Aa
hyper-thyroid treatment
AGE : 22 YRS / FEMALE
I have been diagonised hyper-thyroid 2yrs back and was taking neomercazole n inderal so far. Two months back i took a test and then stopped the medication and again took blood test.
During medication After two months without medication
Free T4 1.19 ng/dl 1.65 ng/dl
TSH <0.01 uIU/ml 0.05 uIU/ml
Free T3 3.97 pg/ml -- didn test ------
Took a radio-active iodine (I131) scan. Now doctor has advised me to take radio-active treatment. Is it advisable to take it now. Marriage is after a minimum of one year only. Currently am takin inderal (20mg : 1 -0- 1) and shelcal 500 (0-0-1). After stoppin the medication for 2 to 3 months, i have now lost weight, hair fall has increased and skin has tanned a lot.
SCAN REPORT : I-131 thyroid study carried out 24 hrs post ingestion shows increased uptake of tracer by both the lobes of thyroid gland. Both the lobes are enlarged. There are small areas of reduced tracer concentration in both lobes. No focal hot area noted. No evidence of functioning retrosternal thryoid tissue. 24 hrs uptake = 49% (Normal 15% to 30%)
IMPRESSION:
EARLY MULTINODULAR CHANGES IN ENLARGED HYPERFUNCTIONING THYROID GLAND.
NB: THERE IS A PROMINENT COLD NODULE IN THE RIGHT LOWER POLE - PLEASE CORRELATE WITH HISTOPATHOLOGICAL STUDIES.
I have been diagonised hyper-thyroid 2yrs back and was taking neomercazole n inderal so far. Two months back i took a test and then stopped the medication and again took blood test.
During medication After two months without medication
Free T4 1.19 ng/dl 1.65 ng/dl
TSH <0.01 uIU/ml 0.05 uIU/ml
Free T3 3.97 pg/ml -- didn test ------
Took a radio-active iodine (I131) scan. Now doctor has advised me to take radio-active treatment. Is it advisable to take it now. Marriage is after a minimum of one year only. Currently am takin inderal (20mg : 1 -0- 1) and shelcal 500 (0-0-1). After stoppin the medication for 2 to 3 months, i have now lost weight, hair fall has increased and skin has tanned a lot.
SCAN REPORT : I-131 thyroid study carried out 24 hrs post ingestion shows increased uptake of tracer by both the lobes of thyroid gland. Both the lobes are enlarged. There are small areas of reduced tracer concentration in both lobes. No focal hot area noted. No evidence of functioning retrosternal thryoid tissue. 24 hrs uptake = 49% (Normal 15% to 30%)
IMPRESSION:
EARLY MULTINODULAR CHANGES IN ENLARGED HYPERFUNCTIONING THYROID GLAND.
NB: THERE IS A PROMINENT COLD NODULE IN THE RIGHT LOWER POLE - PLEASE CORRELATE WITH HISTOPATHOLOGICAL STUDIES.
this is zeta again. I have taken ATD for nearly 2.5 years.
and a USG SMALL PARTS - NECK scan was taken on dec 2003.
Following is the report,
Right lobe of thyroid measuring 1.8 x 1.6 x 3.9 cm. Left lobe of thyroid measuring 2.9 x 1.8 x 4cm. Isthmus measures 3mm.
Both lobes of thyroid are enlarged in size and shows multiple ill defined hypoechoic areas with increased vascularity.
A cyst measuring 0.7 x 0.9cm seen in the right lobe. No evidence of lymphadenopathy.
Impression:
ILL DEFINED HYPOECHOIC AREAS WITH INCREASED VASCULARITY
- THYROTOXICOSIS TO BE RULED OUT.
--------------------- END-------------------
i ll take a scan within a week also..
and a USG SMALL PARTS - NECK scan was taken on dec 2003.
Following is the report,
Right lobe of thyroid measuring 1.8 x 1.6 x 3.9 cm. Left lobe of thyroid measuring 2.9 x 1.8 x 4cm. Isthmus measures 3mm.
Both lobes of thyroid are enlarged in size and shows multiple ill defined hypoechoic areas with increased vascularity.
A cyst measuring 0.7 x 0.9cm seen in the right lobe. No evidence of lymphadenopathy.
Impression:
ILL DEFINED HYPOECHOIC AREAS WITH INCREASED VASCULARITY
- THYROTOXICOSIS TO BE RULED OUT.
--------------------- END-------------------
i ll take a scan within a week also..
MEDICAL PROFESSIONAL
regarding the darkening skin -- forgot to mention to have a cortisol level checked to make sure you don't have adrenal insufficiency (Addison's)
MEDICAL PROFESSIONAL
Sounds like you have had a good trial of antithyroid drugs and are not able to stay in remission off the medication -- your labs and symptoms are suggestive of a significant hyperthyroidism and I-131 is the best treatment option at this point. First, however, would have an ultrasound to evaluate the cold nodule -- this likely needs to be biopsied prior to I-131 as if it is suspicious then surgery would be the next step.
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