Aa
Do I have a thyroid issue. ENTs have been no help.
First time visitor to this site. I am 40 years old, male. For a year I've complained of a tightness or lump in my throat and neck area. Had multiple tests and been to many doctors and told nothing is wrong with me that they see.
I've tested a low positive for an autoimmune issue but doctors tell me these are routinely false positive.
I had an ultrasound of my neck this week. I thought I had found the answer. It read:
"The thyroid lobes are enlarged and has a heterogeneous echo pattern bilaterally. The right thyroid lobe measures 5.6 x 2 x 1.9cm. The left lobe measures 4.6 x 2.3 x 2.3cm. The appearance is compatible with thyroid goiter."
A well recommended ENT today looked at the results and said these are normal, nothing is wrong with me, nothing he can do. He said I may want to check with a rheumatologist (sp?) but didn't exactly explain why or why he could not help.
Based on a little research these measurements sound large to me. Is that true?
I've gotten such conflicting info from doctors. One says it is acid reflux, next tells me there is no way. One says allergies, the next says it is not. This US report seemed to be clear but the "expert" tells me that my symptoms couldn't be caused by the thyroid of this size. Any advice? Thanks.
I've tested a low positive for an autoimmune issue but doctors tell me these are routinely false positive.
I had an ultrasound of my neck this week. I thought I had found the answer. It read:
"The thyroid lobes are enlarged and has a heterogeneous echo pattern bilaterally. The right thyroid lobe measures 5.6 x 2 x 1.9cm. The left lobe measures 4.6 x 2.3 x 2.3cm. The appearance is compatible with thyroid goiter."
A well recommended ENT today looked at the results and said these are normal, nothing is wrong with me, nothing he can do. He said I may want to check with a rheumatologist (sp?) but didn't exactly explain why or why he could not help.
Based on a little research these measurements sound large to me. Is that true?
I've gotten such conflicting info from doctors. One says it is acid reflux, next tells me there is no way. One says allergies, the next says it is not. This US report seemed to be clear but the "expert" tells me that my symptoms couldn't be caused by the thyroid of this size. Any advice? Thanks.
I'm sorry for a slow response. I'm not getting email notifications of responses. I must have done something wrong.
All I am showing on my doc report about the antibodies was this:
Antinuclear Antibodies, IFA. Homogeneous Pattern. 1:80
All I am showing on my doc report about the antibodies was this:
Antinuclear Antibodies, IFA. Homogeneous Pattern. 1:80
In my previous comment :
"Then they do the western blot by Quest, Lab Corp or whatever affordable lab they are contracted with. These labs have a higher false negative rate that false positive rate."
Your Dr is most likely using these Lyme tests, which, unfortunately will not have the two most common Lyme bands in them.
Ask for a C4a infection test - its a scale and most if not all tic infections will set this test off in the "ill" direction. Your Dr might not know it, but it is usually covered by insurance from the same lab the clinic uses now.
What test showed positive in the past ? I did not see it .
For your Dr, have him goggle this!!! - There are also brand new peer reviewed tic illness treatment guidelines from ILADS (International Lyme And Associated Diseases) that are the new standard for treatment which includes long term antibiotics if needed - that's the opposite of the messed up CDC viewpoint that left people chronically ill. This will make insurance companies throw a fit, depending on the state, many will have to cover Lyme next year. Now many look the other direction, or treat 1 month per the old CDC method.
"Then they do the western blot by Quest, Lab Corp or whatever affordable lab they are contracted with. These labs have a higher false negative rate that false positive rate."
Your Dr is most likely using these Lyme tests, which, unfortunately will not have the two most common Lyme bands in them.
Ask for a C4a infection test - its a scale and most if not all tic infections will set this test off in the "ill" direction. Your Dr might not know it, but it is usually covered by insurance from the same lab the clinic uses now.
What test showed positive in the past ? I did not see it .
