My thyroid panel results. Please give me some input.

[Guppy70]

I drove to an independent lab last monday to have a thyroid panel done. It came back yesterday;

TSH: 0.12 (0.40 - 4.00)
FT3: 4.6 (2.3 - 5.0)
FT4: 1.12 (0.80 - 1.76)
TPO ab: 10 (0 - 34)

I've had symptoms over two years now, the past year the worst. I've been having major sweats, night sweats, depression, severe anxiety, severe insomnia, hair loss, dry skin, wrinkly toes and fingers, no interest in former interests (just sitting on the couch since last June, haven't seen any of my friends since then, they all think I fell off the planet) fatigue, lethargy, can't exercise anymore (I used to be a 10+ year avid daily runner, I haven't ran for over 1 year) I feel my heartbeat, it feels like it's pounding in my chest and it sometimes jolts inside my chest. Feels disgusting. And many more weird symptoms.

I don't know what to make of this, the FT3 and FT4 is all within its range. But the TSH is obviously way too low.
I also have a lump on the left side of my lower neck, where the thyroid is.
It started a few weeks ago, I woke up with pain in my neck but I thought that was because I've been laying weird with my head. After I started feeling in the neck I felt the lump and I think it has gotten bigger in just a short time.

My grand mom had a toxic nodule and had her thyroid removed in 1969.  My mom had thyroid symptoms and a lump, biopsy showed it was "struma" and she never needed meds, her symptoms went away on its own.
And my younger sister has just recently been diagnosed with Graves disease. She's now on meds to get her levels down then she will have surgery to remove her thyroid.

I'm scared. I guess I'm mostly scared that the lump is cancer. If I read online, all the symptoms sounds like thyroid cancer. And I'm scared my doctor won't react.
But on the other hand, I'm happy, because it looks like I acctually have something wrong on my thyroid, I'm not just crazy in my head. And I'm trying to focus on that now I can do something about it and become my old self again.

Is there anyone here that recognize my labs and symptoms? What did you get diagnosed with? Did you get better?
Thank you for reading!

[goolarra]

I agree; you don't want to shock your poor tummy too much.

[Guppy70]

Thank you goolarra! Honestly, I would welcome having a little bit of the runs for a while, I've been dropping bricks once a week for so long now, lol. I hate being constipated.
But I think I will have to go slow though, making myself getting used to fill up my stomach again. :)

[goolarra]

Congratulations on the good news!  I hope you get a prompt appointment with the endo.  

Sounds like you may never get out of the bathroom tomorrow!  LOL

[Guppy70]

I just came back from the ENT doctors visit! I was so nervous I was shaking. But, he said he didn't think it was cancer, he was fairly certain it was a hot nodule. It wasn't very big either, he said about 1 cm.
And he said that sometimes they burn themselves out and I might be given meds to get my levels down.
He's faxing my doctor his findings because now I need to go see an endo doc. So my PCP will need to do the refferal. He said I most likely will need a isotopic scan to determine wether it's hot or cold.
I'm applying right now for Medicaid which I'm sure I'll be accepted to. I hope I can get helped, fast. All I want is to go on with my life and to be able to work.
At least I'm so happy I haven't imagined everything, that I'm just not a psycho nervous wreck. Now I can blame my craziness on my stupid and uncooperative thyroid, lol.

I will go to the grocery store today and buy tons of greens and fruits, my Nutribullet will start to work hard tonight. :)

[goolarra]

Well, it's always a good idea to improve your diet if you recognize that it's lacking.  It's just that "improve" and g/f, s/f, d/f, etc. aren't always synonymous.  I like Michael Pollen's very simple philosophy on food.  1-Don't eat anything your great grandmother (or somebody's great grandmother, somewhere in the world) wouldn't have recognized as food.  2-Eat a well balanced diet, mostly, but not exclusively, plants.

Thyroid cancer can cause hypo or hyper, but it often has no symptoms.  I have a neighbor who had a car accident and hurt her neck.  Her thyca was picked up on the neck CT.  Until then, she had had no symptoms whatsoever.  

