Thyroid test with TSH of 0.01

[katbid]

Hi,
I had a third generation thyroid test done and my results are:
TSH 0.01                      Refer Range is 0.40-4.50
T4 Thyroxin Total: 10.6   Reference range is 4.5-12.5
Free T4 Index:  3.5         Reference range is 1.4-3.8
T4 Free: 1.2                  Reference range is 0.8-1.8
T3 Uptake: 33               Reference range is 22-35
FSH: 6.0

I had a repeat test after 6 weeks and got the same results. Can this mean an adrenal problem?

I am 45 years old and had a hysterectomy 6 weeks ago.  Unfortunatley I had the hysterectomy before I had my repeat lab work.  anyway my symptoms are:
very tired
stay cold
crazy weight gain
insomnia
low blood pressure
sore and stiff bones and muscels... now taking steroids for my neck....
sweating unexpectaly
fatigued all the time
tingling on the right side of my face..... have had CT and Xray showing normal...
anxiety

My hysterectomy was a partial and I'm not menopausal yet.

What can all this mean?  I'm confussed by what I have read on the internet.  From what I have read, I should be loosing weight.

I have been referred to an endo.

Thanks

[rumpled]

That TSH is like mine - and I have had pituitary surgery. That indicates a pituitary issue.

You may as well have Hashimoto's (I do too!) and nodules (me too!) but he really really needs to look up and check out the pituitary. Something is up up there! Yooohoo doctor! At least run a couple tests.

[katbid]

okay I made a mistake.  It is called hashitoxicosis.  he was throwing so many words out that I couldn't keep up.  He said my TSH level went from 0.01 to 0.006 but my thyroid stimulating immunoglobulin is high at 213.  ref range is 0-139.  and my Thyroid Peroxidase (TPO) is 38 with a ref range of 0-34. I have a mixed cystic and solid nodule that is measuring over 2cm and one is a solid nodule measuring at 1.6cm.  

I just hope they can fix this.  I want to feel better.  

[rumpled]

The test is a good idea as at least you will see if the thyroid is functioning and how. It can't hurt but odd that the doc is ignoring any other aspect of the endocrine system.

Yes, it is possible. I had the test a long time ago - you take a radioactive iodine pill and get scans of your thyroid and certain time frames up to 24 hours. I used to joke after that I did not have a life, but I had a half-life (it degrades quickly, you are fine).

Let us know what happens.

[katbid]

SO now yhey are  saying thyroitoxicosis. He says I have graves and hashimoto. Several nodules and two of them ate very large. Going to start thyroid uptake scan tomorrow. Has anyone heard of this? Doctor said it is rare.

[rumpled]

A jumping around TSH to me, a layman, means you need more testing.

Yes, you may have nodules or a goiter. I know I had them too. But with my TSH going all over the place, I had a pituitary abnormality - and that is what my main issue was - so I had a thyroid AND a pituitary issue.

Get the thyroid looked at and if it still looks wonky, get him to look up - at the pituitary. If he will not, find another doctor. The ultrasound is what it is - they just have to do probably a biopsy to confirm what the nodules are.

[katbid]

So I got my lab results from endo. Now they say my tsh is normal but I have goiter or nodules.  So now what? Can  I have goiter and nodules?  How cam two seperate blood test show low tsh and the thrif one taken 3 weeks later be normal?  I'm more confused than ever.  My endo is on vacation now and I don't have another appt until 28 sep.  Should I just leave this alone now since my labs are normal?  Should I get a repeat ultra sound?  

[horselip]

Rumpled is right on.
It does not sound like your endo has the Pituitary on his radar, at least yet. But then it sounds like he is taking your thyroid seriously by ordering the ultrasound. So it could be that he is focusing on this first as it causing symptoms and you have nodules, etc. It is pure conjecture at this point to know exactly what your endo is planning. You'd have to ask the endo directly.

I don't know that much about hyperthyroidism so I would take your question about that to the Thyroid forum.  But Rumpled pretty much said what happens next.

Vit D should be checked in folks with hormonal probs. Many of us hormonal folks are low and it can be corrected.Your endo said that you would talk more later. So you might write down your questions so that you are sure to get answers at your next appt.

Just know that the pituitary gland "could" be acting up here and there is testing that can be done to see if it is.
Horselip

[rumpled]

Vitamin D can be effected by hormones. I take a lot every day. I take D3.

Hot nodules are less likely to be cancer but really, he cannot say anything - I had a cold one and it was benign anyway. The only way to tell is an iodine uptake test.

The ultrasound is a good idea. I still think he is ignoring the fact that TSH IS A PITUITARY TEST!!!

Are you asking about treatment for nodules or goiter? Either meds or surgery - depending. They will do a FNA - needle biopsy, to confirm what they are.

[katbid]

Well I had my endo appointment Monday.  The Dr. Seemed as confused as I was.  He said there is a problem but he hasn't figured it out yet.  So he did more blood work to check my TSH, T3 and T4, and Vitamine D (why that?).  I am scheduled for an ultrasound next monday.  He said I may have a hot nodule or maybe a goiter.  He wouldn't discuss what the treatment would be or what the next test would be if both of those were negative.  He said we would talk more later.  He did not start me on any meds yet either.  Don't blame him for that because he says i am having both hyper and hypo symptoms.  But more hyper.  
Does anyone know what the treatment is for those two things listed?  And could it be if it isn't that?

Thanks

[SwanSong]

You can also feel cold if you're hyperthyroid. It would be experienced as shaking chills at times even if the weather is warm. You can also gain weight with hyperthyroidism. Each person is different and that makes diagnosing the disease difficult.

[rumpled]

A steroid may suppress your thyroid further, just so you know. The endo should take that into consideration.

[katbid]

Thank you for your response.  I just started the steroid a couple days ago because of severe neck pain.  My appointment with the endo is scheduled for Monday.  

[horselip]

It could be pituitary. It's good that you have been referred to an endo. Just make sure that it is an endo who is experienced with pituitary issues.

The steroids will cause weight gain, anxiety and sleep issues where you could feel artificially amped up. This is more if they are used for a long time and your cortisol levels are already ok. It's just something that you should be aware of. Steroids do have good uses though for short term pain issues though just be careful.

Also your Thyroid hormones seem more on the high side of the reference range so you might be feeling a bit hyperthyroid too. (sweating, insomnia)

Be patient, if it is pituitary you may have multiple reasons why it is so hard to lose weight. Hopefully this endo will be able to help you to get on track hormone-wise.