For your Dr, have him goggle this!!! - There are also brand new peer reviewed tic illness treatment guidelines from ILADS (International Lyme And Associated Diseases) that are the new standard for treatment which includes long term antibiotics if needed - that's the opposite of the messed up CDC viewpoint that left people chronically ill. This will make insurance companies throw a fit, depending on the state, many will have to cover Lyme next year. Now many look the other direction, or treat 1 month per the old CDC method.
COMMUNITY LEADER
I'm going to let LazyMoose address the Lyme part, since he's much more familiar with those tests than I am.
What antibody tests are you referring to were negative in August? Thyroid specific antibodies are Thyroid Peroxidase Antibodies (TPOab), Thyroglobulin Antibodies (TgAb) and Thyroid Stimulating Immunoglobulin (TSI). TPOab and TgAb are used to diagnose Hashimoto's Thyroiditis, which is most often associated with hypothyroidism, but is often characterized by periods of hyperthyroidism in the beginning stages. TSI is the definitive test for Graves Disease.
Low body temperature is usually associated with hypothyroidism. Your TSH and FT4 indicate hyperthyroidism.
What antibody tests are you referring to were negative in August? Thyroid specific antibodies are Thyroid Peroxidase Antibodies (TPOab), Thyroglobulin Antibodies (TgAb) and Thyroid Stimulating Immunoglobulin (TSI). TPOab and TgAb are used to diagnose Hashimoto's Thyroiditis, which is most often associated with hypothyroidism, but is often characterized by periods of hyperthyroidism in the beginning stages. TSI is the definitive test for Graves Disease.
Low body temperature is usually associated with hypothyroidism. Your TSH and FT4 indicate hyperthyroidism.
One more note if this matters. Along with keeping a diary of my symptoms I started tracking my temp through an oral thermometer. I've always been in the 98.1 range or slightly higher or lower. For the past 3 weeks I've regularly been at 96.1 to 96.9 with an occasional at 97.1. That's it.
Also, I never used to have any trouble swallowing pills my entire life. The past 10 months I've had to use every creative way possible to get pills of any size down. Swallowing saliva is especially uncomfortable. "At rest" I feel like I'm constantly tight or choking and must keep water handy. Food is not so much of a problem.
Also, I never used to have any trouble swallowing pills my entire life. The past 10 months I've had to use every creative way possible to get pills of any size down. Swallowing saliva is especially uncomfortable. "At rest" I feel like I'm constantly tight or choking and must keep water handy. Food is not so much of a problem.
Thanks for all the responses. It is so nice. I have my info here. I'm not sure what's relevant but here goes with a few things that stood out on the labs. There are a lot I'm leaning out that looked good but let me know if I should post all.
I posted my US results in the first post with measurements and what it said.
They also noted in the US that "under the mandible on left side is a nonvascular homogeneous structure measuring 1.25 x 3.73cm. Suggesting a salivary gland.
My bloodwork from 09/03/14 showed normal values for protein/total serum, albumin, alpha-=1-globulin; alpha-2 globulin; beta globulin, gamma globulin, M-spike (not observed), globulin, Total; A/G ratio.
On 9-23-14: The TSH shows 0.475 with range of 0.450 - 4.500.
On 5-29-14: The TSH showed 0.794 (same range)
On 5-29-14 my Serum Ferritin (30-400) showed high as 411 ng/mL.
LDL Cholesterol Cal (0-99) showed high at 108 mg/dL
MCV (80.0 - 97.0) showed high at 97.6 fL.
Lyme Disease AB Quant IgM was 1.07, noted as high, with equivocal range being 0.80 - 1.19. The Western Blot showed negative at <0.91.
There were various IpG results listed under this and mine showed "absent" except for IgG P41 AB with "present abnormal."
Lyme AB IgM by WB showed Absent.
During Aug 2013, I was tested for Lyme and showed <0.91.
On 9/23 My T4, Free (Direct) shows 1.67 with range of 0.82 - 1.77.
On 5-29-14 my T4 was 1.23.
On 08-25-13, my billirubin total showed high at 1.5 (range of 0.00 - 1.2).
During those Aug 2013 tests, I showed all negatives for any antibodies.
