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Thyroid Cancer, Nodules & Hyperthyroidism (Expert Forum)
To all Forum Participants
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.
To all Forum Participants
by PhilipG, May 22, 2006 12:00AM
Please note:
Dr. Lupo will be out until 6/21, the forum will be closed to new questions until then.
Regards,
Med Help
Dr. Lupo will be out until 6/21, the forum will be closed to new questions until then.
Regards,
Med Help
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Good morning. I am struggling to get diagnosed as I have all the symptoms, but not the test results to back it up. I find it so interesting all the people with these hugely out-of-whack tests that don't have symptoms and the same number of people with symptoms that have "normal" test results...makes you wonder.
What I wanted to suggest is having your adrenals tested. In doing a lot of research, I've seen mentioned over and over that increasing thyroid meds when your adrenals are fatigued can make your symptoms worse. Perhaps that is the case with you.
If you haven't already, go check out the website: www.stopthethyroidmadness.com.
They have adrenal self-tests and a whole forum dealing with adrenal issues and thyroid. They can answer questions and there are other topics that may help you find other possible causes for your reaction.
I wish you luck in your efforts to regain your health.
I would try to get her into another endo even if you need to go out of town. It sounds like she is going back & forth between high & low thyroid with high being more dangerous. Tell her not to get discouraged but don't quit trying until you get the help you need. Can you post the normal ranges of the above tests as the vary from lab to lab.
Before seeing another physican I would ask for all of her records ,from the physicans she has seen, so they are at your fingertips.
If you live in the US and when she starts feeling the same way...high heart rate & choking sensations take her to your ststes university teaching hospital's ER. I'm sure there is someone there that takes your insurance that they can refer you too.
Please, don't ever presume that just because the physican is a specialist ,as in your endocrinologist, that they know what they are doing. Medicine is just like any other profession, you have the good & the bad. It's too bad Dr. Mark is gone because he is one of the good ones.
You can even type thyroidologist into your search engine & maybe you can find someone to help you that isn't too far away from where you live.
That is sometimes what Dr. Mark recommends to those posting with similiar situations.
You need someone who knows what they are doing.
What is a Thyroidologist
A thyroidologist is trained in internal medicine, endocrinology, thyroid hormone
analysis, ... What are the usual reasons you should see a thyroidologist? ...
www.thyroidologists.com/about.html
Here's a web site for you to start with.
Thyroidologists
Lists doctors who are experts in diagnosing and treating cases of thyroid disorders.
www.thyroidologists.com
Let us know what happens. Talk to you soon. Any more questions...we're here. OK. God Bless You & your mom, TJ
This is a better web site to find a thyroidologist.
http://www.thyroid.org/patients/specialists.php3
It sounds like your mom is Hypo trying to Hyper/Graves' which is not unusal and the normal course for most Graves'. Or she could be both Hyper/Graves' and Hyper/Hashi. Whatever, both are equally as dangerous if left untreated for too long. Or maybe something else is going on, but one thing is known, your mom needs medical. Get copies of her Labs with the Lab ranges for future references. I hope you get her sucessful help and treatment soon, she sounds real sick, and, this is not easy on you either.
Good Luck!
Washington State will probably be a really good place for her to go as they are up on all the newest data, if they are a teaching hospital, & those types of hospitals tend to dig into the condition more to find the cause of the signs symptoms. They also have all types of physicans available.Have her paperwork available but let them start fresh with her as far as diagnosis. Only give them the tests they ask for because sometimes a what one doctor or radiologist thinks is normal another may not. Like I said in my prior post, if she gets bad again or any worse put her in the car & drive up to Washington Univ. ER & she will be evaluated & start treatment right away.She sounds like one sick cookie.
I feel your pain. I said when I was diagnosed with Graves that the name of this disease is appropiate because you feel like your going to die anytime. Her symptoms sound so much like what I experienced when my Graves was discovered it's scarey...I slept upright(when I slept...insomnia) for almost 6 months because my choking would worsen when I was lying down. I was so close to a thyroid storm by the time I seen the right person that it wasn't funny. My heart rate was up in the 180's at times too. 4-6 stools a day, 60# wt. loss, tremors. anxiety, panic attacks, mood swings, hair loss, palpatations, fatigue... along with the rest of the symptoms is just a nightmare & I really feel for your mom & you.
DO NOT LET HER RUB HER NECK OVER HER THYROID AREA...My endo told me she did not even want to touch mine wben I was so symptomatic because it causes the thyroid to release even more thyroid hormones.
Don't fool around with the other doctor's she has seen take her directly to the ER at Washington State. Sometimes you have wait 1-2 mos when seeing a specialist for the first time. Ig you take her to their ER she will be red-lined through.
Take care of yourself too. Remember we can only do what is humanly possible. God Bless you, TJ
Yes,hypothyroid can change bowel movements.