LOTS of other reasons for both hypo and hyper...  Let me know what your ENT has to say.

[Guppy70]

Goolarra, yes, I was disappointed after those six weeks gluten free. I had hoped to at least get some more energy, but nothing.

But I know I do need to eat better. Well, to just eat. And I want to fill my body with healthy stuff like greens and fruits and clean proteins. I don't eat junk food either, I just don't eat enough. When my kids are here I'm forced to cook so then I eat much better.
I'm going to start juicing, I have a Nutribullet that's awesome. And I'm going to use organic produce. And on top of that eat as much chicken and fish as I can. And nuts, youghurts and so on. I'm desperate.

So I'm going to the ENT tomorrow hoping to get more answers. I'm not sure I'm prepared to hear them, that's all.
Can thyroid cancers cause hypo and/or hyper? Gaaaahhh! Sorry, now I'm just rambling but I tend to do that when nervous. :)

[goolarra]

Going gluten free doesn't help everyone with a thyroid disease.  I went gluten free several years ago for reasons other than thyroid.  I didn't expect it to do anything for my Hashi's, and it didn't.  There are different protocols out there that claim to LOWER antibodies with a gluten free, sugar free, dairy free, etc. diet.  There is no cure for autoimmune thyroid disease, so if the book claims to cure Hashi's, I'd be very suspicious of it.  There's a lot of discussion on this subject if you want to explore the archives.

Graves' will often go into remission.  However, I've been on this forum since 2008, and I am yet to hear the first person say that Hashi's went into remission.  My advice on the g/f, s/f, d/f diet is that if it makes you feels better, then by all means pursue it.  If it doesn't and you're just doing it in hopes of improving your thyroid condition, you are probably going to be very disappointed.  You said you tried g/f and it had absolutely no effect...    

[Guppy70]

I acctually went completely gluten free last fall, for 6 whole weeks. My mom has gluten intolerance so I thought my symptoms then might be because of that. But it didn't do any difference at all. But, I did still get sugar in my diet. I'm going to juice a lot of greens and fruits, avoid all sugars and gluten again. Do you know if coconut sugar is ok? Bees honey?
I'm not really hungry or longing for anything anyways, so it'll be easy.

I can go for days not eating much at all. I cant eat anything in the am. One sandwich and an apple or a banana in the evening is all. Still my weight is the same as it always been..
But that can be because I feel depressed also.

One thing I've noticed also is that I hardly have to shave my legs and armpits these days. As to before I had to shave them daily.
I still have my eyebrows, but the ends have "chops" in them, as if tiny parts are missing.

I have no health insurance so this is stressful and scary because of that part too. I'm scared what the ENT will charge tomorrow. And what a possible biopsy will cost and so on. And then all the lifelong Rx's...

Thank you tgirlnc for your support! :)

[tgirlnc]

I am sorry that you are having such a hard time and I completely empathize.  If your sister has Graves and your grandmother had a toxic nodule, sounds like there is a lot of connected history with thyroid issues (I am sorry and I can relate).  That said autoimmune is genetic and if your sister has an autoimmune, chances are that you have an autoimmune as well (may or may not be the same one).  It is definitely like chasing a ghost...and diet is an essential area to address.  If you haven't already, I would cut out gluten and sugar immediately (I know it's hard, but totally worth it...they are highly inflammatory elements to the body)....and ask the doctor to do bloodwork for autoimmune markers (graves, hashi, and others).  
Also, with your sister having graves, have her check out Elaine Moore's website and information (Sorry for repeat, but Elaine and her website truly saved me).  Endos and most US doctors do not know how to treat Graves at ALL....and they tend to over medicate and recommend radio active iodine as a go-to treatment (which you should NEVER do unless it is a last resort and anti-thyroid meds or natural treatments do not work)..because especially with Graves your thyroid's overactivity is a victim of the autoimmune trigger (which is the "ghost"...)...but many have put themselves in remission with diet, supplements (minerals and vitamins)..and lifestyle changes (removing toxins, stress etc.)..same goes for Hashi.
All the best to you and let me know if I can be of further help.