My doc says to get re-tested in 3 weeks for Lyme but I'm concerned about not starting some sort of antibiotic now given what I've read about not treating Lyme and because I've had symptoms for so long now. I've left him a voice mail asking about this. I have pinged a group about a LLMD in my area. There is one and he does not get good reviews at all from what I'm seeing.
Correct, I meant ANA before.
On 08-08-14 I showed a positive prelim for ANA Screen but ANA final was negative at 1:80.
On 08/26/14 I had a homogeneous (smooth) pattern at 1:80 (different doc called this a low positive; not an overall negative).
Anti-SSB Ab was < 1 units (normal 0 to 15)
Anti SSA Ab was 1 unit (normal 0 to 15 units)
Thanks for all the responses.
I posted my US results in the first post with measurements and what it said.
They also noted in the US that "under the mandible on left side is a nonvascular homogeneous structure measuring 1.25 x 3.73cm. Suggesting a salivary gland.
My bloodwork from 09/03/14 showed normal values for protein/total serum, albumin, alpha-=1-globulin; alpha-2 globulin; beta globulin, gamma globulin, M-spike (not observed), globulin, Total; A/G ratio.
On 9-23-14: The TSH shows 0.475 with range of 0.450 - 4.500.
On 5-29-14: The TSH showed 0.794 (same range)
On 5-29-14 my Serum Ferritin (30-400) showed high as 411 ng/mL.
LDL Cholesterol Cal (0-99) showed high at 108 mg/dL
MCV (80.0 - 97.0) showed high at 97.6 fL.
Lyme Disease AB Quant IgM was 1.07, noted as high, with equivocal range being 0.80 - 1.19. The Western Blot showed negative at <0.91.
There were various IpG results listed under this and mine showed "absent" except for IgG P41 AB with "present abnormal."
Lyme AB IgM by WB showed Absent.
During Aug 2013, I was tested for Lyme and showed <0.91.
On 9/23 My T4, Free (Direct) shows 1.67 with range of 0.82 - 1.77.
On 5-29-14 my T4 was 1.23.
On 08-25-13, my billirubin total showed high at 1.5 (range of 0.00 - 1.2).
During those Aug 2013 tests, I showed all negatives for any antibodies.
My doc says to get re-tested in 3 weeks for Lyme but I'm concerned about not starting some sort of antibiotic now given what I've read about not treating Lyme and because I've had symptoms for so long now. I've left him a voice mail asking about this. I have pinged a group about a LLMD in my area. There is one and he does not get good reviews at all from what I'm seeing.
Correct, I meant ANA before.
On 08-08-14 I showed a positive prelim for ANA Screen but ANA final was negative at 1:80.
On 08/26/14 I had a homogeneous (smooth) pattern at 1:80 (different doc called this a low positive; not an overall negative).
Anti-SSB Ab was < 1 units (normal 0 to 15)
Anti SSA Ab was 1 unit (normal 0 to 15 units)
Thanks for all the responses.
One infection marker test a regular Dr can do is the C4A. It measures internal infection. Its also used to monitor infection levels during long term treatment.
If this is off and your Western Blot positive, that pretty much says your positive.
All your symptoms are some of the symptoms of Lyme, but can be other causes also. Lyme is the great imitator. Aches and pains and anxiety attacks are some early symptoms. As Lyme progresses it leaves the blood (hiding from killer immune cells that float in blood) and goes into white tissue and the nervous system where the immune system is useless.
Only roughly 66% of known lyme infected people w/ symptoms recall having a bullseye rash.
There are other tick born illness also. Depending on the state, some are more common than Lyme. Until recently Lyme was the worst one to get.
If this is off and your Western Blot positive, that pretty much says your positive.
All your symptoms are some of the symptoms of Lyme, but can be other causes also. Lyme is the great imitator. Aches and pains and anxiety attacks are some early symptoms. As Lyme progresses it leaves the blood (hiding from killer immune cells that float in blood) and goes into white tissue and the nervous system where the immune system is useless.
Only roughly 66% of known lyme infected people w/ symptoms recall having a bullseye rash.
