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Silent Thyroiditis dx. 2010 - Still Not Sure If I Should Be Medicated o...
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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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Silent Thyroiditis dx. 2010 - Still Not Sure If I Should Be Medicated or Not?

Dr. Lupo,

I had silent thyroiditis dx. 08/2010.  Three years later, and (my endocrinologist and) I do not know if I should be medicated on thyroid hormone.  I have never tested positive for TPO, AG, or ANA antibodies.  I have no family history of thyroid issues.  I have been on and off Synthroid four times.

Before my thyroiditis, when I felt great, I happened to get thyroid labs done a few times.  The TSH was always between 2-3 and the Free T4 was always 1.0.  This was from 2009, before the thyroiditis:

TSH 2.79 (Range: 0.40 - 4.50 )
Free T4 1.0 (Range: 0.8 - 1.8 )

Now, I had my thyroid labs done at nine weeks off thyroid hormone and the results were:

TSH 1.99 (Range: 0.40 - 4.50 )
Free T4 0.9 (Range: 0.8 - 1.8 )

I'm confused because my TSH is "better", but my free T4 is "worse".  

If I am totally honest, I feel "okay", but a little bit like I am running on empty.  Would more time might raise my Free T4 a bit or has the window of opportunity passed?  Over the past couple years, my Free T4 off medication was always 1.0.

Also, I had an ultrasound last week.

FINDINGS:

Thyroid gland: Numerous bilateral thyroid cysts containing internal echogenic material with ringdown artifact consistent with colloid cysts are overall stable from the prior study.  Normal in size, homogeneous in echotexture.  Normal vascularity.

IMPRESSION:

Persistent numerous bilateral thyroid cysts containing internal echogenic material with ringdown artifact consistent with colloid cysts.

What do you think?  Should I be medicated on Synthroid, give it more time, or do not medicate on Synthroid?

Thank you!









97953_tn?1193367871
Your TSH is normal - looks like you recovered from thyroiditis.
Ultrasound shows small benign sounding cysts that can be followed with periodic recheck.
Would usually not recommend medication.
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