[Guppy70]

tgirlnc, thank you for your post! Sounds aweful, I hope that you're doing great now though!
And wow, I didn't know your thyroid could get both Graves and Hashimotos, must be the worlds most miserable double-whammy.
I hope I'll get to go to the bottom with this, and soon.

My sister who is diagnosed with Graves, went to her doctor because she thought she needed antidepressants. She has gotten so anxious and antsy. Luckily, for her, her doctor gave her some pills but he also said let's just do a blood test and check your thyroid. And the rest is history.

I just ordered a book from a woman who cured her Hashimotos in 3 months with a clean diet. She doesn't even need meds. I'm a firm believer that our diet influences our well-being completely so I'm going to try it.

I woke up this morning again with a terrible pain in my neck lump. It seems to hurt more and more. The pain was gone when I went to bed but that's because I took ibuprofen. I had to get up and take two pills again and now it feels better again.
Luckily they called from my doctor and I'm going in to the ENT Thursday, tomorrow morning.

[tgirlnc]

I would get tested for Graves antibodies as well.  I have Graves and my TSH is often WAAAY off from my FT4 and FT3 and eye bulging is often an indicator of Graves. Before I was diagnosed...I had the same symptoms- I had no energy, was depressed...couldn't tolerate heat..it was awful and I had no idea what was going on, until I took my pulse and it was 136 resting (why I was so tired and sleep was so hard).  Also, one can have Graves and Hashi at the same time (I have a friend who has both and goes from one end of spectrum to the other). If you haven't already done so, I would immediately de-stress your life as much as possible and start eating as clean, organic and natural as possible.  
Also, look up Elaine Moore- she is an expert in Thyroid disorders-primarily Graves and her website is a wealth of knowledge..it has literally saved me! Lastly, the other person who posted is ABSOLUTELY RIGHT- you must be your own advocate, I have gone through at least 4 doctors in 2 years.  They have a very narrow scope of treatment and understanding of thyroid....and if you do have Hashi or Graves both are autoimmune diseases and need to be addressed as such and not thyroid disorders as most doctors would have you do.  If you are in an area of the country with a good integrative doctor- I would make an appointment STAT!  

[Guppy70]

Yes, they might have always been uneven, just that I reacted when my daughter exclaimed how much smaller one is to the other. I think I'm on the edge right now. I think I'm starting to see thyroid in everything, lol.

An ENT should be good in figuring out lumps in the neck, I hope I can get in soon.
I'll keep you posted, hopefully with good news! :)

[goolarra]

Are you sure your eyes haven't always been different from each other?  I have two very different eyes, always have.  One is bigger and much more "open" than the other.  This shows up especially in photos.  As I get older, I'm developing my grandmother's droopy eyelids, which only makes it even more apparent.  

I'm sorry you're discouraged, but you're being referred to an ENT, and that's a good thing.  Patience, patience...this will take a little time...

[Guppy70]

So I've been to the doctor today. He is referring me to an ENT for evaluation of my neck lump. And he also thought we needed to have the thyroid panel redone again, I'm not sure when.

I hope this ENT doc can help me further. I just want to start living again.

One funny thing is, my daughter said yesterday that "mom, one of your eyes is smaller than the other". I never mentioned this to the doctor, but now I do notice it myself. And I've been taking photos of my face with my iPhone and it's very obvious that way. Then I googled it and it does come up as a Graves symptom.
God, I'm gonna turn into a cave troll before I'm getting to the bottom with this. Right now I just want to cry and pull out the few hairs I have left out of desperation.
I'm reading about people with Hashimotos, where they go undiagnosed for 20+ years because their numbers aren't "that bad".
Sorry, but I'm having a bad day and needed to vent. :)

[goolarra]

Most of us who have Hashi's are TPOab positive, but some are only TGab positive and some are both.  I got lucky and have both the little nasties...

