Can someone help me with my thyroid scan results?

Question

I'm hoping someone can help me with my scan results. My Endo did'nt seemed concerned about anything. 
Multiple sagittal and axial scans of the thyroid were performed.
Findings: The right lobe measures 4.5 x 1.5 x 1.7 cm in the longitudinal, AP transverse dimensions. No cystic or solid nodules are identified.
The left lobe  measures 3.5 x 0.7 x 1.2 cm in the same dimensions. No cystic or solid nodules are seen. 
The isthmus has an AP dimension of 6 cm.  
I would appreciate any info someone could give me. Remar

FabricFran · Answer

I dont know why people thing vegetarians eat lots of soy. I am vegetarian and I don't eat soy because its constipating. It tastes good yes. I eat beans, lentils, nuts , quinoa. My husband eats just those , I also eat some fish, eggs and a drop of cheese. Just no animal meat. Plenty of protein!!

remar · Answer

It was a typo on my part about my isthmus. It is 6mm.
I've been trying to get more protein in my diet and it is hard with me being a veggie. I'm not vegan so I do eat eggs, cheese and drink milk. Also, I buy a protein drink that can be mixed with milk or juice and have that everyday. No soy, and boy it's hard to find foods without it.
Yes, I agree that since my labs show I was right on the border line I should be retested for antibodies. Thank you so much for all of your help! Corena

TamraW · Answer

Read posts 9 and 10 in this discussion. She lists her TGab as a 20, and I recall that those are old results from the summer. 
:) Tamra

TamraW · Answer

Barb, Remar's TGab results were from a prior post on this forum this summer. I was recalling those results. Her TPO was within range. Her TGab was 20, and 20 is the cutoff that her lab uses.   

The 800 TGab I referred to belongs to another friend on this forum, not Remar. 

:) Tamra

Barb135 · Answer

remar typed "Thyroid Peroxidase and Thyroglobulin Antibodies   { 20    Ref range  {20"

How do we know whether that was TPOab or TGab?  Yes, I see thyroid peroxidase listed below, but is that correct?  

Tamra typed "No, wait, your TGAB was 20, not your TPO. The labs you sent me indicated 20 as the cutoff for TGAB. You were at exactly 20. Yes, get the antibody tests again. It has been over six months since the last. I have another friend on this forum. I will send you her name. She has positive TGab (over 800) and negative TPO. She has NO nodules, just a swollen thyroid. I need to research this and determine if it's the TPO antibodies that cause nodules or maybe it's just a coincidence".  

So where did the "800" for TGab come from?  Are there 2 separate lab reports and some of us are only seeing one?   What am I missing here?

898_1 · Answer

+1

TamraW · Answer

And one more thing about you being a vegetarian. I'm not judging you. I love animals, too. I have other good friends who don't eat meat, but they don't have thyroid problems. In every book I've read, from Mary Shomon, Drs. Shames and Dr. Arem, they emphasize a high protein, low carb, low or no soy, diet for thyroid patients to feel their best. I know it is challenging for a vegetarian to follow a high protein diet while eliminating soy. Your diet could also be affecting your health. I'm not saying to eat meat, but try to find a good protein source while cutting back on soy and carbs. 

:) T.

TamraW · Answer

No, wait, your TGAB was 20, not your TPO. The labs you sent me indicated 20 as the cutoff for TGAB. You were at exactly 20. Yes, get the antibody tests again. It has been over six months since the last. I have another friend on this forum. I will send you her name. She has positive TGab (over 800) and negative TPO. She has NO nodules, just a swollen thyroid. I need to research this and determine if it's the TPO antibodies that cause nodules or maybe it's just a coincidence. 

If you had such a terrible reaction the last time, then I don't understand why the doc doesn't check you for adrenal and pituitary issues, as well as ALL of your bodily hormones. Thyroid cannot be ruled out because of your neck, which is swollen at times and because of your TGAB results in the past, but you definitely need a complete workup. Also, I know you are a vegetarian, but you may not respond well to synthetics, and it may end up that dessicated will be your only option. 

:) T.

898_1 · Answer

It looks like there is a typo in the report  the thickness is not 6 cm but most likely 6 mm!!
the most common readings for the thickness is 2.7..3 mm. It is hard to say what causing it because ultrasound did not reveal any textural or vascular abnormalities. 
In order to better see if any swelling is present in the neck , you need to tilt your head back and swallow.

remar · Answer

So if the antibodies test is anything over 20 then does that indicate Hashi's? 
Yes, I do need to see her because when I took 25mgs it almost sent me to the hospital. So I want to make sure my adrenals are alright before I take the meds. 
I could be hypo but if my adrenals are not functioning right then I could have a bad reaction to the meds, right? Thanks for your help Tamra. Big hugs. Corena

TamraW · Answer

I don't know. My endo said this to me as he was looking at my ultrasound. He said it's over two times bigger than normal. I interpreted this as 2 1/2. : ) 

I remember this antibody test from a while back. Because your TPO is 20, it might not hurt to get another one. Antibodies can fluctuate. 

Your frees are on the low side. I know you are hesitant to take the Synthroid doc gave you. Call her office tomorrow and tell the nurse you need to see her one more time before insurance is gone. You should explain to her why you are afraid to take the Synthroid and ask her to check adrenals for peace of mind. 

: ) T.

remar · Answer

Hi Tamra! 
Here are my labs. 
Thyroid Peroxidase and Thyroglobulin Antibodies   { 20    Ref range  {20
Thyroid Peroxidase Antibodies  {10   Ref range  {35
FT4 1.0   Ref range   {0.8-1.8
FT3  309    Ref Range   230-420
TSH  2.31    Ref range  0.40-4.50
Do you know what the normal size of a isthmus is supposed to be? As you can see from my above post, mine is 6 cm.What is the size of yours? Big hugs to you Tamra. Corena

TamraW · Answer

Hi, sweetie, please post your antibody (TGab and TPOab), TSH, FT4 and FT3 results. My thyroid isn't that big. It is a very small goiter. My isthmus is over 2 X the normal size. The Hashi antibodies must be having a family reunion on my isthmus. 

You neck does look swollen in some pictures, and I know that this bothers you. I sure hope your docs pursue this further and test your adrenals. 

:) T.

remar · Answer

What would make my isthmus thick? There is no mention of any nodules in it. 
It does feel a little tender and swollen at times.

898_1 · Answer

Well, the isthmus is thicker then the average size but unless it is tender to touch or the ultrasound showed different echotexture or nodule in it, it may not require treatment.

blsdnsvd · Answer

Please post your lab results including the ranges and i'm sure that someone will respond as to whether or not you can still have hypo symptoms depending on the reading, even if they are considered to be in the normal range.

remar · Answer

Thank you both so much for getting back to me. The reason my Endo ordered the scan is because I've been having hypo symptoms. My labs show that I am with in normal range. She checked TSH, FT3, FT4 and antibodies. They were all normal. 
Do you think my isthmus is enlarged? You can see on my throat that it looks large. 
The next step is to check some other things. Like calcium, vitamin D, B vitamins and hormone levels.  Thank you both again. Remar

898_1 · Answer

Based  to the description the thyroid is normal. One lobe can be slightly larger then other

blsdnsvd · Answer

By reading your results, it doesn't seem as if there is an issues with your thyroid gland as far as nodules are concerned. May i ask, the reason for the scan????