Enlarged thyroid lobe while on levothyroxine

[bluphoenixangel]

I Aug. i had an U/S which showed my left thyroid lobe to be enlarged. While on my levothyroxine my TSH T3 and T4 levels were normal. Diagnosed with hypothyroidisnm in 2004. Had uptake and scan and said abnormal uptake and scan demonstrating findings consistant with Grave's Disease. Off meds for over a month before scan.  How can i go from normal levels while on Levothyroxine to having hyperthyroidism in a scan? What causes a goiter to be on only one side?

TSH 3.60
T4 0.91
T3 1.20

[bluphoenixangel]

Had sub-total thyroidectomy on Thursday. Found it was a good thing i opted for surgery being as it was wrapping itself along the inside of my neck. During surgery i lost 200 cc's of blood, but came out if it with my voice and feeling better than i had in a while. My surgeon advised me that radioactive iodine would not have remedied my problem and that it lookes like Hashimoto's Thyroiditis. I should get the pathology report in about a week with definate findings. Thank you for your assistance.

[Mark Lupo, M.D.]

One cannot diagnose hyper on a scan -- you can have elevated uptake with Hashimoto's hypothyroidism (ie elevated TSH causing increased uptake) -- this is a common confusion in reading these I-123 scans.

goiters can lack symmetry, would not worry too much about this.  If the hypo does well with levothyroxine, would continue on the dose that keeps things stable.  Ultrasound is a better way to evaluate goiter than I-123 scans.

[bluphoenixangel]

Forgot to mention losing most of my voice, coughing to catch my breath if i talk too loud or try to yell. Neck discomfort.