I can identify with it never being simple.  Most of us got to this forum because it wasn't simple.  

Good luck in the morning, and I'll be anxious to hear how you do...  

[Guppy70]

Lol, yea, I can't be called a clean freak these days...:)

My TPO ab was 10 (0-34) but I will say I want the other ab tests done too.
Hashi's makes a lot of sense, at least now when I'm having these hyper symptoms as well.

I'm going in tomorrow morning (sooo nervous) and I will let you know what my doctor says.

I woke up this morning too (early) with a huge pain in my neck (lump area) and I haven't touched that little nasty thing at all since you told me. So something's definitely up there. And everywhere. Boy, this whole thing is driving me crazy. But, of course I'm sure it's going to be real complicated. It's never just simple with me...:)

[goolarra]

Thyroids are a little irregular, and nodules are very common.  They come and go.  

You're right that thyroid dysfunction is not well understood by the medical community.  You have to be prepared to be your own advocate and learn as much as you can so you can help manage your own disease.  However, if you're in control, you will find the care you need.  At this point, I pretty much drive my treatment; my endo just writes the scripts...  

You can see that both FT3 and FT4 have gone up and TSH has gone down considerably in the past year.  It's a good idea to take those with you to the doctor so you can compare them.  

Well, it's good you've been cured of being a clean freak.  Clean freaks make the rest of us look really, really bad!  LOL

I think I forgot to mention above that it might be a good idea to be tested for Hashi's, too, just in case.  The two antibody markers of Hashi's are TPOab (thyroid peroxidase antibodies) and TGab (thyroglobulin antibodies).  While Hashi's is ultimately hypo, early stages can be characterized by swings from hypo to hyper.  It's always good to rule out as much as you can on one blood draw.

[Guppy70]

I went to the same lab last year, April, as well. Since I didn't feel well. I'm going to post those results too;

TSH: 1,10 (0,40 - 4,0)
FT3: 3,4 (2,3 - 5,0)
FT4: 0,92 (0,89 - 1,76)

My sweats didn't start around June-July sometime. They came several times an hour, like a wave. It felt like the skin under my breasts turned 120 degrees, it lasted for about a minute and left me dripping in sweat. I also had (still have, but not as severe) night sweats where I woke up drenched. So bad I had to change clothes and get a bath towel to put over the sheet.

My horrible sweats went away pretty much completely in December of last year and that was the same time my hair stopped falling out (I was losing 400+ hairs a day, my kids told me I had bald spots on top of my head)

But now, since a few months back both the day and night sweats have come back. Just not as strong as last year. I feel it when it's coming, when it's "going on" but it doesn't make me feel like I'm burning up and it doesn't leave me drenched. Just clammy.

My hair doesn't fall out like before and it has grown back in, no more bald spots, but it's still very, very thin.

The lethargy I'm feeling is crippling. I "want" to do so much, but I can't. I used to enjoy so many things, now I don't even listen to music anymore. I hardly clean my house, and I used to be the biggest clean freak ever.

It feels like I just sit on the couch and watch on my Facebook how everyone else are living their life to the fullest, how they grow, get promoted, get relationships. And I'm still, a year later stuck on my couch.

If I'm depressed it's only because of this, how pathetic my life has become.

So, my labs last year were all within their range. TSH was perfect. But, both FT3 and FT4 are pretty low within their range. I thought I'm just going to show them here. And I will bring them to my doctor too next week.

[Guppy70]

Thank you for explaining, it makes perfect sense. Hopefully the "lump" is just irritation and nothing more. I don't want to go through biopsy and other investigations, not to mention surgery. But it's just that the other side doesn't feel like that at all, but maybe the thyroid is a little irregular, naturally?

But I still hope there's something that's "off", that I can easily fix so I can feel healthy enough to live my life again.
It all pretty much started after I had a hysterectomy 2+ years ago (left one ovary) I've been thinking it might be menopause but it's just so severe in nature. I just can't function, I can't work, I can't do anything.