There are other tick born illness also. Depending on the state, some are more common than Lyme. Until recently Lyme was the worst one to get.
Lyme detection is pretty complicated for average MD's. The standard testing they will perform is usually Elisa ( sometimes called Lyme titer) and is only 50% accurate. Then they do the western blot by Quest, Lab Corp or whatever affordable lab they are contracted with. These labs have a higher false negative rate that false positive rate.
The more accurate tests are least likely to be covered by insurance. Igenix Lab is the most popular in this field - their tests are more in-depth. Their western blot will show all the bands including the two bands that the CDC said to remove from testing after the short lived Lyme vaccine made many people W blot positive in the North East. But those are the two most common Lyme bands in people that are bitten - way to go CDC!
Most states have a grass roots Lyme Association, start searching VA for one online. They can connect you with known LLMD's - not many around.
The more accurate tests are least likely to be covered by insurance. Igenix Lab is the most popular in this field - their tests are more in-depth. Their western blot will show all the bands including the two bands that the CDC said to remove from testing after the short lived Lyme vaccine made many people W blot positive in the North East. But those are the two most common Lyme bands in people that are bitten - way to go CDC!
Most states have a grass roots Lyme Association, start searching VA for one online. They can connect you with known LLMD's - not many around.
COMMUNITY LEADER
It sounds like you might have been hyper with the low TSH and high FT4. Can't imagine no one testing FT3, under those circumstances.
So let's back up... I think you mean you were low positive for ANA, rather than ABA? ANA is anti-nuclear antibodies and is positive with several autoimmune diseases, but often, not with autoimmune thyroid disease. It's most often, definitely positive with RA, Lupus, MS, etc, but negative with Hashimoto's and/or Graves Disease, which are the autoimmune thyroid diseases.
If there is a possibility that you have Lyme Disease you have to have an LLMD (Lyme Literate MD) because most doctors don't run the right tests and if they do, they don't know how to interpret them. I can't remember everything I know about the western blot.. We have a member who has been dx'd with Lyme and it took a long time to get the dx... I'll try to contact him.
In the meantime, post whatever labs, with reference ranges you think might be pertinent.
So let's back up... I think you mean you were low positive for ANA, rather than ABA? ANA is anti-nuclear antibodies and is positive with several autoimmune diseases, but often, not with autoimmune thyroid disease. It's most often, definitely positive with RA, Lupus, MS, etc, but negative with Hashimoto's and/or Graves Disease, which are the autoimmune thyroid diseases.
If there is a possibility that you have Lyme Disease you have to have an LLMD (Lyme Literate MD) because most doctors don't run the right tests and if they do, they don't know how to interpret them. I can't remember everything I know about the western blot.. We have a member who has been dx'd with Lyme and it took a long time to get the dx... I'll try to contact him.
In the meantime, post whatever labs, with reference ranges you think might be pertinent.
Thanks for the responses.
I have been to 7 ENTs and have found all of them unhelpful. No intellectual curiosity and wanting to chalk it up as anxiety. I literally had two of them tell me that because I feel it while I'm at work and at home it must be stress because those are stressful places.
I have an appointment with an endocrinologist and a rheumy but those are about a month away unfortunately.
I've been keeping a diary of my symptoms the past 2 months. For a year it was the lump-knot-tightness in my left neck or throat area. For the past 3 months, a bad tingling tongue has come on almost non-stop. Dry mouth at times. Also, I started having pain in joints when I never used to have problems (was healthy-active). Shoulder, knees, my right foot went numb and appeared swollen. I've also had what I call a tightness in the tongue at times where I found it difficult to speak. My head started pounding in the back of the head and heat and ice don't seem to help it. I've never been prone to anxiety or panic attacks, been healthy & active, but all this has hit me.
On 5-29-14 my TSH measured as 0.794. On 9-3-14, it measured as 0.475.
On 9-13-14 my T4,Free was 1.67 (reference was 0.82 - 1.77).
I'm not at home right now and don't have all of the ranges. I don't believe my T3 has ever been tested.
