goiter with normal test results

[tanns]

I have had three ultrasounds on my thyroid over the past year.  The first two were on the high side of normal and the last one showed an increase in size of my thyroid and I was told I have a goiter.  I can see that my neck area is larger and it feels sometimes like an octopus is wrapped around my throat as I have weird pains that kind of shoot off from the thyroid area.

I have had numerous lab tests over the past two years.  My TSH has always been in the normal range and hovers anywhere from .67 to 1.24.  All other labs have been normal as well.   I saw an endocrinologist who ordered both antibody tests, both normal as well.  He had suggested synthroid and gave me a prescription but changed his mind when the lab work all came back normal.

Fort the past two and a half years I have been battling mysterious ailments.  I have dizziness quite often, chest pains, irregular heart beats at times, lots of weird pings and pangs, shooting pains and other things that have all been checked out by the doctors (cardiologists, gi, pulmonary, internal med and more).  My hair is thinning and falls out a lot on a daily basis, my metabolism is fighting me hard and I've gained some weight.  

I guess my questions would be,
Is it possible to have completely normal labs and still have something wonky with my thyroid?  
How would this be proven if that is the case?
Can the thyroid cause "shooting pains" to the neck and collarbone (left side)?
What would you suggest next for me (if anything)"?

Thank you for your time,
tanns


I don't want to just "try" synthroid but is that the only way to figure out if all my weirdness is due to the thyroid?  

[lcarter6]

I have recently had normal labs too (TSH 1.2-1.9-- can't remember T-numbers but they were within range, not sure about the antibodies as they have not been tested yet).  I, also, have a goiter that was discovered when I requested a thyroid scan (I'm having hypothyroid symptoms, plus history of x-ray treatments to my head when I was 5 yrs old). Fortunately, living now in Panama, it's posible to just request such things to be done. But, a 1 1/2 yrs ago when in TX, my family dr said "everything is fine" -- yet I recently discovered the TSH at that time 4.7 just before we moved.   I read on the Mayo clinic page, I think it was, that sometimes the thyroid will increase in size to make up for any hormone problem, producing a goiter.  At first it is able to keep up and the goiter is mild and difused.  But as it gets worse the goiter grows and can become noduler.  My dr in Panama is treating me with synthetic thyroid hormone (I'm sure my history has something to do with his decision to treat it, with a 3 month repeat of all blood tests and scan).  It has been my experience that sometimes drs are philosophically handicaped because of their training and lack of experience with certain diseases - so, one dr will treat you early, where another will want to wait until you hit all the criteria marks of well established disease.  For example, I went through many yrs of  incorrect DX's for Celiac Disease with many different drs, including 2 gastrointerologists who are suppose to know about such things; before finding someone who knew about the disease (his son had it!) and put me on a gluten free diet, which has eliminated all symptoms for 6 yrs now. My suggestion, is to find another dr who is more wholistic in their approach to medicine and is willing to find the answer beyond just blood tests.

[uecker]

just wanted to say I have the exact same issues you do with shooting pains and collarbone issue. Sounds like thyroiditis.  I also get light-headed, tired, sick feeling for no reason with the slightest amount of exertion. TSH runs between .6 - 1.4.  All of my other thryoid tests are normal as well.  Pain in my left collar bone radiating to shoulder - every test in the world has been done - only issue I have is a multi-nodular goiter left lobe that is sub-sternal (grows towards chest cavity under collar bone). In my case, the fine needle aspiration came back indeterminant and the goiter is big enough that it deviates my trachea (the dominant nodule is about 5 - 6 cm in size). Docs think I also have a thyroiditis condition that makes my thyroid become painful and possibly over/under perform. Bottom line - I need to have the goiter removed 1) to confirm it isn't cancer 2) to alleviate the deviated trachea 3) hopefully to get my thyroid to calm down and maybe the right lobe can keep me off meds

I obviously don't have an answer because I am doing the same thing you are but at least you aren't the only one!

[Mark Lupo, M.D.]

if you have consistently normal thyroid labs, then there is not likely a thyroid hormone imbalance - -so something else is causing the generalized symptoms.  The neck symptoms may be due to goiter if there is significant enlargement.  Would consider ENT evaluation to see if it is thyroid or other etiology for the neck pains.