Tx for Hypothroid

[Joanne531]

At my annual GYN physical, the doctor felt a nodule on my thyroid.  He asked about symptoms and I told him I was experiencing Sleep disturbance, weight gain, dry skin, fatigue and thinning hair.  He ordered some labwork and had me go for an ultrasound.  Results TSH 2.164, Thyroxine, fee 1.04, Free T3 2.79, the ultrasound showed slightly enlarged right lob and some scattered tiny cysts bilaterally.  He said because I had so many symptoms he started me on Levothyroxine 50 mcg once a day.  I had labs one month later with results, TSH 0.902, Thyroxine fee 1.33.  I am not feeling much better.  I am still gaining weight, even though I eat very healthy and work out at least 3 or 4 times a week.  Is there really a problem with my thyroid, and am I taking medication unnecessarily?

[Mark Lupo, M.D.]

The thyroid function was normal to begin with - a trial of thyroid medication is reasonable, but not likely to help with weight, etc.  Since the ultrasound did not show a nodule -- no FNA is needed, but Hashimoto's is likely with the "small cysts" - this is likely inflammation.  If the antibodies are positive for Hashi, the thyroid medication may be more helpful to prevent goiter than to help with symptoms at this point.

[898]

. Was the nodule suspected during the palpation confused with unilateral lobe swelling? Usually the swelling of one lobe may suggest the thyroiditis.It could be a good idea to check the thyroid antibodies level as it may suggest the autoimune condition (Hashimoto's thyroiditis)