toxic thyroiditis

[bentley905]

I had normal bloodwork but was diagnosed with hashimoto's via a biopsy on a nodule five years ago.  A month ago, bloodwork showed hyperthyroidism.  An ultrasound last week showed one of two nodules is larger.

Doc wants me to see a radiology oncologist to have a dose of radiation to put me into hypothyroidism.  I am very nervous about this.  Endocrinologists in this area are booked for 7 months.  IS this a normal procedure?

[Mark Lupo, M.D.]

I-131 (RAI) is commonly used for hyperthyroidism due to Graves or over-active nodule(s).  But the diagnosis is not clear in this case.  IF the labs show persistent hyperthyroidism (ie, repeat the labs now) - then do an I-123 scan to see WHY the thyroid is overactive then discuss treatment options and expected outcomes.  IF on the I-123 scan the nodules are not hyper-functioning, then repeat FNA may be indicated if they are increasing in size.

[bentley905]

I had my nodules biopsied 5 years ago and the endo looked at the cells and said they were characteristic of hashimotos.  My internist had the scan from 10 years ago (the one the endo took was not sent to him, only the report) and one nodule looks larger.  I don't know if it is larger than it was 5 years ago.  I am going to have the report sent.  

My levels as of june were T3 241, thyroxine free 1.8 and TSH 0.01.  I have been on tapazol but for this test, I went off it for 3 days (I misheard the doc's office.  I thought they told me to lay off the meds for that long but it was supposed to just be to not take the dose the morning of the test).  SO this is really my levels without meds.  

The doc told me to have the rai without having a biopsy of the nodule to see if it is cancerous.  I do still have two nodules but it is the one that is larger.  

I am thinking that it might be better to have it biopsied and go from there.  I am very nervous about RAI.  DO you have any suggestions for research?  I think I said in my post that there is a 7 month wait list to get into an endocrinologist.

[bentley905]

Oh, the also the doc did not say I should have the thyroid removed.  I actually have more symptoms of hypo thyroid than I do hyper.  I asked for the bloodwork because I am so exhausted, I can't keep my eyes open.  Also have been gaining weight despite exercise.  

I have my levels regularly checked so I do know that in november my TSH was 1.28

[cosmicsoul]

What was your TSH? What did the biopsy show? Are the nodules cancerous? Hashimotos is diagnosed by level of antibodies the last I heard not from biopsies... although maybe they can show some antibodies through that. Do you have hyper symptoms? I would not rush into Radio Active Iodine just yet. Research this and make a decision later. Do they also want to remove your thyroid?

[hashisgirl]

look up Hashistoxicosis