need help any advice/ sugguestions would be appreciated.

[bgtown]

Dr Mark & all thryroid sufferers  HELP! I am hashi patient with goiters.  Have been on 100 mcg synthroid for approx. 7 months.  I had another ultrasound 1 ago.  Goiter has grown from 2.5 cm to 2.87 cm on the right side I now also have a 1 cm on the left. My symptoms are getting increasingly worse.  Exhaustion, fatigue, menstrual cycles horrible, alot of weight gain, brain fog -  name it !  I just feel worn out, also out of breath constantly!!  I was referred to ENT he said I had 2 options 1) surgery to completely remove the thyroid gland (said that would make the hashi go away) & goiters.  Or 2nd he would put me on Cytomel 25 mcg 2x's daily this is in addition to 100 mcg of Synthroid, and try this for 2 months.  I decided to try to Cytomel. Can anyone tell me if this is likely to work. I really don't want the surgery but I cannot keep continuing to get worse. I go back to the ENT on Feb. 17th. Also, wondering if I will feel worse after surgery,  it seems like if I have no thryoid I will be even more exhausted/ fatigued than I already am.  Also, my TSH is .73 ,  how can this be right when all of my symptoms including the size of the goiters(plus now I have 2) is worse.  I am very confused with all of this, please help!  Thank you.

[Mark Lupo, M.D.]

that's a lot of cytomel - unlikely to work in the majority of cases, but the idea is to suppress the TSH with extra thyroid hormone so the thyroid is not stimulated by TSH to grow -- it's worth a try provided but that you don't get too stimulated by the cytomel.  With the TSH of 0.73 I wouldn't expect that lowering it more will shrink the gland too much.

If the cytomel improves other symptoms then long-term cytomel/synthroid combo treatment (but not at these doses) may be worthwhile (w/ or w/o surgery).

Surgery is not guaranteed to cure the hashi - the only reason I would do surgery is if there is a concern for cancer (do fine needle aspirate first) or if the thyroid is large enough to cause choking-type symptoms.

by the way you have ONE "goiter" - that just means a thyroid is enlarged - sounds like you have at least two nodules within that goiter...

[bgtown]

I mean to say I had another ultrasound 1 week ago. Also maybe shoudl mention when I found out I had hashi and goiters TSH was at 14.

[bgtown]

Now I am more confused both my family physician and the ENT told me that once they removed the entire thyroid I would not have hashimoto anymore.  Can you explain to my why I would still have it??

[lildeb]

Hashimotos is an auto-immune disease. That means your immune system is attacking your thyroid. The reason it would not cure it is because even though the thyroid is removed, the auto-antibodies would still be produced thru the immune system. Also, with surgical removal of the thyroid there are always pieces of thyroid tissue left and this tissue can reproduce itself.

In this case Dr. Mark is absolutely right. Listen to him.
lildeb

[bgtown]

Does this mean that I will still have all of the symptoms of Hashimoto's?  And,  this may sound like a stupid question, but where do all of those antibodies go? If they are no longer attacking the thyroid  - do they cause problems elsewhere?