THYROID CANCER / NODULES & HYPERTHYROIDISM
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blood test results
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by annieface, May 20, 2006
HI I JUST RECEIVED BLOOD TESTS RESULTS FROM MY DOCTOR..I HAVE BEEN EXPERIENCEING HORRIBLE SYMPTOMS FOR QUITE SOMETIME...FATIGUE, DEPRESSION, MUSCLE ACHES, GASTRO PROBLEMS SUCH AS BLOATING, CONSTIPATION, THE DRYEST SKIN EVER, AND A LOT OF WEIGHT GAIN, THESE ARE THE ALL THE SYMPTOMS I CAN THINK OF RIGHT NOW...MY TSH TEST CAME BACK AS 6.88, MY T3 UPTAKE (WHICH I NOW READ IS NOT A GOOD TEST)IS 26, T-4 THYROXINE TOTAL IS 8.6 AND THE FREE T-4 INDEX (T7) IS 2.2...HE NEVER RAN A REGULAR T-3 TEST...ALSO I HAD A THYROID ULTRA SOUND DONE AND I HAVE A NODULE ON THE LOWER POLE OF THE RIGHT TYHROID LOBE...NOW THIS DOCTOR OF MINE DIDN'T THINK ANY OF THIS WAS A BIG DEAL BUT SUGGESTS I GO TO AN ENDOCRINOLGYST..I WAS QUITE UPSET OVER HIS NON CARING ATTITUDE..I AM TIRED OF FEELING THIS WAY...COULD SOMEONE GIVE ME SOME INPUT PLEASE? THANK YOU
Answer:
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by Mark Lupo, M.D.Blank, May 20, 2006
Would do FNA biopsy of nodule if >1-1.5cm, repeat TSH, check antibodies and likely start thyroid hormone treatment.
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by rwr, May 20, 2006
Go see an endrocinologist.  I was also just diagnosed this week with a TSH of 10.5.  You echo my feelings.  My regular doctor just prescribed Synthroid and said come back in a month.  He did no other tests even though I asked.  I went to an endrocynologyst after that experience and several follow up tests including the ultrasound.  I am waiting for the results, but I can tell you this...the experience was much better and I feel more confident that I will be treated with a more specific mix of thyroid hormones to address both T4 and T3 levels.  My doctor also did a cortisol test.  Anyway, go see another doctor who specializes in throid problems.  My thought is that you shouldn't mess around with an incompetent doctor who doesn't understand how bad you have felt for so long.  It's not your fault.
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by GravesLady, May 20, 2006
Your TSH along with your symptoms suggest T4 deficiency/hypothyroidism.

Although the FTs are important to relate thyroid disorders,
TSH is the best test to relate whether a person is hypo or hyper.
Serum FT4 measurement is a more reliable indicator of thyroid status than TSH when thyroid status is unstable. When thyroid status is stable and hypothalamic-pituitary function is intact, serum TSH measurement is more sensitive than free T4 (FT4) for detecting mild (subclinical) thyroid hormone excess or deficiency.

As previously suggested, go to an Endo who deals with a lot of  thyroid issues.  Have TSH, both FTs, full antibodies and the nodule revisited.  No use getting up set with your doctor for something you can not control, other then going to a new doctor peferably an Endo.  Getting up set only casues stress which is not good for thyroid, TED, weight gain/loss, etc. or general health.

Good Luck!





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by annieface, May 20, 2006
well thanks everyone for your input it was really helpfull..i am going to make an appointment with an endo doctor..the nodule is only 13 mm..i am assuming that is very small...i forgot to say that the family doctor is ordering some type of iodine test for nodule to see if it is benign...what is an antibody test?
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by Julie65, May 21, 2006
It's a blood test to determine whether or not you have Hashimoto's or Graves (autoimmune thyroid disorders).
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by Mark Lupo, M.D.Blank, May 21, 2006
13mm is 1.3cm -- I usually biopsy these.  The iodine scan is not helpful at this stage and CANNOT distinguish benign vs cancer.  It is NOT indicated for a nodule with a high TSH.  Cancel this until you see a thyroid expert.
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by annieface, May 22, 2006
thank you very much i will cancel the test and i am going to call an endo doctor that my brother in law goes to..he has graves disease...the doctor is over 2 hours away but he's suppose to be good his name is Dr. Alan B. Schorr he's in langhorne pennsylvania.
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by wonderme, May 23, 2006
Hi.  You made the comment: "When thyroid status is stable and hypothalamic-pituitary function is intact, serum TSH measurement is more sensitive than free T4 (FT4) for detecting mild (subclinical) thyroid hormone excess or deficiency."

What would constitute the hypothalamic-pituitary function NOT being intact?  I believe that I have adrenal issues (low cortisol, low DHEA and low ACTH) -- would this affect the thyroid tests?  What tests would be best for me?  My TSH has fluctuated from 0.9 to 1.58 (ref range 0.5-5.5) but my Free T4 has remained constant at 1.1 (ref range 0.8-1.8).  Don't have Free T3 (prim doc and endo both poo-poo it -- ugh!), but my Total T3 was just below mid-range...

I still have all the symptoms but the tests don't "prove" it.  U have made every lifestyle change I can -- I eat fruits, veggies, whole grains, protein, all organic (milk, too); I exercise 4-5 x a week (pilates, don't have stamina yet for my low-impact aerobics), get plenty of sleep, drink plenty of water, don't drink alcohol or soda (drink one cup coffee couple times a week), etc., etc., etc.

Anyway, I'd mostly like to remedy the unrelenting fatigue and irritability.  It would be great not to have dry hair, skin and not be constipated.  I'd be happy if I could sleep through the night and be refreshed in the morning.  I'd love to not be cold all the time (my bbt is 97.2-97.8, and does fluctuate during the day...)

Any thoughts?  How do you feel about self-treating?  If a possibility (want to be safe), what would you recommend?

Thanks!