Thyroid Cancer / Nodules & Hyperthyroidism Expert Forum
Thyroid Nuclear Scan
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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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Thyroid Nuclear Scan

Hi Dr. Mark, I have to have a thyroid nuclear scan w/ uptake next week.  I'm curious if the RAI they use is the same stuff given for ablation.  If so, will this test harm or kill some of my thyroid?  I don't want to become more hypo than I already am.  

Thanks for your help!
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The test will not harm/kill the thyroid.  It uses I-123 at a very low dose -- different from the I-131 we use for therapy.

By the way, if you are HYPO, why are you having a scan?  If you have a nodule and are on meds for HYPO, the next step is FNA (not scan).  If you've already had an FNA which came back indeterminant (ie follicular lesion), then a scan may help if the nodule is clearly hot....
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Yes, I am hypo and have Hashimoto's.  I have been unsuccessful in finding a good endo (even though 2 of the endos I visited in the Houston area were diplomates as well---one endo actually advised me to crush my Synthroid and mix w/ orange juice when I inquired about my difficulty in swallowing solids.  I didn't have a problem swallowing the pills.  She advised me to ask my GP about that, as though it was not thyroid-related.  Clearly, the dysphagia was due to enlarged thyroid/goiter).  I was in pain and had swollen lymph nodes; I was not aware those were symptoms of HASHI (until I came to this site)- nor did the endo tell me, so I went to my GP for treatment.

My GP ordered the RAIU and I've been off the Synthroid now for 3 weeks.

Since June I've had 2 ultrasounds of my thyroid, plus a CT of neck soft tissues w/ contrast.  Diffusely enlarged thyroid (forgot dimensions, but quite enlarged)...but no nodules at all.  Just typical HASHI.

Why can't you be cloned and move to Houston? :)  I don't know how to find a good endo at all.  I've tried researching all that I can and both of the endos I've seen are highly regarded in the field for my area (and were recommended by United HealthCare).

Thanks for your help Dr. Mark!
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I also live in the Houston area, and appear to be having thyroid issues.  I have a nodule, as well as hyperthyroid symptoms, including feeling something is stuck in my throat, heart palpitations, etc...  I have been waiting to see the endocrinologist, but will finally get in next week.

Who have you seen?  I'm not sure if you have already seen the endocrinologist I am seeing, but maybe this will help.  I am seeing Vivian Rodriguez -- she is off of Holcombe.  My PCP referred me to her because I was tired of having other (male) doctors tell me everything was in my head and to reduce the stress in my life.  Dr. Rodriguez listens and seems to do what is appropriate to treat you. I've heard lots of good things about her.

It seems as though there aren't as many endocrinologists available to meet the demand.  And, even fewer "good" endocrinologists.  I hope you find someone who can help you.
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I have a co-worker who sees Dr. Rodgriguez and she had nothing but good things to say about her.  I'm not sure if she accepts my insurance...but I didn't see her because she's not close to where I live at all.  

I'm not sure if I can give the doctors' names on here, but I'd sure like to.  They are both diplomates in endo on I-45N at The Woodlands if that helps any.

Thanks for your recommendation...I will check to see if she accepts my insurance.

I think I've gone the past 3+ weeks without Synthroid (and am now fatigued, moody, have dry skin, and lots of hair loss), for a scan that I don't need.

Grrr.
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Oh also, regarding what you wrote:

"It seems as though there aren't as many endocrinologists available to meet the demand. And, even fewer "good" endocrinologists. I hope you find someone who can help you."

I totally agree (and I can't believe we have the best Medical Center in the world right here and yet we can't get decent treatment for our thyroid problems).  I think the endos are all flooded with diabetic patients.  

Good luck to you.
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Your goiter is likely just hashimotos as you point out.  Not sure what the scan will tell you/your GP...

Painful variant hashi will often improve with time (ON synthroid...) keeping TSH around 0.5-1.5.  The lymph node swelling often decreases as well.  IF not, then surgery is an alternative.

There are a few thyroid experts in Houston listed on the ATA website -- www.thyroid.org.
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Thank you very much Dr. Mark.  I appreciate your taking the time to not only respond to my questions, but revisting the post as well.
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I just wanted to give everyone hope for finding the right endo and being diagnosed correctly.

It took me years and doctor after doctor telling me that everthing was in my head until I finally found a wonderful woman to help.  Unfortuantely, I am in Cleveland and can't help those of you in Texas, but keep looking.  Don't take the brush offs you are getting.  I took started out being diagnosed with Hashimotos' disease.  At Christmas I wound up having my entire thyroid removed.  Since there was no way to clearly tell whether there was cancer in the nodule I decided to have it all removed. I was lucky I chose surgery, there was cancer, so I went through one round of iodine radiation in February and just finished my scan and uptake about an hour ago.  My levels are completely normal, there were no signs of the cancer antibodies.  The good thing is that when I am on the meds I feel like a different person!  I just need to even off my levels of synthroid to get my metabolism moving and I will be a happy camper.

Good luck to you all and keep looking for the right doctor - it is worth the wait!
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