Four months ago I was low positive for I believe ABA anti-nuclear bodies but it went negative at 1:80 when they titrated up. They did not say it was a specific disease as it was low positive.
Last week my family doc tested me for Lyme. Three months ago it was negative. Now it was a low positive at 1.07 but went away with the western blot test. Wants me to test again in 3 weeks.
I know these aren't the complete lab results you noted. I will post more tonight when I can get them back out. Thank you.
I have been to 7 ENTs and have found all of them unhelpful. No intellectual curiosity and wanting to chalk it up as anxiety. I literally had two of them tell me that because I feel it while I'm at work and at home it must be stress because those are stressful places.
I have an appointment with an endocrinologist and a rheumy but those are about a month away unfortunately.
I've been keeping a diary of my symptoms the past 2 months. For a year it was the lump-knot-tightness in my left neck or throat area. For the past 3 months, a bad tingling tongue has come on almost non-stop. Dry mouth at times. Also, I started having pain in joints when I never used to have problems (was healthy-active). Shoulder, knees, my right foot went numb and appeared swollen. I've also had what I call a tightness in the tongue at times where I found it difficult to speak. My head started pounding in the back of the head and heat and ice don't seem to help it. I've never been prone to anxiety or panic attacks, been healthy & active, but all this has hit me.
On 5-29-14 my TSH measured as 0.794. On 9-3-14, it measured as 0.475.
On 9-13-14 my T4,Free was 1.67 (reference was 0.82 - 1.77).
I'm not at home right now and don't have all of the ranges. I don't believe my T3 has ever been tested.
Four months ago I was low positive for I believe ABA anti-nuclear bodies but it went negative at 1:80 when they titrated up. They did not say it was a specific disease as it was low positive.
Last week my family doc tested me for Lyme. Three months ago it was negative. Now it was a low positive at 1.07 but went away with the western blot test. Wants me to test again in 3 weeks.
I know these aren't the complete lab results you noted. I will post more tonight when I can get them back out. Thank you.
Endocrinologist Dr Mark Lupo stated this on one of his Medhelp answers:
"I do 6-8 ultrasounds a day in the office and usually the measurements of normal thyroids are 4-4.8 x 1.0-1.8 x 0.8-1.6cm which is consistent with published dimensions."
http://www.medhelp.org/posts/Thyroid-Cancer---Nodules--Hyperthyroidism/Normal-Thyroid-Size/show/263195
An enlarged thyroid gland with a heterogeneous echotexture is a common ultrasound presentation of Hashimoto's thyroiditis.
"I do 6-8 ultrasounds a day in the office and usually the measurements of normal thyroids are 4-4.8 x 1.0-1.8 x 0.8-1.6cm which is consistent with published dimensions."
http://www.medhelp.org/posts/Thyroid-Cancer---Nodules--Hyperthyroidism/Normal-Thyroid-Size/show/263195
An enlarged thyroid gland with a heterogeneous echotexture is a common ultrasound presentation of Hashimoto's thyroiditis.
COMMUNITY LEADER
A goiter is an enlarged, inflamed thyroid... I'm not sure why they're telling it's "normal".
Have you had any thyroid blood work done, such as TSH, Free T3, Free T4? What antibodies have you had tested that are low positive? Please post whatever results you have and be sure to include reference ranges, since those vary lab to lab and have to come from your own report.
Do you have any symptoms, other than the tightness/lump in your neck area?
Have you had any thyroid blood work done, such as TSH, Free T3, Free T4? What antibodies have you had tested that are low positive? Please post whatever results you have and be sure to include reference ranges, since those vary lab to lab and have to come from your own report.
Do you have any symptoms, other than the tightness/lump in your neck area?
Have an Answer?
You are reading content posted in the Thyroid Disorders Community
We tapped the CDC for information on what you need to know about radiation exposure
Endocrinologist Mark Lupo, MD, answers 10 questions about thyroid disorders and how to treat them
A list of national and international resources and hotlines to help connect you to needed health and medical services.
Herpes sores blister, then burst, scab and heal.
Herpes spreads by oral, vaginal and anal sex.
STIs are the most common cause of genital sores.
