Abnormal Thyroid Tests - AGAIN!

[LindaSa1]

I'm a post-menopausal (5+ years) 57 yr. old who has a hx of HYPERthyroidism 20 years ago.  I was treated with Tapazole for 18 months and it resolved.  

A more current hx reveals a weight gain of 40 lbs over the past two years with NO change in diet or exercise level.  No symptoms.  Blood worked revealed T4, Total of 9.1, T4, Free, Calculated of 2.33 but a T3 Uptake of 25.6.  Ultrasound of the thyroid shows "Bilateral Heterogeneous Thyroid lobes, with a single distinct 2 millimeter left lower pole nodule noted."  My PCP and an endocrine consult both recommend "watching" the nodule and I was placed on 25mcg of Synthroid.  

Seven weeks later, my TSH is 3.95, T4, Free 1.2 and T3, Total 177, HOWEVER my Thyroid Peroxidase AB is 313.0.  

The endocrinologist is not concerned and wants to follow my "nodule" again in 4-5 months.  

What does this Antibody result imply?  Thank you!

[Mark Lupo, M.D.]

The heterogeneity on US has been there for years most likely - this is seen in immune system attacks against the thyroid both in graves and hashimotos -- the TPO AB has also likely been positive for years -- looks like the TSH suggests that you are borderline hypo and this is the opposite end of the spectrum of thyroid immune system attack  -- would increase the synthroid to keep TSH around 1.0.  The weight is tough to explain -- research has not shown the thyroid at these levels to have a consistently significant impact on weight.  There may be a mild decrease in metabolism due to borderline hypothyroid and there is certainly a decrease in metabolism with menopause (poorly understood).  Don't worry about the 2mm nodule now -- just repeat the ultrasound in 6 months to be sure it's not growing.  About half of women >50 would have a small nodule.

[PNWBabe]

Don't let the doctors try to tell you that your weight gain probably isn't from hypo/menapause..of course it is!!!! The new range for determining thyroid disease is .3-3.0, so, with your TSH at 3.95, it's my opinion that you are indeed hypo. Being put on such a minute dose of synthroid is going to do squat for you and your symptoms. I do agree that watching the nodule is a good idea. The fact that you have antibodies makes a big difference and I would suggest that you find a doctor that will give you the attention you need and deserve. I would suggest that you get a great book called "Hormones, Health and Happiness" by Steven Holtze , it has a world of knowledge in it that will help you on the road to feeling great!

[Melody274]

Hello I am 31 year old merried woman. And me and my husband just desided it was time to have our first baby. Since all of this is all so new to me I am so scared because I am currently on synthroid medication 137mcg . I asked my doctor if there would be any harm if I was to get pregnant. He said no? But then I asked my regular doctor and she said that it was extreemly important to keep taking the medication and for me not to stop taking it even if I was to become pregnant. She said that if I stoped then my baby can have low birth weight or even mental health problems. Is this true??  And if Im planning to leave my job soon to finish school what kinds of inssurances can cover my thyroid pills. Please help me

[LindaSa1]

You said you'd increase the Synthroid dose to maintain my TSH @ around 1.0.  What dosage would you recommend?  Thank you.  Linda

[Mark Lupo, M.D.]

increase to 50mcg recheck in six weeks and continue to titrate the dose to keep the tsh around 1.