Is a thyroidectomy my best option?

[hashimotogirl21]

I have been dealing with thyroid problems for about the past 4 years now. I was told from one doctor that I had nodules and they were increasing in size with each sonogram I was having every 6 months. I was put on synthroid for 3 months but there were no changes so I was taken off.  I was also scheduled to have a biopsy last summer but when the doctor came to preform it he said that there was too much growth so no biopsy was done. I recently saw a new endocrinologist, where he said that there are no nodules but instead my throid is extremely enlarged. He also diagnosed me with Hashimoto's disease. My new doctor put me on Synthroid for 1 month to see if my thyroid would decrease in size and if not he suggested having my thyroid removed. I have been suffering from hair loss, weight gain, brittle nail, fatigue, depression, anixety, as well as difficulty swallowing. So my question is, is my best option to have my thyroid removed?

[gimel]

Your limited test results sure don't look normal to me.  Even though TSH is totally inadequate as the primary diagnostic for thyroid, your TSH is high that it is a good indicator that you are hypothyroid.  Also, your Free T4 appears to be too low.  Even if it is within the lower range limit, that is too low.  It needs to be around the middle, along with having Free T3 in the upper third of its range, or as necessary to relieve symptoms.  You don't even know what your Free T3 level is and it is the most important test to know.  Likely it needs to be in the upper third of its range.  Without ever a med dosage high enough to achieve those levels of Free T4 and Free T4, it is no wonder you are having hypo symptoms

As I suggested previously, "Seems to me that before considering surgery based on the info you gave above, the first priority should be to get you adequately tested to see where your thyroid hormone levels are.  Those tests should be Free T3 and Free T4 (not the same as Total T3 andT4).  Then based on those test results, your meds should be adjusted adequately to relieve your symptoms.  Depending on your current levels of Free T3 and Free T4, and how how fast your body can acclimate to increasing doses of thyroid med, getting to that point may take some time.  By then you should clearly know if your thyroid gland is responding to the meds or not."  

I strongly urge you to go back and request  tests for Free T3 and Free T4.  If the doctor resists, then you should insist on it and don't take no for an answer.  While there it would also be good to test for Vitamin A, D, B12 and ferritin.  When test results are available, then please post results and their reference ranges shown on the lab report and members will be glad to help interpret and advise further.

Keep in mind that a good thyroid doctor will treat a hypo patient clinically by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels.  Symptom relief should be all important, not just test results, and especially not just TSH results.  You can get some good insight into clinical treatment from this letter written by a good thyroid doctor for patients that he sometimes consults with from a distance after initial evaluation and tests.  The letter is then sent to the participating PCP of the patient to help guide treatment.  In the letter, please note the following statement, "the ultimate criterion for dose adjustment must always be the clinical response of the patient."

http://hormonerestoration.com/files/ThyroidPMD.pdf

[hashimotogirl21]

I put them into the tracker

[gimel]

Test results and reference ranges where?

[hashimotogirl21]

My levels have been pretty normal. I will input what test results I have into the graph. I have also had multiple thyroid sonograms where my thyroid has been increasing. I do not have the exact measurements though.

[gimel]

So you have been diagnosed with Hashimoto's, and put on some dose of Synthroid for 3 months, but no changes occurred and you were taken off the med.  So now you have a large thyroid gland (that could be due to inflammation related to the Hashi's).  And the new Endo wants to put you on Synthroid for a month and if the gland doesn't decrease, then he wants to remove it.  Meanwhile you have lots of hypo symptoms.

Seems to me that before considering surgery based on the info you gave above, the first priority should be to get you adequately tested to see where your thyroid hormone levels are.  Those tests should be Free T3 and Free T4 (not the same as Total T3 andT4).  Then based on those test results, your meds should be adjusted adequately to relieve your symptoms.  Depending on your current levels of Free T3 and Free T4, and how how fast your body can acclimate to increasing doses of thyroid med, getting to that point may take some time.  By then you should clearly know if your thyroid gland is responding to the meds or not.  

There are some other tests I want to mention, but first, please post the thyroid related tests that have already been done for you and their reference ranges shown on the lab report.