Yes, I think I'm tired because I sleep so poorly. If I try to take a nap during the day my mind keeps on racing and I can't find peace. If I manage to drift off I always startle awake after 15-20 minutes, like in panic.

I have read so many horror stories about people who never get to feel better again, even with treatments and that too many doctors lack knowledge and understanding of the endocrine system and they get sent home with antidepressants even when their numbers are clearly off and they have long laundry lists of symptoms.

I feel better though in that sense I'm not too worried it might be cancer anymore after your explanations. And that's priceless to me. :)

[goolarra]

Are you tired due to insomnia, but too antsy to sit down?  You have to keep moving?

It might take a few days for the irritation to go away.  The pain might originally have been caused by the way you slept on your neck, but then you started "exploring" it and making it more irritated???

Yes, they're toxic because they produce too much hormone.  What should happen is the pituitary checks thyroid hormone levels in your blood.  It evaluates those levels, and if they're too low, it puts out a little TSH to stimulate your thyroid to make T4.  If the level is just right or too high, it doesn't put out any TSH.  So, the pituitary controls your thyroid hormone levels using TSH.

A toxic nodule is kind of like a mini thyroid within your thyroid.  Usually, the thyroid produces a lot of T4 and a very little bit of T3.  T3 is made elsewhere in your body by converting T4 to T3.  However, when you have a toxic nodule, it produces mostly T3, and it doesn't need TSH to do it.  So, your pituitary no longer has control of your hormone levels.  The nodule can just keep "dumping" hormones into your blood stream.      

[Guppy70]

seal ling = swallow (auto correct...)

[Guppy70]

Again, thank you for taking time replying to me! :)

I've been reading about hot and cold nodules, and about Plummers disease. It sounds like me, except I have a lot of hypo symptoms as well. Like I'm not hungry at all but still don't lose a pound even if I hardly eat. I'm chronically constipated since over one year now (which is a pain in itself)
But at the same time I have these hard and fast heart beats, anxiety almost like panic attacs and a wired feeling. I'm too tired to do anything but it feels aweful to just sit down.

Those nodules can start to produce thyroid hormones as well (?) and make so that too much is in the system.

I haven't touched the lump since I read your advice but I still feel it when I'm seal ling, but that can perhaps be due to prior touching.

But, it started out of the blue, the pain. I thought first it was because I've stretched the neck ligaments while sleeping. And I had to take ibuprophen to make it go away.
Now I've had a raging head ache for a few days and keep on eating ibuprofen, but that can be due to stress of this whole thing.

Please tell me more about toxic nodules. So, they are "toxic" because too much hormones is not good for the body?

[goolarra]

Last time I saw my endo, who is very gentle, he felt a nodule.  He had a student with him, and she took her turn checking it out.  She was not as gentle, and by the time she'd finished jabbing at my neck, my neck actually DID hurt!  Of course, after that, I had to feel around myself...never did feel the nodule, but I made my neck sore.  I had an U/S a while later, and whatever it was had disappeared.  

TSH is very variable.  It can change as much as 70% just by what time of day the blood is drawn.  So, it could very well be back in range.  However, your FT3 is also high.  And it's your FT3 that is concerning more than your TSH.  

I can tell you've been doing some reading.  Do you understand how a toxic nodule works?  If not, I'll be happy to explain.

[Guppy70]

Goolarra, thank you so much for answering!

Yes...I'm guilty for keeping on touching my lump, haha. I had no idea that can effect it, make it bigger. So I have stopped now, immediately.

So can my low TSH level be a fluke and perhaps be normal, say next week? Can it be out of whack because I've touched the lump too much?

I'm going to my doc on Monday,I'm almost certain he wants to redo all the tests. I'm going to be certain to ask for the tsi ab too.

Thank you also for making me feel better about the lump being cancer or not. I know I should just stop Googling. It just makes me more sweaty and nervous than I'm already am.