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Thyroid  (Expert Forum)
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Elevated TSH, antibodies...? re swollen gland, chronic sore throat
Answered by
Mark Lupo, M.D. - Thyroid Nodules, Thyroid Cancer, hyperthyroidism, hypothyroidism, Thyroid Ultrasound
Thyroid & Endocrine Center of Florida Sarasota - FL
Questions in the Thyroid forum are answered by Dr. Mark Lupo. Topics covered include goiter, graves disease, Hashimoto's thyroiditis, hyperthyroid, hypothyroid, thyroid cancers, thyroiditis, and thyroid stimulating hormone (TSH).
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MedHelp Member's Question

Elevated TSH, antibodies...? re swollen gland, chronic sore throat

by Heather123, Oct 05, 2005 12:00AM
I have been seeing a RE re infertility.  The clinic said my TSH was 6.3.  They ran a thyroid panel and found that my TSH was 4.99 two weeks later and that my antibody level was elevated.  I am on .1 mg of Synthroid daily.  I have had many symptoms of hypothyroidism for a long time (sensitivity to cold and light, fatigue, forgetfulness, carpal tunnel, very restless legs and feet, bad sleep, weak, etc.) but the last few months I've added more hair loss than normal (several strands in shower and when combing) and extremely stiff, painful ankles in the AM or after I've been lying down a while, and I've noticed one eye looks droopy in photos.  I had my TSH checked in Feb, it was 2.83.  I saw an ENT for chronic throat and sinus pain - she felt a swolllen gland on the right side of my neck.  I was negative for Mono.  The CT and MRI scans showed no problems except mild sinusitis.  I had also had hives for 3 months - the ENT and Allergist said possibly Acid Reflux.  I also am constantly clearing my throat and lose my voice often.  I did have chest pains for a few weeks (on the rt side - where Acid Reflux would strike).

Anyway...I'm thinking I should go to an Endocrinologist (not the RE) to check out the lump.  I'm also wondering if the throat pain (hurts almost 24/7) could be related.  Doctors have felt the thyroid area but haven't said anything was swollen.

Any opinions, related experience stories, whatever would be greatly appreciated.  Also, has anyone been tested for adrenal fatigue?

Thanks! :c)

Doctor's Answer

by Mark Lupo, M.D., Oct 05, 2005 12:00AM
Hard to say what the "lump" is - easy to do a thyroid ultrasound (often done by the endocrinologist in the office) to determine if it is a thyroid nodule.  Some of your symptoms sound like reflux - so aggressive treatment there makes since.  The hives could be auto-immune thyroid and getting the TSH to around 0.5 has been helpful to some of my patients with hives.



Adrenal fatigue can be tested for with an ACTH stimulation test -- however treatment for adrenal deficiency is STEROIDS - so the only time I would take steroids is if the test truly shows an abnormality.
Member Comments (14)

by Heather123, Oct 05, 2005 12:00AM
Wanted to clarify - Acid Reflux was diagnosed due to right side chest pain and chronic throat pain.  Three-month long hives were thought to be from Amoxicillin, although I hadn't had a problem with it previously.

by Jen612, Oct 05, 2005 12:00AM
To: Heather
I really don't know too much - I'm relatively new to hypothyroidism - was diagnosed in July just has husband and I had decided to try for our first.  All I can say is to definitely get in with a good endocrinologist - for the main reason that you are planning to be pregnant and an endo can keep the best watch over you.  I totally understand the fatigue and muscle soreness with hypothyroidism and I'm still not sure that I'm on the right dose of Synthroid but from I hear - you will feel better eventually!  Hope that helps   -Jen

by Heather123, Oct 05, 2005 12:00AM
Thanks, and good luck to you both ttc!  I am hoping this is the answer - everything else is OK (tubes, etc.).  I did read it can take several months to regulate - hope it doesn't take me that long!  I really want a family ASAP - I'll be 38 in January.

by Jen612, Oct 05, 2005 12:00AM
To: Heather
It definitely is frustrating!  At first I was really upset that we found out about my thyroid just as we decided to try but it could have been worse.  Untreated hypothyroidism is a big cause of infertility in couples so we could have tried for a year with no luck before finding out I guess.  We're trying to stay positive too - its tough to be patient since its been a couple of months and I'm still not regulated.  Good luck to you!

by Heather123, Oct 05, 2005 12:00AM
I went for a ttc checkup in Aug '03 - he didn't do anything more than a regular exam and declared me "OK" - I had no idea about the thyroid tests.  Even when I went to my new doctors a year and then a year and a half later no one ran a full thyroid panel :c(  I didn't know about it 'til I went to a RE last month.  Most doctors only test TSH, sometimes T4 also - those may be OK but there may be a different thyroid level that is off, or one might have thyroid antibodies (like me).

For anyone starting to ttc I would tell them to definitely insist on a FULL thyroid panel.  Thyroid problems are quite common.  Imagine if this was my whole problem all a long, and I've spent almost 2 yrs ttc!  Sigh...

by Heather123, Oct 05, 2005 12:00AM
Thank you :c)

by Jen612, Oct 05, 2005 12:00AM
To: Heather
That's exactly what my doctor did too!  She said a lot of the things they would test for, nothing can be done about, so she did an exam and said we could try whenever we wanted! Crazy!  Well at least if this is your problem, you're well on your way to getting it under control!

by Heather123, Oct 07, 2005 12:00AM
Thanks for the advice.  I've been skimming through several thyroid books and am confused.  Of course I want to feel normal again ASAP, but another main goal is to get pregnant.  I am supposed-to get my TSH to between 1-2 (last it was 4.99, prev 6.3).   I've read that some people need T3 and T4.  I've read Armour is not good if you are trying to conceive, then I've read things about Synthroid.  I am really confused.  I think I will be making an endocrinologist appt soon.

by Mark Lupo, M.D., Oct 07, 2005 12:00AM
To: ARMOURGIRL
PLEASE CITE REFERENCES THAT REFUTE TSH AND FOLLOW PATIENTS LONG TERM (AT LEAST 5 YEATS) TO DOCUMENT THEY DON'T DEVELOP IRREGULAR HEART RATE/A-FIB/STROKE/OSTEOPOROSIS AT A HIGHER RATE THAN KEEPING THE TSH 0.5-1.5.

by Heather123, Oct 08, 2005 12:00AM
I have read about Armour having both T3 and T3, and how many people cannot convert properly, and that many people have had better results with Armour.

I am planning to see some other doctors and find out exactly what I should be taking for best results.  Of course, I'm aware that it may take people a long time to find the correct dose and/or medication that makes them feel 100%.

Besides feeling better, I want to get pregnant ASAP.  In another forum I was told I may have some immune problems b/c of my elevated anti-thyroid antibodies.  Should I just go to an endocrinologist, an immunologist????  Right now I am on .100 Synthroid daily for a month per my Reproductive Endocrinologist.  Maybe I should be seeing these other doctors to find out exactly what, if anything else, is going on????  But then you would think the RE would know what he's doing?  Also, is my thyroid