Normally constipation.
I have had a thyroid ultrasound, which showed nodules. I then had a biopsy of the largest nodule, which was benign but the final diagnosis says "benign consistent with nodules of multinodular goiter". The ENT that I was sent to by my PCP insists that it is not thyroid causing my problems and suggested very strongly that it was "hormones and depression". My TSH 2 yrs ago was 1.26 and in 5/06 it was 1.01.
I have 2 sisters and my mother that have been on thyroid meds for years and they all tell me I have the same symptoms.
I am so frustrated and am to the point that I don't feel like going anywhere because I continue to gain weight and look so bad, plus being exhausted.
Any suggestions?????
Thanks
According to New England journal of medicine - "The symptoms of both hyperthyroidism and hypothyroidism are non-specific and can be mimicked by other conditions. Thus the practice of prescribing thyroid treatment on a clinical basis alone without biochemical confirmation carries potential risks"
Nodules are quite common occurring in more than 50% of the world's population and among healthy thyroid people. The likelihood of developing a thyroid nodule increases with age and in part represents the aging process of the thyroid gland. Although most nodules are harmless and do not require any treatment at all unless the nodule is a hot nodules that is causing hyperthyroidism.
Your TSH is in the healthy normal range, however both FTs would have told more about your thyroid situation. Also presences of antibodies with normal levels might indicate that your thyroid is in the process of failing (showing potentional thyroid problem) but not failed yet or enough to reflect in your levels. Suggest having levels check on a regular bases to keep on top of of the situation.
Also, you might want to have a metabolic profile/Adrenals done.
Some of symptoms of adrenals are similar to those of thyroid and taking thyroid meds when the adrenals are fatigued can make symptoms worse, therefore you might respond negatively. A metabolic profile/Adrenals is a combination of blood tests run together that evaluate kidney and liver function, electrolyte imbalances and blood sugar disturbances. A complete blood count with a metabolic profile can help pinpoint other basic disorders. Somet endos don't want to pursue the problem if they decide that it's not an endocrinology problem. In that case you'd check with a Family Practice Doc, Internist, GP or your OB/GYN to see if they would order these tests and help determine what's causing your symptoms.
Good Luck!
http://thyroid.about.com/gi/dynamic/offsite.htm?zi=1/XJ&sdn=thyroid&zu=http%3A%2F%2Fwww.thyroid-info.com%2Ftopdrs%2Fidaho.htm
This is my first time here. Six weeks ago I was diagnosed with severe hypo & Hashimoto's with a TSH of 92. (that's not a typo - it was 92!!). My cholesterol was 319. I was put on 50mcg Levothyroxine. After six weeks I felt like a new person, lost 22 lbs. went for bloodwork. My TSH dropped to 6.2 and my cholesterol dropped to 211. I felt great. I was then put on 75mcg Levo (it's been one week now) and all of a sudden I feel horrible! Fatigued, muscle pains. I'm wondering because my doc told me I was also positive for ANA - which I think is from the Hashi. She referred me to a rheumotologist. I'm wondering now if I'm feeling lousy due to the increase in levo or something else (fibromaylgia (fibromyalgia) maybe??) I know my TSH level is still high but why would I feel worse with a higher dose of levo? Any ideas?? Thanks
Just wanted to tell everyone that since Dr. Mark is away, you might want to check out this fairly new website. It has lots of good information and forums to ask questions. It;s at www.stopthethyroidmadness.com
am
Your body is probably trying to adjust and heal from being hypo, to normal levels. It takes time to heal - it probably will take as long as you were sick/hypo. That is, if you do every thing corrert - per doctor, per health, per meds., etc. The symptoms of both hyperthyroidism and hypothyroidism are non-specific and can be mimicked by other conditions so it is wise that your doctor is checking other avenues of health as well.
Good luck and feel better soon.
Thanks!
So what I relate is from my personal experience, others experiences and reading info. which is mostly from medical and thyroid orginations sites. I am not a doctor or in the medical field. I just want to be of help to others which is ment by suggestions only.
Why, have I offended you?
Im 39 and have been exhuasted for about two years. I do have a 24 month old but I have noticed headaches daily low body basal temps under 97 every morning. Fatigue, QUICK hair loss all over and most noticable on the top behind the bangs (no history of familyhair loss) very heavy periods I get cold and my feet turn bluish upon cold, I cant sleep and I am not getting depressed. I am thin have always been so no weight gain and no constipation at all.
I have had autoimmune testing for Lupus and also checked for Rhumatoid arthritis. I had my thyroid checked one year ago and was normal, had it checked 6 months ago and it was normal. I don't know what to do at this point I am feeling very hopeless. Was advised to see a dermagologist but what can he tell me other then my hair is thinning? I feel not right something is off. Can anyone in the same boat offer some advice to me? plz email me ***@****
Thank you for your kind words and appreciation.
