Endocrinology: Low Luteinizing Hormone (under 0.2) and low FSH (under 0.7); ACTH was normal (8 with range of 6-50) and total cortisol normal (9.1 with range of 4-22). Hemoglobin A1c normal at 5.4. I will forever believe I have some kind of thyroid abnormality, but everything's technically in range. TSH just seems to have huge fluctuations (reference range .47-4.68): 0.8 pre-illness at end of February; 1.58 in June; 1 in July 10; 2.93 two weeks later on July 23; and 1.81 a month later Aug. 24. TT3 was slightly high July 23 (1.71 out of max 1.62), but insignificant according to endocrinologist. Free T4 was 0.77 on July 23 and 1.2 July 10. Thyroid Peroxidase (TPO) Ab negative at 0.5 and Antithyroglobulin (TG) Ab at 0. Historically, I was subclinical hyperthyroid in 2004 when I couldn't maintain a healthy weight and had slightly increased iodine uptake and two small lesions; 2009, suddenly gained 30 pounds and both thyroid lobes were enlarged and small nodes in both lobes with normal iodine uptake; now, both lobes normal size with three nodules in left lobe. My mom had a thyroidectomy for suspicious nodules and now takes thyroid hormone.

Gastroenterology: Upper GI endoscopy showed "Striped moderately erythematous mucosa without bleeding was found in the gastric antrum"; biopsy for H. pylori was negative, but I've been on Pantoprazole for years and research shows that can cause false negatives in H. pylori biopsy. My gallbladder was removed for gallstones in 2016 and they took my appendix out too because it was in the wrong place; CT of abdomen and pelvis shows a fat-containing incisional hernia at my umbilicus now. A biopsy of my liver at that time showed "The surrounding liver shows mixed inflammation of the portal tracts, which is mild to moderate, and contains neutrophils, eosinophils and lymphocytes, predominantly. Foamy histiocytes are also seen in association with the portal tract." Still not sure if that's potentially involved somehow. Imaging today shows a 4cm focal nodular hyperplasia, benign-appearing, but it can't tell you the pathology of the liver. My LD5, which is correlated with the liver and skeletal muscle, was elevated at 25% with range of 3-14% (LD1 was slightly low at 18% with range of 19-38%; LD2 was slightly low at 27% with range of 30-43%; LD3 was normal at 20% with range of 16-26%; LD4 was high normal at 11% with range of 3-12%). Alkaline phosphatase was slightly high at 134 (ref 38-126) in early July, but dropped to 93 on 7/26. ALT and AST have been normal, although AST was slightly higher than ALT at 28 to 26 on 6/25. Total bilirubin has been slightly low at 0.1 on 6/8 and 7/26. Celiac biopsy and blood panel were negative. I've been having some abnormal bowel stuff, and mom has ulcerative colitis, so now they want to do a colonoscopy. I also had a bad episode of abdominal pain last Friday, so am debating hernia repair surgery.

Infectious disease: Other than the Lyme mentioned above, only other weird thing was a randomly positive Quantiferon Gold TB blood test, but the chest X-ray and CT were both normal and I'm low risk, so my infectious disease specialist is thinking it was a false positive (just re-tested yesterday); I had negative TB tests in 2015 (skin) and 2011 (skin AND blood). Everything else has been negative - blood cultures, CMV, Epstein-Barr (showed pattern of past infection -- last negative in 2007), Q fever, histoplasmosis, ehrlichia, baronella, tularemia, West Nile, Cryptococcus, hepatitis, ASO. Immunoglobulins and procalcitonin were in normal range.