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Thyroid Cancer, Nodules & Hyperthyroidism (Expert Forum)
Why? From Hypothyroidism to Hyperthyroidism.
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.
Why? From Hypothyroidism to Hyperthyroidism.
by Wanpei, Dec 07, 2006 12:00AM
I wastold by the doctors that I was hypothyroidism first. After taking small dose of Synthroid for 1.5 month, I became hyperthyroidism. The doctors told me they don't know why? Can anyone help me here? Here are my test results:
TSH T3 T4
6/29/06 72 Physical exam
7/5/06 27.99 3.18 0.7 Thyroid Antibodies > 1000
Thyroglobulin Antibodies 604
7/24/06 1.3 1.14 Started Synthroid 50mcg/day
7/26/06 0.74 4.63 1.3 Started Synthroid 100mcg/day
8/1/06 0.12 6.34 1.81 Reduced to 25mcg/day
9/6/06 0.02 7.05 2.1 Stop Synthroid
10/23/06 <0.01 5.63 1.6
12/6/06 <0.01 4.65 1.8
11/29/06 NM Thyroid Uptake and scan. Scan shows slightly heterogeneous uptake in both lobes with possible small defects due to cysts or nodules in the right upper and lower pole.
TSH T3 T4
6/29/06 72 Physical exam
7/5/06 27.99 3.18 0.7 Thyroid Antibodies > 1000
Thyroglobulin Antibodies 604
7/24/06 1.3 1.14 Started Synthroid 50mcg/day
7/26/06 0.74 4.63 1.3 Started Synthroid 100mcg/day
8/1/06 0.12 6.34 1.81 Reduced to 25mcg/day
9/6/06 0.02 7.05 2.1 Stop Synthroid
10/23/06 <0.01 5.63 1.6
12/6/06 <0.01 4.65 1.8
11/29/06 NM Thyroid Uptake and scan. Scan shows slightly heterogeneous uptake in both lobes with possible small defects due to cysts or nodules in the right upper and lower pole.
Doctor's Answer
by Mark Lupo, M.D., Dec 10, 2006 12:00AM
, Dec 10, 2006 12:00AM
Interesting -- you have autoimmune thyroid disease -- initially presenting with clear hypothyroidism and now 3 months off thyroxine are persistently hyperthyroid. This could be a hashitoxicosis -- check TSI/TBII to further evaluate. Or it could be recurrent silent thyroiditis with a background of auto-immune thryoid disease (hashimotos) -- but in that case would expect low uptake on the 11/29/06 scan.
I presume you are not taking any synthroid, thyroid medications, or herbs/supplements purported to help the thyroid.
Would do ultrasound to eval if any of the "small defects" require FNA.
Follow thyroid function over time to see what the trend is -- may need antithyroid drugs or radioactive I-131 if persistent hyper.
I presume you are not taking any synthroid, thyroid medications, or herbs/supplements purported to help the thyroid.
Would do ultrasound to eval if any of the "small defects" require FNA.
Follow thyroid function over time to see what the trend is -- may need antithyroid drugs or radioactive I-131 if persistent hyper.
