Thyroid Cancer / Nodules & Hyperthyroidism Expert Forum
Parathyroid or Thyroid?
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Questions in the Thyroid forum are answered by Mark Lupo, MD. Topics covered include Goiter, Graves Disease, Hyperthyroid, Parathyroid/Calcium Problems, Thyroid Cancer, Thyroid Nodules/Cysts, Thyroiditis, Thyroid & Pregnancy, Thyroid Stimulating Hormone (TSH), Thyroid Tests, and Thyroid Surgery.

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Parathyroid or Thyroid?

I have MS and Diabetes, until  a year ago  diabetes was under control, then my levels started going high and low for no reason, adjustments to meds made no difference,  also developed more fatigue than I already had,  Nuvigil didn't work anymore,  hair was thinning, skin dry like sand paper in spite of all the water I drink and moisturizers I use. Heartburn so bad  Nexium alone doesn't help- have to take several tums a day, weight gain in spite of lack of appetite, hot flashes and sweating spells alternated from freezing 1 minute to sweating the next, the list goes on  began experiencing joint pain ,numbness and tingling without cause, MRI and EMG ruled out pinched /impinged nerves but they did find  lump on my collarbone,  they did  cat scan, lump was  lipoma the scan showed my thyroid was enlarged, was sent to an endo who did a sonogram showing thyroid was 5X larger than normal, basicTSH was normal but he refused to do more tests saying I only had 2 choices, Radiation or complete removal, he also would not tell me what was wrong so I went back to my PCP and insisted he do all the tests possible for the thyroid and I got all but 1 test result back today,
Summary: THYROID II PROFILE (T3U, T4, T7, TSH), THYROID PEROXIDASE AB
Tests: (1) THYROID II PROFILE (T3U, T4, T7, TSH) (119)
T3 UPTAKE                 27.9 %                      20.0-38.5
T4 (THYROXINE)            11.6 UG/DL                  4.4-12.4
CALCULATED T7 (FTI)       3.24                        1.05-4.50
TSH                       0.9 UIU/ML                  0.5-4.7

Tests: (2) THYROID PEROXIDASE AB (4513)
! THYROID PEROXIDASE AB
[H]  169 IU/ML                   10 in the past with low Vit D 6 to current 14.
97953_tn?1193367871
The low Vit D should be addressed and PTH/calcium should be tsted if there is a concern for parathyroid.  The TSH is normal w/ positive TPO antibody c/w autoimmune thyroid disease but normal current thyroid function that does not mandate treatment.  Would seek a second endo opin as you may have diffuse goiter due to autoimmune thryoid diseaes but w/ TSH of 0.9 there is not a medication to correct it.
3 Comments
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5062073_tn?1363034592
that sentence "10 in the past with low Vit D of 6 to current of 14" should have read previous tests showed my calcium over 10 with low Vit D of 6 to current of 14, suggestive of parathyroid?
My last test came back,
Tests: (1) THYROGLOBULIN AB (4516)
! THYROGLOBULIN AB          1 IU/ML                     <4

so that was normal.
I would guess it means I have an autoimmune thyroid but which one?
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5062073_tn?1363034592
Thank you Dr Lupo, I did seek a 2nd opinion, the new endo said based on the sonogram I have Hashimoto's disease but with the size of my thyroid the only option I have is surgery for total removal, the sonogram said I had no nodules but the new endo did another scan in her office and found several small nodules on the left lobe and some on the right along with a grape sized one on the right. She said I can't be experiencing thyroid symptoms though because my thyroid still tests normal, the only symptoms she can attribute to the thyroid is the swollen neck, sore throat , dizzy spells I get when I raise my arms as the swelling has compressed my right carotid artery and swollen tongue. She did a bunch of blood work including the PTH and is sending me to the surgeon who specializes in thyroid cancer and parathyroid disease, not saying I have C, but due to the fact she thinks the thyroid has invaded sensitive areas I need the best surgeon out there and if it turns out it is C then i will be under the best care.
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