Goiter

[Shannie1031]

So for the last few weeks or longer I was sporadically feeling a lumpiness in my throat, especially while sleeping.  I thought it was how I lie in bed while reading.  Then this lumpiness, this weird feeling that isn't exactly painful just awkward and uncomfortable is a daily annoyance.  So bad in fact I felt nausea from the feeling in my neck.  Sort of like something is rolling up and out; of course nothing ever did.  So now this feeling his constant I feel like I'm either vomiting or choking.  Lovely!  So I also have asthma so my breathing is not 100% in the first place, add tightness to my throat and what? Full blown panic attack sure, lets not sleep tonight.  So I finally drag my feet to a Dr.  guess what PA says I have an enlarged thyroid, i.e. Goiter.  So now I am to have a thyroid ultrasound blood work.  Now this goiter is extremely uncomfortable, borderline painful; especially when I swallow, cough or yawn (oh yawning *****).  Is this simply because I am now aware of this enlargement in my body. The pain and discomfort seemed to become more acute during a 24 hour fever spike, which is what motivated me see a Dr in the first place.

[gimel]

Glad to hear that you have made progress on the hair loss problem.  What was the latest test result for ferritin that you mentioned?  

Have you tested for B12?  Have you continued with supplementing with Vitamin D?

Your Free T4 level is at 50% of the range, which is what we recommend as necessary for many people.  Your Free T3 is at 66% of its range, which is pretty good for many people.  There is room for an increase if symptoms persist, but it makes me wonder if your diet and exercise are comparable to before the thyroidectomy, when you weighed 58 Kg?  If so, then you might see some benefit from taking the increase in Euthyrox and see how that affects you.  

One other thing that comes to mind is the possibility of deficiencies in the numerous variables which affect transport of serum thyroid hormone into the organs and cells of the body such that serum thyroid levels sometimes do not accurately  reflect tissue thyroid levels.  Also, Vitamin D and cortisol levels can affect how available thyroid hormone is metabolized at the cellular level.  From studies the best measure of tissue thyroid levels is the ratio of Free T3 to Reverse T3.  So, if possible I suggest testing for Reverse T3 and Free T3 again, so that they come from the same blood draw.  Also I suggest that you test for cortisol.  The best test for cortisol is a diurnal saliva cortisol test panel of 4 tests across a full day; however, many doctors will not order this test and instead will order a morning serum cortisol test.  The saliva testing is Free cortisol.  The serum cortisol test is for Total cortisol, which is not as useful, but may be all that is available to you.  Do you think you can get these tests done?

[scarredofthyroidectomy]

Good Afternoon,hope u r fine :)
Plz check an advise regarding the below new blood test results (now i'm terribly gaining weight before operation i was 58Kg now i am 67Kg)
my hair is not falling like before thx to you the ferritin now is normal after taking 3 pills of iron...
FREE T3       2.79    NORMAL IS 1.45 TO 3.48
FREE T4       1.28    NORMAL IS 0.71 TO 1.85
TSH               1.75    NORMAL IS 0.47 TO 4.64
the Dr has increased the EUTHYROX from 75 to 100 because of the weight gain...i appreciate ur help regarding the weight...
Thx a lot

[gimel]

When my ferritin was approx. 40 I started taking two pills of 28 mg and it went up to 80.  So it appears that you would need more than 2  of those pills.  By the way I understand it is a good idea to stop taking the iron several days in advance of the test, to avoid a false high result.  

[scarredofthyroidectomy]

Hi,hope u are fine,i just took the 2nd pill after reading ur advice & i will be taking 3 pills daily, before going for blood test i ll stop taking it for one week & i will send u the results again.. Thx a lot :)

[scarredofthyroidectomy]

Hi,next blood tests will be after 2 months..shall i take 3 pills of iron instead of 2??

[gimel]

Your ferritin is terribly low, so no wonder you are having hair loss.  I am not sure that the prescribed iron dosage will be enough to adequately raise your level to optimal of 70.  When will you re-test?  

