the blood sugar is low so it is important the evaluation be done in a controlled setting where the blood sugar can be monitored closely, the labs drawn quickly if the level is low and then the blood sugar can be corrected rapidly.
I would not expect the presence of red blood cells to affect the thyroid studies. Hearing her case initially made me think of hyperthyroidism although it does not seem that this is present based on the normal TSH level.
Again, follow with her doctor is very important.
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