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Goiter relief

Dr. Lupo,

I am a healthy 37 y/o female .

Hashimoto’s diagnosed 3 years ago... increases and decreases in Synthroid the entire time based on labs and symptoms..

Recently I have been put on 88mcg Synthroid for 6 weeks after 3 weeks of no meds based on possible postpartum thyroiditis. The 3 weeks of no meds made me severely hypothyroid with a TSH of 102 and FT4 and FT3 under the norm range.

My most recent labs: (which was only 4 weeks after the start of 88mcg Synthroid)
TSH 69 (0.60 - 3.30)
FT4 0.82 (0.71 - 1.40)
Thyroid Perox AB >900 ( <9.0)

My symptoms still hypo for the most part, I've had "episodes" of hyper off and on but overall hypo symptoms. My doctor feels my labs are obviously on the way towards normal.

For the last few days I have been experiencing more hyper symptoms:
Hot flashes
Increased heart rate slightly higher than normal (not tachycardia)

The most troublesome symptom today is my "goiter" feeling. It comes and goes and feels like someone has their hands around my throat and squeezing but not to the extent that i can't breath but very uncomfortable nonetheless. I applied a cool wash cloth but it hasn't helped.  If this is just transient hyperthyroid due to hashimoto’s is there anything I can do to alleviate the goiter feeling until the “hyper” phase passes? will an over the counter anti-inflammatory help? (side note: doc did not feel any nodules, all normal ultrasound findings, only stated my thyroid gland as “enlarged”)  

Thank you very much for your time.
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97953 tn?1440868992
The goiter is stimulated by the high TSH - this should improve with normalizing TSH.  With the post-partum thyroiditis concern, there may have been additional thyroid damage and your dose may need to be higher to normalize TSH.
The hyper symptoms are non-specific - it may be adjusting to the huge swing in thyroid status.  Often it takes 2-4 months for things to settle down and feel back to normal.
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