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Enlarged & Heterogenous Thyroid
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Enlarged & Heterogenous Thyroid

An MRI scan has showed an "enlarged and heterogeneous left thyroid lobe with a chain of cervical lymph nodes".

The scan was carried out following severe pain in my neck for over a year which has at times been affecting my swallowing quite badly. My TSH was 1.39 (normal I believe) last year.

It is so painful, but I feel the pain is coming more from the side of my neck/under my jaw. Could this be connected to the enlarged thyroid?

Many thanks!
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My T3 and T4 are within normal limits too...
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649848_tn?1357751184
Was there mention of nodules on the thyroid gland? Enlarged thyroid gland could cause pain and difficulty swallowing, but it would have to be pretty enlarged to do so.  Not sure what the "chain of cervical lymph nodes" means.  The body has a lot of lymph nodes.

Was there any comments about nodules on the thyroid? Was there an "impression" at the end of the MRI report?  Most of the time, the radiologist will make "recommendations for follow up" if s/he thinks there's something out of the ordinary. Recommendations could include biopsy, FNA, etc.

How about posting those "normal" T3/T4 results, along with reference ranges, which vary lab to lab and have to come from your own report.  Also please let us know if they are FREE T3 and FREE T4, or if they are totals...... tests for Total T3 and Total T4 are considered obsolete and of little value, but if that's what you have, post them anyway and we'll go from there.
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Hi Barb, thanks for the reply.

There was absolutely no mention of anything except for the "enlarged and heterogenous left thyroid lobe" and "the chain of enlarged cervical lymph nodes". The report was unfortunately somewhat lacking in detail. The summary said I should be referred to an endocrinologist and that an ultrasound is required. Sadly due to the NHS waiting lists, this may take quite some time.

These were the results five months ago, in October 2012.
Free T4 - 15.4  (11.0-26.0)
TSH - 1.32  (0.35-4.50)
Free T3 - 4.6  (3.9-6.8)

I believe these are normal? Does this then rule out a thyroid problem?

Apparently the size of my enlarged thyroid has increased mildly since a previous scan five months ago.

Thanks very much for your advice.
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1756321_tn?1377771734
My TSH has been 1.4 or 1.5 mU/L for decades so when this changed it was due to Hashimoto's thyroiditis. If you don't have hypothyroid symptoms with then this is your normal. No way are your free numbers my normal. These are my labs...

TSH - 1.5 mU/L (0.4 - 4.0)
Free T4 - 16.6 pmol/L (10 - 20)

TSH - 2.8 mU/L (0.4 - 4.0)
FreeT4 - 15.5 pmol/L (10 - 20)

TSH - 3.7 mU/L (0.4 - 4.0)
Free T4 - 15 pmol/L (10 - 20)
Free T3 - 4.7 pmol/L (2.8 - 6.5)

TSH - 6 mU/L (0.4 - 4.0)
Free T4 - 13 pmol/L (10 - 20)
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649848_tn?1357751184
Your results are within the ranges, so technically, they'd be considered "normal" and most doctors would rule out thyroid condition - get that - "most doctors"......lol   We, here on the forum have learned that "normal" and "in range" really don't always mean a lot because a person can be "in range" and still not be normal for them.

Your Free T3 and Free T4 are quite low in their ranges, indicating that you could be somewhat hypo, in spite of "normal" TSH.  TSH is a pituitary hormone that stimulates the thyroid to produce hormones; it does not cause symptoms, nor does it correlate with symptoms.  FT3 is the hormone actually used by the cells and correlates best with symptoms. Your FT4 is only 29% of its range, which your FT3 is only 24% of its range.  Rule of thumb is that those on medication should have FT4 at about the midrange point and FT3 in the upper 1/3 of its range.  I know you aren't on medication, but IMO you might benefit from a trial dose to bring your levels up a bit higher.  

Enlarged/swollen thyroid is often indicative of Hashimoto's Thyroiditis, which is an autoimmune disease in which the body sees the thyroid as foreign and produces antibodies to destroy it.  This destruction often last for years and it's not unusual for symptoms to be present long before blood work really shows a problem, and not everyone has the same symptoms.  You should ask your doctor to test thyroid antibodies, Thyroid Peroxidase Antibodies (TPOab) and Thyroglobulin Antibodies (TGab).  You need both tests because both antibodies are indicative of Hashi's but some people only have one or the other, while some have both.
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