Enlarged Thyroid

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For the past two years I have been having various symptoms that align with hypothyroidism. I have been fatigued, severe brain fog, thinning hair, weight gain, cold hands and feet, cold intolerance, etc.. I have had numerous tests which show normal thyroid profiles (TSH, T3, T4, etc) however ultrasounds and CT scans have shown that I have an enlarged thyroid with nodules. I have also developed food and environmental allergies, as well as chronic lymphdenopathy in my groin, armpits, and neck. I have increasing ANA levels (1:300+) and a high Rheumatoid factor. While my TSH has fluctuated in and out of range, it has not stayed high or low. I have had numerous other work done, and other brain fog causing illness have been ruled out (HIV, B12, mineral imbalances, vitamin deficiencies), (MRI's are normal) (CT Scans showed swollen lymphnodes), (Celiac and other rheumatic diseases have been dismissed).. I am wondering why my thyroid is enlarged without the TSH being out of the normal range. Could this be an Iodine deficiency? Do you think this could be Hashimoto's, or something else. Im currently seeing an endocrinologist, and rheumatologist, and was hoping for a second opinion. Thanks

[Mark Lupo, M.D.]

Thyroid enlargement in this setting is most commonly autoimmune -would test TPO/Tg antibodies.  Iodine deficiency is less common, but urine iodine test can be done to exclude.

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*Without nodules