I am still researching and learing myself. There is a lot of
questions to thyroid issues which can be overwhelming.
Its nice to have people to learn from and to share with, and
we all can learn from each other, I'm sure.
Good Luck!
~~~~~~~~~~~~~~~~~~
I am not a Doctor or in the Medical field.
My statements and comments are meant as a guide only,
not a diagnose or treatment. That is between you and your doctor.
I'm looking to see if anyone has experienced anything similar to what I'm currently dealing with.
I'm 36, and I was diagnosed by my OB/GYN this past March as hypothyroid, with a TSH of 7.5. He put me on 100 mcg's of synthroid. Within two weeks of taking the synthroid, I began having heart palpitations and extreme shortness of breath. I stopped taking them for a couple of days, but began to feel worse so I continued with the medication. About three weeks later, I nearly passed out in the store. I decided then to completely stop...that was the first week of May. Just over four weeks from when I initially began with the synthroid.
About 7 days later I began to experience muscle pain in my upper legs, which eventually spread to my entire body. The overall fatigue and muscle fatigue became overwhelming. I visited an endocrinologist on May 31 and a blood test revealed I was now HYPERTHYROID...in less than 8 weeks I went from hypo to hyper!
The muscle pain and fatigue has literally crippled me. I cannot do any much beyond lying down. I'm litigation paralegal, and I work long days, and I'm currently unable to even drive to the office. Showering causes me to have to lie in bed for at least a half hour to recover.
Last week I had a radioactive iodine scan, it revealed no tumors, and the diagnosis is thyroiditis. The doctor believes I may have a virus attacking the thyroid. At this point the frustration, and inability to do my job, is stressing me out beyond belief. I need some answers somewhere to help me get on the road to recovery.
Anyone ever experience the same, or something similar?
It really doesn't make a difference if you have Hashi, unless you personally want to know and don't mind paying for the extra expense.
You are already being treated and there is no other, or different treatment for Hashi.
Your TSH and both FTs on how they relate to each other will tell and then antibodies will confirm. Anti-TPO (thyroid peroxidase) and the anti-thyroglobulin
Thyroid peroxidase (TPO) antibody (TPOAb).
Any doctor can order the test, they just have to know how to read them and its so simple I am sure that will know how.
If you post regarding them, get hard copies with the Lab ranges.
Your symptoms are either that you are not at the right level for you and you are still too hypo or something else is going on. Adrenal/metabolic symptoms are close to that of thyroid, you might want to explore those if your levels are not the issue and/or other health conditions that share the same symptoms that your are experiencing.
Good Luck!
~~~~~~~~~~~~~~~~~~
I am not a Doctor or in the Medical field.
My statements and comments are meant as
information only, not as a diagnose or treatment,
for that is between you and your doctor.
These are in chronological order:
11/30/04
Uric Acid Serum 5.1 normal
Antistriptolysin o Antibodies 229.1 High
C- Reactive Protein, Quant 5.5 High
Antinuclear Antibodies - Negative
Thyroid Panel
TSH 5.514 ( a tad high)
T4 6.2
T3 25 (on the low end)
Free Thyroxine Index 1.6
Sedimentation Rate-Westergren 15
6/28/05
Thyroid Panel
TSH 5.60 - high
T4 5.1
T3 25
Free Thyroxine Index 1.5
11/05/05
Thyroid Panel
TSH 6.814 high
T4 5.1
T3 22 low
Free Thyroxine Index 1.2
2/28/06
Hepatic Function Panel - all within normal limits
Lipid Panel - high cholesterol, high Triglycerides
Thyroid Panel
TSH 5.508
T4 5.1
T3 25
Free Thyroxine Index 1.3
5/26/06
Cortisol 8.0 Limits 3.1 - 22.4
Thyroid Panel
TSH 7.014
T4 5.1
T3 24
Free Thyroxine Index 1.2
I know that this is not all of them but just a portion - still waiting for more copies from GP. Since I basically only have the limits to go by, without really knowing their meaning, can you make sense of this? What else would you suggest if it were you?
I can't thank you enough - it helps to atleast know what I am looking at.
Limits:
TSH 0.350-5.500
T4 4.5-12.0
T3 24-39
Free Thyroxine Index 1.2-4.9
If you are on estrogen whether by meds or nature (child bearing years) the FTs should be done because estrogen interferes with the T levels but not the FTs. actually they should be done regardless because it tells whether the thyroid is performing properly.
Haves these Labs done - TSH, FT-3, and FT-4, and, to set your mind at peace to know definitely, have antibodies done for Hashi and Graves' - some people have both autoimmune disorders. Your levels don't relate to Hashi however I could be wrong.
