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Thyroid Cancer, Nodules & Hyperthyroidism (Expert Forum)
Clinically Significant?
Answered by
Mark Lupo, M.D. - Thyroid Nodules, Thyroid Cancer, hyperthyroidism, hypothyroidism, Thyroid Ultrasound
Thyroid & Endocrine Center of Florida
Sarasota - FL
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.
Clinically Significant?
by sam_40, Mar 30, 2007 12:00AM
I've been hypo with a multi-nodular goiter (no dominant nodes) and take .125 mcg Levothyroxine. Recent blood results: TSH 1.03, T4 1.03
Is it me or is the T4 low?
Also, while I have very few medical problems, I think they are all related to and can be traced back to hypothalamus.
Here's a quick summary:
1. Am currently 39.
2. At 29, diagnosed as Hypo. No family history. Negative anitbodies. Why am I hypo?? Told a genetic anamoly has to start somewhere. Guess the buck starts with me.
3. At 33, was diagnosed with premature ovarian failure -- Repro Endo said feedback loop (from ovaries to pituary) was broken. Last week endo said hormones out of whack, so at 39, he has declard menopause (he's going by hormones not by monthly cycles).
4) At 38, was diagnosed with Cluster Headaches (episodes usually last 4-6 months).
5) While not a medical problem, I've been telling the doc for years that I am never hungry. It usually takes a minimum of 36 hours between meals before I even begin to feel pangs. I have to remember to eat, otherwise, I'll go for up to 3 days without a meal.
Is it clinically significnat that all of these relate to the various functions hypothalamus or is it just coincidence? Neurologist thought it was interesting, but said he treats me for cluster headaches not the endo stuff. Also said hypothalamus was too small to get a good look at on the MRI.
Should I be pursuing this with my endo? Are there diagnostic tests that could be done? What if there are structural issues with the hypothalamus -- can it be treated (or maybe the sysmptoms are treated individually as they are doing today). Does the hypothalamus systematically fail as one ages? Is this anything I should even be concerned about?
Thanks for your thoughts on this!! I really appreciate it!
Is it me or is the T4 low?
Also, while I have very few medical problems, I think they are all related to and can be traced back to hypothalamus.
Here's a quick summary:
1. Am currently 39.
2. At 29, diagnosed as Hypo. No family history. Negative anitbodies. Why am I hypo?? Told a genetic anamoly has to start somewhere. Guess the buck starts with me.
3. At 33, was diagnosed with premature ovarian failure -- Repro Endo said feedback loop (from ovaries to pituary) was broken. Last week endo said hormones out of whack, so at 39, he has declard menopause (he's going by hormones not by monthly cycles).
4) At 38, was diagnosed with Cluster Headaches (episodes usually last 4-6 months).
5) While not a medical problem, I've been telling the doc for years that I am never hungry. It usually takes a minimum of 36 hours between meals before I even begin to feel pangs. I have to remember to eat, otherwise, I'll go for up to 3 days without a meal.
Is it clinically significnat that all of these relate to the various functions hypothalamus or is it just coincidence? Neurologist thought it was interesting, but said he treats me for cluster headaches not the endo stuff. Also said hypothalamus was too small to get a good look at on the MRI.
Should I be pursuing this with my endo? Are there diagnostic tests that could be done? What if there are structural issues with the hypothalamus -- can it be treated (or maybe the sysmptoms are treated individually as they are doing today). Does the hypothalamus systematically fail as one ages? Is this anything I should even be concerned about?
Thanks for your thoughts on this!! I really appreciate it!
Doctor's Answer
by Mark Lupo, M.D., Mar 31, 2007 12:00AM
, Mar 31, 2007 12:00AM
Hypothalamic problems are rare and difficult to diagnose. Your thyroid levels are fine on the 0.125mg dose. Would consider recheck antibodies for thyroid AND for ovaries. If thyroid Ab's still negative look at the ultrasound of thyroid for heterogeneity often seen in Hashimotos (up to 10% of hashi pts have negative ab's). IF this is all autoimmune -- ask the endo to consider testing for other, associated autoimmune problems as well.