[scarredofthyroidectomy]

Good Morning, Hope you are fine..
Here are the requested blood test results:
Ferritin      16 ng/mL                      Normal Range 18-160 ng/mL
Vitamin D       48.8 ng/mL             Normal Range 50-70 ng/mL
Please advise :(((( i am so worried
the Dr told me to take 2 pills of Iron per day each one 28mg & Vitamin D 50000IU one pill per week
my hair is still falling especially while showering :(((
Awaiting for ur reply & thx a lot

[scarredofthyroidectomy]

Hi, It was a total thyroidectomy..
I already visited the gynecologist i thought i have a prblm with the hormones or i have Ovarian Cysts but she told me after the blood tests & the ovarian ultra sound that everything was normal & i should  include fruits & veg in my diet since i am eating everyday meat or fish honestly i hate veg & fruits..
I am going for Vit D & B12 & Ferritin Blood test & i will send u the results soon.
:( I just need my hair to return normal just like b4 the stupid surgery do u think stress can cause hair loss????

[gimel]

Well I was certainly wrong in my expectation that your Free T3 would be low in the range.  Looking at your FT4 and FT3 levels it is puzzling how they could both be above range when you were taking only 100 mcg of T4, after a thyroidectomy.   So was it a total thyroidectomy?  What is your weight, please?

I also suggest that you should push the doctor to test for Vitamin D, B12 and ferritin.  You should know your levels in order to assess how much to supplement in order to optimize.   D should be about 55, B12 in the upper end of its range, and ferritin should be about 70 minimum.  

In addition, from your symptoms and your age I suggest that it would be a good idea to test for free testosterone, progesterone, and estradiol.  Low levels or imbalances among these can also cause symptoms.

[scarredofthyroidectomy]

Hi..
Dr told me he wants me to get Ferritin (Iron storage) & he didn't ask for Vit D blood test he told me u need to complete the 3 months course since i took only 2 months...
I have an extreme hair loss, i am gaining weight easily before surgery was 58Kg now i'm 65, my eyebrows are very thin unlike before..
i was doing exercises daily after surgery i feel exhausted even after walking a small distance..i m loosing confidence in my self..always thinking negative i feel very weak tired & lazy like i'm 60years old however i'm 31..
Please advise i am so worried

[gimel]

I am a little confused about the tests.   You posted results on 4/5 from 3 weeks prior.  Were you taking the 100 mcg of Euthyrox at that time?  

Also how did the doctor decide to give you Vitamin D and iron?  Was it based on test results?  If so, please post those.  

Your Free T4 and Free T3 are above range, and higher than typically needed.  The low TSH is a result of the Free T4 and Free T3.  When taking adequate thyroid med TSH frequently becomes suppressed below range.  That is not a concern.  TSH is basically a useless test when taking thyroid med.  

What symptoms do you have now?

[scarredofthyroidectomy]

Hi, Here are the new blood test results:
Free T3   3.50  (Normal Range 1.45 - 3.48)
Free T4    2.11 (Normal Range 0.71 - 1.85)
TSH         0.023  (Normal Range 0.47 - 4.64)

Leucocytes total count    5.71 (nORMAL 4 -10)
Hmoglobin                       13.1 (Normal 11.5 - 16.5)
Red Cell Distribution Width    14.1 (Normal 11.20 - 15.50)      
Basophils                         0.5 (Normal 0 - 1)

The Dr told me to decrease the Euthyrox to 75mg & gave me Iron pills (28mg) Plus NEBILET (5mg) & Vitamin D (1pill per week 50000UI) & Vitamins CENTRUM Lutein from A to Zinc (1 Pill per day)
Please advise i am soooo worried dunno why my TSH is very high as well as the T4 & T3
Appreciate ur reply
Thx

[gimel]

Your Free T4 is more than adequate.  TSH really means nothing when taking significant doses of thyroid med.  You were not tested for Free T3 which is very important.  Free T3 correlates best with hypo symptoms, while Free T4 and TSH do not correlate well at all.  Hair loss can be related to a number of things, but in view of your symptoms after the thyroidectomy I expect that you will find that your body is not adequately converting T4 to T3 and that your Free T3 level will be too low in the range.  So you should get tested for Free T3 also every time you go in for tests.  

Also, hypo patients are frequently too low in the ranges for Vitamin D, B12 and ferritin.  D should be 55 minimum, so you need to supplement as needed to optimize.  B12 should be in the very upper end of its range, and ferritin should be about 70 minimum.   Ferritin is very important for good hair.  Even though your hemoglobin was in range, ferritin is a protein that stores iron and acts as a buffer for iron deficiency or overload.  I recommend that you get tested for ferritin and supplement as needed to optimize.  

