hashimoto's nodule

[RenKat]

Hi,Doc,

Hope you can help after 3 years of no answers!  I detected a nodule 3 years ago, had the ultra sound and the ct, and the increased meds (synthroid, now levothyrozin).  I am about to go off the meds for a nuclear scan.
I am already exhausted, battling weight issues and now, been prescibed a high cholesterol medication with scary side effects.
Picking are poor in Tampa, and I don't know that there will be a thryoid surgery or an ablation at the end of this.  Do I need this test?
Please help!

[Mark Lupo, M.D.]

linda - if the nodule is over-active ("hot") then adding more thyroid hormone (ie thyroxine) to the system should be avoided.  But if the RAI knocked out the nodule's ability to overproduce thyroid hormone, then you may need thyroxine treatment - as it seems to be the case with your situation

[Mark Lupo, M.D.]

There is no indication to come off meds for a nuclear scan at this point.  The nodule needs to be biopsied.  An ablation with I-131 is not likely to help -- unless you have an overactive nodule(s) that have been treated with levothyroxine (which should be avoided in cases of overactive nodules).  

The nodule needs to be addressed first, then the question of whether or not you need medication and if the thyroid function is normal or abnormal - ie, are the fatigue, weight and high cholesterol due to a thyroid problem?

Would be happy to consult - I have several patients from the Tampa Bay area.

[RenKat]

Thank you for the reply to my question on the 26th.  I have Hashimoto's Thyroiditis and have been searching for an answer to the detection of a nodule 3 years ago.
I was diagnosed hypothyroid since the birth of my child and on synthroid for 16 years.  High TPO's and the nodule detection have sent me to various "specialists" that have increased my meds for reduction purposes. Questions have gone unanswered.
I have not had an FNA or a biopsy, only multiple Ultra Sounds.  I cancelled the recently ordered nuclear scan, fearful for my heart (and all other concerns!) being off meds for a month with no idea what will occur afterwards.
No one will answer why the high cholesterol they want me to take simvastatin for, since I don't eat any high cholesterol foods.  Nor will they tell me where this nodule is going, IF it is going!
I am currently on 125 mcg of Levothyroixin and I do take a scriptual vitamin D 50,000 iu weekly, in addition to 1000-1500 mg daily of calcium citrate.
p.s.  I am 47, had a hysterectomy at 36 and have one kidney.  Any help you can provide would be so very appreciated and Yes!
I would be interested in a consultation, because no one answers have been forthcoming for me.  Thanks

[Applecore]

The endo told me they were still producing and that is why I am having so much trouble getting regulated.  I am thinking the thing to do would be to remove them.  He is giving me a very small dose of levothyroxine 37.5 and on Sunday I would take 50 to try to bring it down.  Well it did in 3 weeks it brought it down to .42.  I stopped taking the 50 and only take the 37.5 now.  I just feel so bad with depression and anxiety and it just came on when  the tsh jumped from 4.5 or 5.7 I don't remember exactly to .42.  He told me the produce and just dump into my body when they want to and it can't be controled.  A psychiatrist is trying to control the symptoms with medicine for depression and respiradol.  I have only been on this for about 2 weeks.  It is helping some but some days it does and some days it doesn't.  It seems to me if this is going to continue the best thing would be to have it taken out.     You said that you see patients in Tampa.  My sister lives in Dade city and we could come there to see you.  Do you do the operation if needed.  I haven't found a really good doctor here.  The one I am seeing just keeps saying I'm ok and I'm not ok.   Thank you.

[Applecore]

What did you mean when you said unless you have an overactive nodules that have been treated with levothyroxine ( which should be avoided in cases of overactive nodules.    I have overactive nodules that I am taking levothyroxine for and I had RAI done in Jan. 2006  which did not work.  I have had serious problems since.  I can only take 37.5 mg of levothyroxine and was taking 50 on Sundays only but now my tsh is down to 0.42 from 4.5 in 3 weeks.  I stopped taking the 50.  I am taking risperado and doxepin just recently started on 1 week ago to try to override the symptoms from my thyroid.  I am looking for a new endo to try to see what is going on this me.  That is why I asked about what you meant.     Thank you.   Linda