Thyroid Cancer / Nodules & Hyperthyroidism Expert Forum
goiter but normal thyroid testing
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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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goiter but normal thyroid testing

Hi.  My blood tests are normal for my thyroid.  I have a goiter and was given an uptake test with one of the uptakes being around 35% (high.)   I take lithium and was told once that lithium can prevent your thyroid from functioning properly but show as normal in TSH and other blood tests.  Now, that doctor doesn't remember where he found that.  Not great timing, since I now have a goiter and am seeing an endocrinologist.  The endo. was not familiar with that and I, of course, wanted to pass that info. on.  Have you heard of this?

Also, on a related note, my endo. is not done with me yet (wants to get an ultrasound) but says that if all looks okay there, I will not be treated with thyroid hormone even though I have the goiter and don't want it to grow.  Is this the norm?

Thanks so much in advance.

TK
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97953_tn?1193367871
Lithium is well known to cause goiter and thyroid function problems -- most commonly hypothyroidism, but sometimes hyperthyroidism.  It is also well known to trap iodine -- making the uptake value slightly high, but not alarmingly so.  Lithium is not known to cause nodules, so if the ultrasound shows nodules, then that is not likely related and biopsy may be indicated.

If lithium is causing a problem, the TSH is usually elevated -- would look closely at the TSH value and if it is borderline high, in the presence of a goiter, would consider thyroid hormone treatment.  The goiter may happen even with preserved thyroid function.
4 Comments
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I forgot to ask if I could also have a response from Dr. Lupo, since I am already receiving some conflicting info. from my own doc. about not remembering where he got prior info.   Thanks.

TK
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My mother has a goiter that has now grown so big it is pushing her airway over, but she had surgery years ago that damaged her vocal cords therefore; surgery is not in the future.  She has normal thyroid panels, and I have hypotyroidism with nodules discovered some years ago with no follow up from primary care physician.  I am on synthyroid and have blood test once a year that are normal. I now have problems with extreme fatigue and hair loss.  Can this be related?  My family history is aunt (mother's sister) hyperthyroidism and uncle (mother's brother) with hyperthyroidism.  My grandmother also had prenious anemia. My fatigue is so bad I some days can not even function.  Can this also be a sign of other glandular problems? I would also like to be treated by an endocronologist.  Is this a good map for treatment.
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231441_tn?1333896366
Hi Trish,

With what you've just described, you definitely need to be seen by an endocrinologist for reevaluation and management.

Best wishes

Sally
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97953_tn?1193367871
Mark Lupo, M.D.Blank
Thyroid & Endocrine Center of Florida
Sarasota, FL
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