I am new to this forum and am just looking for some information to be informed when I speak with my doctor.
I was referred to an endocrinologist because my primary physician felt a small nodule on my thyroid, along with enlarged lymph nodes. I have always had larger lymph nodes and they become very prominate when I get sick. My sister had thyroid cancer and had her thyroid removed, along with radioactive iodine treatment years ago.
They did an ultrasound on the nodule and said it was very small, 5 mm on my right lobe. They also ran labs on me and they came back as follows:
TSH 1.43 mU/L Normal Range 0.45-4.50
T4 Free 0.8 ng/dL Normal Range 0.8-1.7
TPO-Ab 11 IU/mL Normal Range <35
They ran other labs, I have extremely high cholesterol (but I'm breastdfeeding so it can't be treated yet) and a borderline high A1c. (I also had GD with my last 3 pregnancies.)
I had a follow up this week and they did another ultrasound on my thyroid and the nodule is still there but I don't know its size and had lab work done but waiting on the results.
I am a 40 year old woman and have a family history of hypertension, heart disease, diabetes and thyroid cancer.
Symptoms I have been having are:
Fertility issues (went through IVF to conceive and maintain pregnancy but did not have fertility problems when I was younger)
Struggle with weight loss (have been dieting and doing the Insanity workout with little change)
Hair loss (I had a baby 10 months ago so attributed that to hormones but it has not slowed and my hair is very thin now)
Fatigue (Again, attributed symptom as part of having a baby, but I struggle throughout the day)
Hot flashes (Maybe just getting older and hormones?)
Depression and stress (Could be due to hormones?)
Joint pain (Could be because of getting older and doing Insanity workout?)
I have always felt relatively healthy but I am getting older so maybe some of these symptoms can be explained because of that. I am doing what I can to be healthy by dieting and exercising, with the exception of my cholesterol which will ultimately need to be controlled by medication (Its over 300).
Should I be concerned with my Free T4 being at the very lowest end of normal? Should I ask for more or different blood work? Should I be worried about the small nodule since my sister had thyroid cancer? It seems as my doctor ushers me in, talks about 2 minutes and says, "I'll see you in 6 months."
Help! I am a little of a control freak and am very lost.
Hi there........... sounds like you have several things going on at once.
Yes, you should be concerned about the low FT4. You should ask for a Free T3 test. FT3 is the hormone that actually enters the cells. FT4 has to be converted to FT3, so with the low FT4, we can only guess that your FT3 might be very low in the range (or below), as well. Low FT3 and FT4 can/will cause many of your symptoms, including high cholesterol and depression (both are symptoms of hypothyroidism).
The weight gain is also a hypo issue, but it can also be attributed to possible insulin resistance (pre-diabetes) as noted with the borderline A1c, as well as reproductive hormone fluctuations. A low glycemic diet will help prevent full blow diabetes and should also help with the weight issue. I'm fighting that, myself, right now.
There's another thyroid antibody test you should ask for, as well. That's Thyroglobulin Antibodies (TGab). Both TPOab and TGab are markers for Hashimoto's, and some people have one or the other, some people have both. If not tested for both of them, the diagnosis can be missed. Your TPOab indicates that you do not have Hashimoto's, but you still might, because we don't know if you carry the TGab.
I'm not sure I'd stress a lot about the thyroid nodule. Many/most of us on the forum have nodules and they need only to be watched. They become a problem when their characteristics change or they begin growing faster. It should, however, be checked regularly to make sure it's remaining constant.
Thank you Barb for replying. I am already on a low glycemic diet, as I've had GD with my pregnancies and have kept with the diet. Which helps in general and I am following a lower caloric diet. I was told by a dietician while having gestational diabetes to follow a specific diet and have continued with it since having the baby.
I wasn't overly concerned with the nodule, my only concern is my family history.
I will ask about the other tests. Thank you so much for the information. Good luck to you!
Good that you're already on the low GI diet; it's kind of hard to get used to, at least for me.
Family history is always something to be concerned about, but it's really odd how things work, sometimes, with one family member getting a certain disease, while others won't. When there's a family history of certain conditions, they always bear watching.
I have had hashimotos thyroid disease since I was 21. I am now 39 and still struggle with symptoms of the disease. Even with normal range of your blood work you can still have thyroid symptoms and problems especially since you have a nodule, which means something isn't right with your thyroid. I had a nodule and because of the hashimotos they couldn't tell if it was cancerous or not and I opted to have it removed. The same day they found the nodule, they discovered I was pregnant too, and so I had to wait ten months before they removed it. I have had such a struggle with this and I pray that you won't. They have learned more about the thyroid in the last few years, but there is still so much they don't know. I opted for natural thyroid treatment and it has helped me so much more than the synthetic thyroid ever has. I take bovine thyroid I get from my natural pathologist, and it is amazing. but everyone has to learn what works best for them. I hope your nodule turns out to be nothing. Good luck to you, and if you ever need more knowledge about the thyroid there are some great books out there. And congratulations on your little baby!
Hashimoto's, itself, doesn't cause the symptoms; the symptoms are from the resulting hypothyroidism, so if you're still experiencing symptoms, with "normal" hormone levels, that would indicate that your thyroid hormone levels are not right for you. Just because levels are "in range" doesn't mean they're right for you.
Please post your actual FT3/FT4 levels (with reference ranges, which have to be posted with results), so members can better assess your situation.
I'm curious as to the content of your bovine hormone therapy. Most NDT (natural desiccated thyroid) med, such as Armour, NatureThroid, etc comes from pigs. Is your med a script that can be purchased from most pharmacies, or can you only get it from your natural pathologist?
Thyroid nodules are very common with Hashimoto's and < 5% of them turn out to be anything to worry about. I, personally, have multiple nodules on my thyroid. It's very rare to have a thyroid removed because of a single nodule, unless cancer has been diagnosed.
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