Goiter and nodules

[aquacapsak]

I have been diagnosed with a mild goiter (I can't see any malformation in my throat) and two nodules.  I don't have coughing, trouble breathing, swallowing or any hoarseness in my voice. My TSH is borderline low at a little over 9 and my T3 and T4 are normal.  What would be the best form of treatment as the only tests that have been done is a physical examination of my throat, an ultrasound and blood work.  I also have experienced 2 miscarriages (Jan and March 2006) and was wondering if they could have anything to do with my goiter.  I know my diet is lacking salt because my husband complains about the lack of salt in my cooking all the time.

[Mark Lupo, M.D.]

You seem to have hashimoto's -- this is associated with inc'd miscarriage rate.  Would treat to keep the TSH 0.5-1.5.

[Mark Lupo, M.D.]

You seem to have hashimoto's -- this is associated with inc'd miscarriage rate.  Would treat to keep the TSH 0.5-1.5.

[aquacapsak]

I went to my GP yesterday and was told that my TSH, T3 and T4 are now normal.  I don't have a goiter but instead have antibodies which have inflamed my thyroid gland.  I've been fighting off cold germs from my daughter and husband over the past couple of weeks.  I don't have any simptoms of hypo or hyper.  I called my endocrinologist and her secretary told me that the blood work came back normal.  What should I do now? Also, I'm in the middle of having another miscarriage. Very stressed!

[Mark Lupo, M.D.]

Check thyroid antibodies and have a thyroid expert do an ultrasound in his/her office to determine if any of the nodules need fine needle aspiration biopsy.  If the TSH is a little over 9 then the thyroid is LOW -- would repeat to confirm then treat with synthroid or levoxyl to keep the TSH around 1.0.  The miscarriages may be due to underactive thyroid and/or thyroid autoimmune disease - or may be unrelated to thyroid but the key is to control any possible variable.