In hypovolemia associated with diabetes insipidus or pure dehydration, sodium is elevated because only water (not sodium) is lost in those situations.
TSH is elevated, though not severely so, and is consistent with borderline hypothyroidism. This finding is consistent with the history of fatigue. Hypothyroidism in the setting of a diffusely enlarged thyroid gland is suggestive of early stage chronic (autoimmune) inflammation in the thyroid; this process may be associated with simultaneous autoimmune destruction of other endocrine organs.
The hemoglobin is also low, which may occur in chronic disease and may also contribute to the patient's feeling of tiredness.
Patient Reference Hemoglobin (B) 9.4 g/dl 11.7 - 15.5 Sodium (S) 126 meq/l 136 - 145 Potassium (S) 5.8 meq/l 3.5 - 5.1 Chloride (S) 98 meq/l 98 - 107 CO2, total (S) 20 meq/l 23 - 29 Creatinine (S) 1.8 mg/dl 0.7 - 1.2 Urea nitrogen (S) 52 mg/dl 7 - 18 BUN/creatinine ratio 29:1 12:1 - 20:1 Calcium (S) 11.3 mg/dl 8.4 - 10.2 Phosphorus (S) 2.6 mg/dl 2.7 - 4.5 TSH (S) 9.8 uU/ml 0.4 - 5.5