Thyroid Ultrasound Results

Hi,
I am a 20 year old female who has a 3 year old child. I recently had a thyroid untrasound done because, on palpation, my thyroid felt slightly enlarged. I also had labwork done, including a TSH.
My TSH was 2.07.
My thyroid ultrasound results were as follows: Right Thyroid Lobe: 5.2 x 1.6 x 1.3 cm. Left Thyroid Lobe: 4.6 x 1.8x 1.1 cm. Isthmus: 2 mm. "The thyroid gland is in the upper limits of normal for size and diffusley heterogenous in echotexture. No focal lesions are noted. No other sonographic abnormalities are seen."
I also have a history of depression and am taking 20 mg of Lexapro daily, I have fatigue on a daily basis, I lost 20 pounds about a year and a half ago during a severe bout of depression, only to gain it back in a 3-4 month time period earlier this year, and generally I feel like doing nothing at all. I am wondering what the results of my thyroid ultrasound indicate, although my TSH is normal?

Thanks for your time,
Hannah

[cbb1967]

Hi Hannah,

I can sympathize with you.  I am a 47 year old female with a 3 year old child (I also have 8, 24, and 27 year old children).  I have a large nodule (4.5 cm or so) on each side of my thyroid, with a small one also on the right side.  I have been extremely fatigued for a couple of months, with a cough for about 6 months.  I have been out of breath for about a month, so I finally addressed my symptoms.  My TSH levels are normal.  I will see an ENT today to find out the next step.  Have you been referred to anyone else, maybe for a needle biopsy?  I'm hoping that's what they will do to me, as the radiologist said if it were his thyroid he would want it biopsied asap.  We'll see, but I need to have something done.  It's hard with no energy and a 3 year old, huh?  BTW, I also take medication daily, but mine is Celexa 20mg.  I began taking it for anxiety about a year ago.  Was on Lexapro 10mg, but switched due to cost/insurance.

I hope you will pursue your thyroid symptoms and keep us updated.

Take care,
Carol

[vz562]

it is normal for thyroid to enlarge during the pregnancy

[HannahMonica]

The doctor said the only abnormality is the size, but it is still within normal limits, so we will just keep an eye, and re-do the unltrasound in 1 year.

I was more concerned about the term "diffusely heterogenous", but who know?! So, as for the fatigue...i don't know.

[vz562]

diffusely heterogenous roughly means "coarse-grained"

[TamraW]

Sometimes women develop temporary thyroiditis after birthing. Sometimes, women develop permanent thyroiditis after birthing.

Hannah, your TSH is actually considered hypo by many experienced endocrinologists. I wouldn't doubt if it climbs higher in the next few years. Your thyroid sounds like it is inflamed. If your child is three, then any thyroiditis after pregnancy should have resolved.

I developed many issues after birthing my child. She is now six, and we recently discovered I have Hashimoto's, despite the fact that my TSH only reached 2.74.

If you have a TSH over 2, plus hypo symptoms, plus enlarged thyroid, then more thyroid testing is required.

I suggest the FreeT3 and FreeT4 tests to determine your active thyroid levels. Remember, TSH is a pituitary hormone, and isn't always efficient in diagnosing thyroid disease. The frees are the most direct route of measuring your thyroid hormone.  

Also, get the TGab and TPOab antibody tests to see if Hashimoto's is causing your thyroid to swell (very common in Hashi) and to see if Hashi is also causing that TSH to climb and your symptoms. People with Hashi lose and gain sporadically during the first few years of Hashimoto's as the thyroid and antibodies duke it out. We also swing form depression to anxiety, constipation to diarrhea, fatigue to rapid heart rate, etc. It is not uncommon for TSH to swing back and forth during Hashimoto's, which is why TSH is not the best indicator for thyroid disease.

:) Tamra

[TamraW]

Also, read the article below about treating Hashimoto's in the early stages:

http://thyroid.about.com/od/hypothyroidismhashimotos/a/preventative.htm

My endo would have put you on thyroid hormone with a TSH over 2.0. If you do get treatment, then you may find you no longer need depression drugs and you could have more energy. You NEED to get these tests pronto. If you do have thyroid disease, the longer you wait, the worse it gets. I am feeling much improved since taking thyroid hormone.

:) Tamra

[HannahMonica]

I was definatley expecting further testing, T3 T4, etc after recieving the results, but the doc swears everything is fine and we just need to keep an eye on things, i.e. another US in a year...I do, however want to get more labwork done for the many reasons stated in the several responses...sounds like I'm going to have to go to bat with these docs to get further testing done! Thanks guys!