Meaning of initial test results

[SDCA]

My GP noticed during a regular physical that I have an enlarged thyroid. She sent me for some tests and referred me to an endocrinologist. The endo appointment is in two weeks, but I'm curious about the test results now. I've tried researching them, but I find conflicting info and lots of things about T3 and T4, which are tests I haven't had. Here are my numbers:

TSH .91 Normal
Thyroperoxidase Antibody 119
Radioactive Iodine Uptake @ 4 hrs 28%; @24 hrs 57%
Scan showed a nodule and enlargement on the right side

I have no symptoms, which seemed to surprise the guys who did the RAIU and scan.

Is this enough info to make a diagnosis, or will they send me for more tests? Do you even bother to treat a thyroid "problem" that causes no symptoms besides an enlarged gland?

[Mark Lupo, M.D.]

You have a goiter (enlarged thyroid) associated with autoimmune (positive TPO antibody) thyroid disease, but the thyroid function is normal currently (TSH 0.91).  

This may be early hashimoto's, but the 57% uptake is a little high given the normal TSH.  This also may be latent Graves - meaning a risk of developing hyperthyroidism.

I would do an ultrasound to look at the nodule suggested by the scan and determine if FNA biopsy is needed.

Would also do TSH-Receptor Antibody testing which would be helpful to see if Graves is a likely outcome.

Thyroid medications are not indicated at this point in time.

[SDCA]

Thank you for all the info. It sounds like it may end up going either way. I'll ask about these tests if the Dr. doesn't suggest them herself.

[cosmicsoul]

it looks like Hasmimotos contributing to your disease. this means that you have slighly elevated thyroid antibodies (TPO) which is the beginning stage of the disease. looks like you have develped an autimmune disease called Hashimotos thyroditis. Your TSH is normal - good!! - but your antibody count is growing (slowly). At this point, since you have no symptomps and you feel fine - you will proably need to do nothing but monitor your TSH and TPO in every 6 months. Should your antibodies AND TSH numbers grow with time - thyroid hormone supplementation is neccessary. Not very good idea now as it would lower your TSH too much and make you hyper vs. hypo. Nothing you can do to reduce your antibodies as it is a natural process your body is doing. Some say that yoga, breathing, and some other techniques can help in reducing them, you should look into that. Be very greatful that you know you have this at a very beginning stage. Most Hashimotos patients learn this by the time they have experienced years of misery!!!!!!!!!!!!! My TSH was 9.3 and my antibodies were above 1000 when I was diagnosed. You are able to keep your eye on this and perhaps even do things that will prolong the process, but certainly checking blood work to notice change - you are very lucky. I wish you good luck!

[cosmicsoul]

one more thing... the enlargement and nodules can come from the iinfection caused by the antibodies or Hashimotos. You can have an ultrasound done to see how healthy your thyroid lobes are. Also, they can check for warm and cold activities which can indicate the health of your thyroid. To be sure of what the nodules are you can always have a biopsy done - then they analyze the nodule sample itself. Good luck!!