Your levels are hypo so you might want to tweek up meds to the next dose and slowly work up from there. TSH of around 1 - 2 is optimal for most people to feel well and avoid having hypothyroim symptoms and also weight loss is easier, they say (its harder for me but I am hyper). When your TSH comes down, then the F/Ts will go up more into Labs range. By the nature of thyroid disorders we will find it necessary from time to time to adjust med dose throughout life.
When TSH is just right then your cholesterol should come down some and with avoiding cholesterol and processed foods should also help in lowing. Triglycerides should come down with abstinences from alcohol and sweets of all kinds.
Good Luck!
~~~~~~~~~~~~~~~~~~
I am not a Doctor or in the Medical field.
My statements and comments are meant as
informational guide only, not as a diagnose
or treatment, for that is between you and your doctor.
What's the difference between FT3 or 4 and T3 or4? So, if my doc ups my meds again, would that work out all the kinks, you think? And also, would that help with the nodules they found on my thyroid? I guess I am asking some silly questions and taking up space in the forum but asking my doc questions and getting an understood answer is next to impossible - it's sort of like she thinks that I am questioning her in some way - almost like she's offended. I am looking into finding another gp. Once again, I really appreciate your willingness to explain all this to me.
Thank you so much!
Now I need to take back my comment about Hashi because F/T-3 with the F/T-4 along with TSH relates to Hashi. However you are hypo which the T3U confirms.
Total T4 Reflects the total amount of T4 present in the blood, the protein bound which is unavailable T4 and the Free T4. Note that high levels of estrogens from birth control pills or pregnancy, etc. can increase the amount of the protein that binds T4, giving misleading elevated Total T4 values which can look like ‘hyperthyroidism’ when it is not.
Total T3 Reflects the total amount of T3 present in the blood, the protein bound which is unavailable T3 as well as the Free T3. Again high estrogen levels create the same effect as mentioned in relationship to T4 above.
Free T4 Reflects the biologically active free form of T4. This T4 can be converted to T3 or RT3. In the presence of elevated estrogen levels, the Free T4 gives a more accurate assessment of thyroid function.
Free T3 Reflects the biologically active free form of T3 that can generate production of energy. In the presence of elevated estrogen levels, the free T3 gives a more accurate assessment of thyroid function.
If meds are upped, levels still might need to be upped again to get your levels at a point in the Lab range that is best for you before your symptoms can be relieved and once there it might take some time for your body to heal from these symptoms. And you want to go slow to give the meds plenty of time to work for you and slow on the upping of the dosage as not to over shoot your best level. That is small dose at a time.
Depending on what type of nodule you have if med dose will help and I think it has to be a hyper level to do any good. If the nodule has damaged the thyroid it may leave evidence of the nodule. My nodule is still visible even after RAI treatment.
Good Luck!
~~~~~~~~~~~~~~~~~~
I am not a Doctor or in the Medical field.
My statements and comments are meant as
information only, not as a diagnose or treatment,
for that is between you and your doctor.
I had a partial thyroidectomy 15 years ago and also
had 2 parathyroids removed.
I am told I need to have the rest of my thyroid removed
due to FNA Biopsy results that a Hurthle Cell neoplasm cannot be ruled out.
However I am having conflicting advice from Doctors, some say
that I can watch and wait follow up with another biospy, ultrasound, etc.
Others say it needs to come out.
My greatest concern is that the remaining two parathyroids will be damaged or removed.
I was on synthroid on and off for the past 15 years .
I have been off of it for several months becauses my dose was to high 125 mgs. and I became hyperthyroid (no fun!!!!)
I am currently off the synthroid and my TSH is 3.0
and I do not know what te FreeT4 was I was told it was normal,
the Doctor does not check FreeT3.
I am a wreck and do not know if I should proceed with the surgery or not.
Would like to hear from anyone who has had a complete thyroidectomy and how there health is now.
Sorry this is so long.
Thank you.
Belly swollen can be from many reason and health conditions including hypo. I just corrected mine which was due to certain foods. But I'd have doctor check it out because it could be a serious issue or life threatening condition.
Good Luck.
~~~~~~~~~~~~~~~~~~
I am not a Doctor or in the Medical field.
My statements and comments are meant as
information only, not as a diagnose or treatment,
for that is between you and your doctor.
If your Hürthle tumor is 4 cm or larger it has an 80% chance of histologic evidence of malignancy. Hürthle cell cancer reportedly behaves in a more aggressive fashion than other well-differentiated thyroid cancers, with a tendency to higher incidence of metastasis and a lower survival rate.
It is recommended that all patients with the cytologic diagnosis of a Hürthle cell tumor should proceed to surgery to ensure that the carcinomas are identified and managed appropriately.
Better to be safe now, than sorry later - Good Luck!
~~~~~~~~~~~~~~~~~~
I am not a Doctor or in the Medical field.
My statements and comments are meant as
information only, not as a diagnose or treatment,
for that is between you and your doctor.