The important part of following Graves on medications like neomercazole (anti-thyroid medication) is to monitor levels closely (every 4-6 weeks initially) and to pay more attention to T4 and T3 in the beginning as the TSH may take months to increase into normal range -- as the T4 and T3 normalize, the dose is decreased (tapered).
Obese patients can get Graves and there is not always weight loss. The Free T4 looks to be high-normal but the TT3 may be low-normal -- would need to look at reference range for that lab specifically. TPO is not specific for Graves, would suggest confirmation with TSI blood test and or I-123 uptake scan.
These are essentially normal thyroid labs with no evidence of thyroid dysfunction (normal TSH) and a borderline elevated TG antibody. Would usually check TPO antibody as well and if there is thyroid enlargement or a lump, an ultrasound of the thyroid to make sure no nodules.
You should see an endocrinologist for complete evaluation and treatment. Thyroid problems can effect fertility and menses but if corrected, pregnancy is still possible. Usually we correct the Graves with anti-thyroid medications (methimazole) or surgery or radioactive iodine. Once confirmed stable then resume trying for pregnancy if appropriate. Graves Fou...
If the PET scan showed the 1.3cm nodule to be a focal area of increased uptake then the risk of cancer for that nodule is 30-40% and FNA biopsy is recommended. The 7mm and 6mm nodules can likely be watched over time. The thyroid blood tests generally do not predict benign vs cancer for nodules.
Depending on the ultrasound characteristics, symptoms and risk factors, sometimes we elect to observe nodules with indeterminate FNA results. Other times another FNA with molecular marker (genetic) testing might help further risk stratify the concern for cancer. On average, 20-25% of these are cancer but with a small nodule, 1.7cm, it may be worth discussin...
The CT will help determine the extent of the thyroid enlargement as well as the impact on neighboring structures (trachea, esophagus, etc). Goiter is not usually cancer but this should be evaluated with ultrasound and FNA biopsy of any worrisome nodule. Would also test thyroid function - TSH, T4 and possibly TPO antibodies if you have goiter.
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