Had my TSH level tested and Dr. said it was 21. Was not informed of having anything else tested or number just that. So she sent me to have an ultra sound. I have moved since and was not able to see Dr. for results but sent off for my report. I won't be able to see a Dr. Till March due to new insurance not kicking in until then. My report statesRight lobe measures 4.8 x 1.4 x 2.2 cm. Left lobe measures 4.5 x 1.3 x 1.8 cm. Thyroid echotexture is heterogeneous but no discrete nodules are seen. the ghyroid isthmus measures 0.3 in AP dimension. Thyroid parenchyma is diffusely hypervascular. Can you tell me what this means and maybe what my next step may be when I finally can see a Dr.?
I'm not seeing anything extraordinary with the ultra sound report. At the end of the report, there should be a section that says something about "conclusion" or recommended follow up........
With a TSH of 21, I'd expect you to have symptoms of hypothyroidism. What, if any, symptoms do you have?
You should also have been tested for Free T3 and Free T4, which are the actual thyroid hormones; if your doctor didn't do those and/or refuses to do them, you should start looking immediately for a different doctor, since any doctor who diagnoses/treats, based on TSH will keep you ill.
Are you currently on a thyroid replacement medication? If so, which one, what dosage and for how long have you been on it?
The ultrasound indicates inflammatory condition (rough structure of a tissue and increased blood flow)
The volume (Brunn method) of the gland is approx. 12.5 cu cm (average 7.5cu cm; maximum normal limit 18cu cm
I have extreme fatigue, sensitivity to cold, constipation, very dry skin (feels like it is inside not outside on the skin, driving me crazy), weight gain, hoarseness, muscle aches, tenderness and stiffness and stiffness in joints.
All I was told was my TSH level. Not told if she tested T3 and T4 also. After telling me the TSH level (21) she ordered the ultrasound. Like I said since then I haven't seen her. I tried getting in before I moved and she was booked out to long and the nurse said the Dr wouldn't start treatment even if I saw her since I was leaving real soon and would not be able to follow up. She said I would have to keep coming in every 6 weeks to have labs drawn and adjust medication. So now that I have moved and my insurance doesn't kick in until March I have not been treated still so I am not on anything. I would like to see an Endrocrinologist but there is none for many miles so looks like I will have to stick to a Family practice Dr.
Report just tells the findings but no summery or follow up recommendations. Impression says "Nonspecific and could relate to various types of thyroiditis as well as some infiltrative processes."
In my opinion, your doctor was very remiss in not starting you on a medication, in spite of the fact that you would be moving. She should have started you on medication, with instructions to get another doctor and get tested again in 6 weeks.
You really need to get Free T3 and Free T4 tested and get on medication, even if your insurance doesn't kick in until March. If you find a doctor, many of them will give a discount if you pay in cash, at the time of service; or you can go to a walk-in clinic, which often have less expensive rates.
If you can't afford further labs, you might consider going to an online site, such as healthcheckusa, which is a web site from which you can order tests, then they send you to a local lab (usually a national chain lab) for the blood draw and in a couple of days, send you the lab report. For approximately $85, you can get a TSH, Free T3 and Free T4. A copy of these could then be taken to a doctor to get a prescription.
You will need to get antibody tests done, but as 898_1 says, your ultra sound indicates inflammation, which could likely be due to Hashimoto's Thyroiditis, which is the most common cause of hypothyroidism in the developed world.
Your symptoms will only continue to get worse, until you get on medication, and the longer you let it go, the harder it will be to get under control.
You don't necessarily need an endo; many pcp's are just as good. Just make sure get one who will do the Free T3 and Free T4 "every" time they test TSH. You can pre-interview doctors, usually through a nurse, or office manager, to find out what tests they routinely perform and which medications they are open to prescribing.
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