Goiter with Nodules

[Dreamcatcher69c]

I have had an enlarged thyroid for the last 3 yrs. There are at least 3 nodules that are neither hot nor cold per the last NM Scan. Over the last 6 months I have been experiencing hot flashes and cold sweats. At first they were not so bad, but now they are waking me at night at least once sometimes more. I am a 40 yo female, overweight(cannot seem to lose), and my TSH is usually below 1.0. My thyroid seems to be growing as well. Sometimes I am so tired and then when it is time for bed, I cannot sleep. What tests should I have run? My ARNP tends to just run my TSH which is always on the low end of the normal range. She then insits there is no reason to run other tests. Please help!

[TamraW]

Hubby is retired military. We use Tricare Prime. I went to my patient advocate in the hospital where I had my first two lousy endos who said nothing was wrong with my thyroid. My advocate helped me get an appointment with an endo off base.

New endo fumbled around with my goiter/nodules for four months until the wonderful people on this forum told me to request the thryoid tests I mentioned.

Then we discovered Hashimoto's because of my elevated TPOab.

Now, I'm with an endo who actually knows how to treat my disease. 75 percent of his patients are thyroid. Of course, our insurance doesn't cover him, so I'm doing what Tricare calls 'point of service' where they pay 50 percent, less a $300 deductible. I called Tricare and they said I didn't need approval to do point of service.

It is worth it to have a doc who actually knows how to treat me.

:) Tamra

[Dreamcatcher69c]

Thanks so much. I am going to call her today. Unfortunately I use the Veterans Administration for my health care and nothing is "simple" with them. I appreciate your advise. I just wish I could go to an Endo who specializes in Thyroid Disorders.

[TamraW]

Blood tets
TSH
FT4
FT3
TGab  and TPOab for thyroid antibodies to determine if you have an auto-immune thyroid disease causing this.

Also, I suggest testing the pituitary gland to see why it's not producing a lot of TSH, yet you appear to be hypo. Also, if you have an auto-immune disease like Hashimoto's causing this goiter and nodules, please note that Hashis swing from hyper to hypo early on in the disease, so our TSH will also swing high to low. This is why TSH should never be the only test in determining thyroid disease.

Your doc needs to be aware that we are all different. TSH is a pituitary hormone and doesn't always indicate exactly what our thryoids are doing. I would really look for another doc.

I suggest calling the endocrinologist's office and asking how many thyroid patients this endo treats. Too many specialize in diabetes, and don't know enough about thryoid.

This site lists recommended thyroid docs.
http://www.thyroid-info.com/topdrs/

:) Tamra