Episodic Thyroid

[rierieb]

I am 38 and I am having trouble with my thyroid. About 2 years ago I had routine bloodwork and my thyroid was abnormal. It showed that I was my thyroid was hyper (hyperthyroidism) even though I am overweight. I had follow up blood work and it was still abnormal at which time I had a ultrasound of my thyroid and everything was ok. When they did a 3rd blood test my thyroid was showing in normal levels. My doctor said that it may have been out of whack because of using a cortisone injection for my foot.

Now 2 years later I have had 2 additional blood tests that show my thyroid is again hyper and I am schedule for another ultrasound. I have not taken any cortisone shots in over 2 years.

My question is: Can my thyroid be episodic and why would that be?

[rierieb]

I had the ultrasound and it showed that my thyroid was enlarged and that I had a small nodule. Shortly afterwards I had an Uptake test and the results there showed that my nodule was neither hot or cold. When I finally saw an endocrinologist he said that he would like to do a biopsy of the nodule. So we did that today. What could it mean that my nodule is neither hot nor cold? Kinda freaking out. BTW, they have also diagnosed me with Graves Disease and I start medication tomorrow.

[Barb135]

You should always get copies of any blood test, imaging reports, etc.  These become a running record of your health issues; if you change doctors you can provide copies of past reports, which makes it much easier than having an old doctor send records to a new doctor.

In the U.S., doctors are required, by law, to provide you with copies of your lab reports.

[rierieb]

That you for your quick responses. I am not sure which test was done. Initially I had just the regular bloodwork that was is done with a physical (the fasting one). The second time they just checked my thyroid but I am not sure what test was done. Should I ask?

Sorry to ask so many questions. But I am in unfamiliar territory here and kinda worried about this.

[goolarra]

I agree.  Even if your thyroid does look okay on ultrasound, knowing whether or not you have an autoimmune disease is valuable information.  It will let you know how closely to monitor your thyroid and what to expect.  Good luck!

[Barb135]

Yes, you should still request the blood work.  Autoimmune thyroid diseases can be in progress for many years before a lot of symptoms show up. Better to know now, so you have an idea of what will happen down the road.

What blood tests did you recently have that showed hyper?  Was it just TSH or did they do FT3 and FT4, also?

[rierieb]

That you Barb135 and Goolarra for the feed back. I have an ultrasound on Wednesday if  everything is ok with my thyroid should I still request the bloodwork from my dr?

[Barb135]

It's also possible that you have Hashimoto's Thyroiditis, which is another autoimmune thyroid disease.  Hashimoto's is typically associated with being hypothyroid; however, in early stages, it's possible to have periods of hyper, as well as periods of normal.

Along with the TSI that goolarra suggested, you should also ask for Thyroid Peroxidase Antibodies (TPOab) and Thyroglobulin Antibodies (TGab).  You need them both, because some people have one or the other, so without them both, a diagnosis could be missed.

[goolarra]

It's possible that you have Graves' disease, which is autoimmune hyperthyroidism.  With Graves', antibodies from the immune system stimulate the thyroid so too much hormone is produced.  Sometimes, these antibodies go into remission then come back later.

TSI (thyroid stimulating immunoglobulin) is the antibody blood test you should have to determine if you have Graves' or not.