Thyroid Dysfunction

[trisha1104]

Hi there I recently had a thyroid test down because my thorat has a small Goiter. The Tsh was .0.20 and the T3 Uptake was Normal the T4 Thyroxin 10.1 T4 Index (T7) 2.9 Now the T3 Total was 205 I do not know what this all means by I have been told that I may be Hyperthyroid? The sScan showed enlarged right Lobe of Thyroid and Multinodular Gland seen. Can anyone Define this Medically for me. This could explain the Heart Palpatations I have been experiencing and the tiredness.

[Mark Lupo, M.D.]

The slightly low TSH is suggestive of mild hyperthyroidism.  Would retest the T4 and T3 as Free T4 and T3, particularly if you are on birth control pills or other estrogens which make the total T3, for example, look high.

An overactive thyroid could cause heart palpitations and fatigue.  It is not uncommon to see the right lobe is slightly larger than the left.  An ultrasound will help determine if any of the nodules is significantly enlarged to the point where biopsy may be necessary.  Multinodular thyroids are common and 90-95% of them are benign.  Nodules may over-produce thyroid hormone which may be the cause of the slightly low TSH.  The I-123 (nuclear) scan can help determine if the nodule is over-producing thyroid hormone.

[kitcurious]

I just had I-123 test last week ( it's not a treatment). You swallow a small dose of a radioactive iodine and come back in  6 hours for a measurement of what % your thyroid absorbed and to get pictures taken of the thyroid. You return once more in 24 hours for a final measurement of the % your thyroid absorbed.

If you have a lowish TSH and an above average, diffuse, uptake it is more indicative of possible autoimmune hyperthyroidism. If the pictures taken indicate that a nodule is "spitting out" excess hormone it is "hot" and likely the source of the hyperthyroidism. If the nodule is a "cold" area on the scan, and of a certain size, they will likely order a biopsy.

I was elevated, diffuse and have a biopsy scheduled in a week.

[trisha1104]

I forgot to mention that size Right lobe 5.5 x 2.2 x 2.0 cm ill fefined hyperechoic area in the lower pole measuring 24 x 10 x 9 mm. there are 2 well defined solid nodules seen in the lower pole measuring 7 x 5 x 4 mm.adjacent to the isthumus and 5 x 5 x 5 mm more inferiorly.  The isthumus measures 3 mm - The left lobe measurers 3.8 x 1.9 x 1.7 cm.  A 23 x 16 x 12mm complex upper pole nodule is noted 5 x 4 x 4 mm lower pole solid nodule.

Diffusely inhomogeneous echo texture is seen

Impression: Enlarged Right Lobe of Thyroid
                  Multinodular Gland Seen

This all sounds very scary to me..

I am thinking that all this has something to do with Menopause, I have almost the same symptoms as the thyroid symptoms. The thing that gets me is I have no energy and will the Goiter shrink with meds?

[Rosie811]

Dr. Lupo, Im a 29yr old with a constand sore throat; the pain is more intense in the mornings after waking up. (It started in mid January) I have gained about 15lbs in the last 2 months. I also have stomach problems, lower back pain(no urine infection) shortness of breath, palpitaitons and a feeling of intese heaviness in my chest. This symptoms came about 3 weeks ago. Can all this symptoms be related to the sore throat.......please, any advice/information would help. Thank you........Rosie

[trisha1104]

Dr. Lupo,  I saw the Endocrinologist and she started me on a regimen of Steroids for 6 days to see if the Sewlling goes down also a 10 mg. script of Propanolol (Inderal) for the Heart palpitations. So far I have to admit I am on the 2nd day of the Steroids and it reall has gone down. She stated that if it goes down she will not need to doa needle biopsy, but Iam still to have the I-123 Uptake test. And in addition to that I need alnther Ultasound and more blood work including a TSH  - Free T4 -Free T3- Thyroid peroixdise AG? - Thyroid globsub?? - ESR- CRP. I am sorry I cannot read her handwritting. But that is where is it now.  Icannot believe how much better I feel since she gave me those Steroids, no more sore throat, and swallowing is MUCH easier.

[trisha1104]

Week Dr. Lupo I saw the Endocrinologist and she started me on a regimen of Steroids for 6 days to see if the Sewlling goes down also a 10 mg. script of Propanolol (Inderal) for the Heart palpitations. So far I have to admit I am on the 2nd day of the Steroids and it reall has gone down. She stated that if it goes down she will not need to doa needle biopsy, but Iam still to have the I-123 Uptake test. And in addition to that I need alnther Ultasound and more blood work including a TSH  - Free T4 -Free T3- Thyroid peroixdise AG? - Thyroid globsub?? - ESR- CRP. I am sorry I cannot read her handwritting. But that is where is it now.  Icannot believe how much better I feel since she gave me those Steroids, no more sore throat, and swallowing is MUCH easier.

[trisha1104]

Is it possible to hyperthyroid and have a goiter at the same time.

[DarLina23]

I recent have been having my thyroid checked and for years have been getting blood work  done and it shows nothing is wrong however my doctor sent me to have the ultra sound and stuff and that shows I have a hot nodule. And he is having me go see an endo that I used to see as a child. If the iodine test shows one thing and the blood another which is more accurate? He said it looks like hyperthyroid and I have bad anxiety issues he thinks could be linked

[trisha1104]

Dr. Lupo I was wondering why when I awake in the morning my throat is not that enlarged but toward the evening and i mean every evening it start to get VERY sore and my temp usually tops off at 100.2 unless I take an advil I cannot get to sleep. Also, I woke-up with this problem on January 27th and I cannot see the Endo until February 20th I know I have gone this long but, I hope I am not haroming myself by waiting. I called my primary care and she said you can wait it's alright. What are your thoughts on this.

[trisha1104]

What foods can you eat to help Hyperthyoidism or supplements to help combat this disease

[trisha1104]

What is this treatment and what is the procedure

[trisha1104]

What is this I-123 treatment, I mean what are the procedures for it?

[Mark Lupo, M.D.]

Would do an I-123 uptake and scan to see if the nodule(s) are "hot" -- if so, no biopsy needed of these nodules; if not, biopsy the nodules measuring 24mm on the right and the one measuring 23mm on the left.

The only reason in this case that biopsy is not the next immediate step is the slightly low TSH - this brings up the possibility of hot nodule(s).

Menopause can bring out thyroid problems sometimes.

There is not a medication to take in this case -- don't let someone put you on synthroid (levothyroxine).  I-131 treatment may help shrink the nodules but you need the above work up first.