The Importance of Repeating a Greatly Abnormal Lab Test


A good friend called the other day saying her doctor, who was a kidney doctor, ordered some blood work because my friend had lost weight, when she had not been trying to do this. One of the thyroid tests came back as greatly abnormal.

Instead of repeating the test in another lab, the doctor started the woman on thyroid treatment even though endocrinology is not her area of training. She also told my friend to eat a lot of salt because her sodium was slightly low. That makes no sense when the number was just 2 digits below a normal value, which is not something you would worry about. Whenever I found a greatly abnormal lab result, I had the blood work repeated in another lab. If you tell a patient to eat a lot more salt, does that mean a teaspoon, a tablespoon or what? 

Not only should the doctor have ordered new lab work before starting the woman on thyroid, but she overlooked something very important. I wonder if the doctor did not remember that my friend had been treated for cancer of the uterus a few years ago? Weight loss would be worrisome in a patient like this, particularly since she did not have any of the symptoms of either hypo or hyperthyroidism. 

I urged my friend to insist upon having repeat lab work and then find a new internist.  If the thyroid test was still abnormal, I suggested she consult an endocrinologist. 

Image copyright: david__jones/flickr/ CC BY

Article last time updated on 20.09.2016.

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