No - these are not typical symptoms of high TPO (autoimmune thyroid disease - Hashimoto's most likely) with normal TSH/T4/T3. If everything else is checking out normally though, sometimes a trial of low dose levothyroxine would be reasonable depending on current TSH (ie if >2.5-3 range).
It is important to determine the cause of the hyperthyroidism prior to starting treatment. It does not sound like a transient thyroiditis as it has evolved/worsened over 4 months - so it's either Graves' or toxic nodules. Would use carbimazole over PTU if she takes medications. Consider I-123 scan to help sort our cause first and may need ultraso...
If TSH is low-normal, then medications are not typically used as this can cause high/toxic thyroid levels.
Ultrasound may be appropriate; and if the goiter is truly growing rapidly in the setting of Hashimoto's, biopsy may be needed even if there is not a clear nodule.
Looks like mild hyperthyroidism. Assuming you aren't on thyroid meds for an underactive thyroid (in which case your dose is too high), would see an endocrinologist for this and also address the B12 level w/ the endo or your GP.
Would not recommend more I-131 at this point. The stimulated Tg of 22 is fairly high. Would consider another opinion at a specialty center for repeat neck ultrasound as often neck nodes are PET negative. The right lower trachea spot may be able to be seen on good ultrasound.
For the breast - would likely do mammo/US combo and see a breast specialist to ...
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