When did you start having the high heart rate?

[scarredofthyroidectomy]

Hi,Thank u so much for your reply God Bless u..
They didn't check my T3 neither my ferritin..I just got an appointment with a new endocrinologist and i hope that he will help..i will send u the new results soon.Thx once again

[scarredofthyroidectomy]

Hi & thx once again
here is my blood test report since 3 weeks:

Free -T4 1.61 (Normal range 0.71 - 1.85)
TSH         1.19 (Normal Range 0.47 - 4.64)
Hemoglobin 13.1 (Normal Range 11.5 - 16.5)

i was having anemia before  but i never faced this hair loss
i took Vitamin D for 2 months (10000UID per Day) because it was too low 11.7 and normal range was 30 - 60
I am also taking NEBILET 5mg since i have very high heart rate (159 while walking slowly/Shopping)
Thank you so much

[gimel]

Also, please post the reference ranges for those tests, as shown on the lab report.

[gimel]

After a thyroidectomy 100 mcg of T4 does not seem like an adequate dose to relieve hypo symptoms, and you have quite a few.  If you will please post your thyroid related test results, we can give you a better assessment of your status and advise what should be done.

[scarredofthyroidectomy]

Hi,I got the same symptoms except difficulty in swallowing i was suffering of thyroid disorders 7 years ago & i postponed all kinds of treatments till the goiter became 2.1 cm then i decided to go for a surgery i didn't even visit an endocrinologist i went direct to the surgeon (same surgeon who did my appendectomy) i told him kindly remove my whole thyroid for insurance reasons i went for blood tests..Biopsy just to get the approval..finally 19th of November 2015 i went for operation i was not only scarred i was going crazy till they gave me a kind of drug that made me really crazy lol was laughing b4 entering the operation room i don't remember my sister was telling me..anyways the operation was not bad at all even the pain i didn't expect that it would be just like a sore throat OMG i regret thinking abt it..after 12 days the surgeon called me telling me that LAB results were negative & i can start taking my EUTHYROX i started 50mg then 75mg now i m taking 100mg my problem is my weight & my hair i'm really gaining weight can't control my appetite especially the sweets OMG plus my hair is falling till i'm scarred to be bald...Please do the proper tests & don't think about it at all it's a stupid operation if ur Dr will advise u to do it just prepare for it by drinking lots of water & milk plus avoid all kinds of caffeinated drinks & update us ..
Get Well soon & wish u all the best

[Barb135]

Make sure your doctor ordered Free T3 and Free T4, otherwise, you will get tests for Total T3 and Total T4, which are considered obsolete and not very useful.  

The CBC and CMP won't tell you anything about your thyroid.  High cholesterol is a symptom of hypothyroidism, so the lipid panel can come in handy.

You should also ask for the thyroid antibodies, Thyroid Peroxidase Antibodies (TPOab) and Thyroglobulin Antibodies (TgAb) to determine if you have Hashimoto's.  Treatment won't change, but, if you have Hashimoto's, you'll know that thyroid function will decline over time until, eventually, your thyroid will produce nothing and you will be dependent on replacement medication.

[Shannie1031]

Thanks for your help.  At this point the only symptoms I think I may have related to thyroid are possibly temperature intolerance, hot to cold, excessive sweating, anxiety, stress, but I'm usually anxious so it's hard to tell if this is a symptom or me.  My seasonal allergies seem to be in over drive as well, not sure if this is related or not.  At first I thought my throat tightness was post nasal drip due to my allergies.  

No I don't think she requested thyroid antibodies.  I should be getting TSH, T3, T4 and in addition to thyroid panel I will also CBC, CMP and lipid panel.  Its been forever since I've had blood work so that's why I'm getting the full shebang.

[898_1]

It sounds more like inflammatory process (based on description) looking forward to see an ultrasound

[Barb135]

When you get your blood work and ultrasound results back, please post the results, with reference ranges and we'll help you interpret them.

The feelings you're having are quite normal with a goiter.  Most of us, here, on the forum have "been there, done that"... It can be kind of scary, , but is probably nothing to worry about...

It gets worse, with anxiety, so try not to think about it too much, and be sure not to rub or palpate the area, as you'll irritate it even more.  

Do you know if your doctor is testing for thyroid antibodies to see if you have Hashimoto's?

What other symptoms do you have?