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Hyperthyroidism Endocrineologist
Dear Dr. Lupo-
I am a 48 yo traumanurse in a Level One hospital. On saw MD 12/24/2010 at that time he drew labs on 12/27/2010, I awoke 42 lbs heavier , went to Internest who reviews labs and find that TSH .0006 L and T3 free 6.02 H ,T4 free 2.36 High ,total T3 2.42H > Thyroid US showed Mulitnodular nodules on the right pole Tyroid uptake scan shows Cold nodules After 4 Hours 14.3%H ,24Hours 31.2% also High Right thyroid Nodules 5.6x 2.8 cm Left LowerlobeRight lobe 5.8 x2.5cm Mds here in Boca
admitted me to inpatient Bp 240/140 and increased wt of 42 lbs. Now they want to use Tapozole- problem is I have CVID and immiune deficency disease and that frug can make things worse RAI will take too long per Endo so I am scheduled for a FNB asap to see if the nodules are Cancer if not do you think a thyroidectomy would be better that med then do a synthroid replacement which is what is going to happen any way? I truly wish you were on this coast or new and Endo that is great to manage new onset hyperthyroidism! Any referals?
ERNURSE
I am a 48 yo traumanurse in a Level One hospital. On saw MD 12/24/2010 at that time he drew labs on 12/27/2010, I awoke 42 lbs heavier , went to Internest who reviews labs and find that TSH .0006 L and T3 free 6.02 H ,T4 free 2.36 High ,total T3 2.42H > Thyroid US showed Mulitnodular nodules on the right pole Tyroid uptake scan shows Cold nodules After 4 Hours 14.3%H ,24Hours 31.2% also High Right thyroid Nodules 5.6x 2.8 cm Left LowerlobeRight lobe 5.8 x2.5cm Mds here in Boca
admitted me to inpatient Bp 240/140 and increased wt of 42 lbs. Now they want to use Tapozole- problem is I have CVID and immiune deficency disease and that frug can make things worse RAI will take too long per Endo so I am scheduled for a FNB asap to see if the nodules are Cancer if not do you think a thyroidectomy would be better that med then do a synthroid replacement which is what is going to happen any way? I truly wish you were on this coast or new and Endo that is great to manage new onset hyperthyroidism! Any referals?
ERNURSE
COMMUNITY LEADER
I'm sorry, but Hashimoto's is *not* "just an inflammation of the thyroid gland; Hashimoto's is an autoimmune disease in which the body sees the thyroid as "foreign" and produces antibodies to "kill" it....... eventually, the thyroid no longer produces hormones. Hashi's is usually associated with being hypothyroid, and, while the antibodies may go into remission, it does not "go away".
Graves Disease is also an autoimmune disease, usually associated with being hyper.
Have you had antibody tests to confirm/rule out either Graves or Hashimoto's. For Graves Disease, you need to get tested for Thyroid Stimulating Immunoglobulin (TSI); for Hashimoto's, you need to *both* Thyroid Peroxidase Antibodies (TPOab) and Thyroglobulin Antibodies (TGab). Some with Hashi's have just TPOab or TGab, some have both.
Have you had ultra sound to check for nodules on your thyroid? Sometimes when one has nodules, they can leak hormones independently of the thyroid, which could also make you hyper.
If you've had the antibody tests, please post results, with reference ranges.
Graves Disease is also an autoimmune disease, usually associated with being hyper.
Have you had antibody tests to confirm/rule out either Graves or Hashimoto's. For Graves Disease, you need to get tested for Thyroid Stimulating Immunoglobulin (TSI); for Hashimoto's, you need to *both* Thyroid Peroxidase Antibodies (TPOab) and Thyroglobulin Antibodies (TGab). Some with Hashi's have just TPOab or TGab, some have both.
Have you had ultra sound to check for nodules on your thyroid? Sometimes when one has nodules, they can leak hormones independently of the thyroid, which could also make you hyper.
If you've had the antibody tests, please post results, with reference ranges.
Dear Barb-
Thanks for your response. Normal ranges for the following are as follows: T4 - 5.5-11.0,I
came in at 18.6 high, TSH normal range is 047-4.68 I came in at 0.006 very low almost nonexsistant ,T3 Free 2.77-5.27 I came in at 6.02 High ,T4 Free normal range .78-2.19 I came in at 2.36 high ,T3 Total normal range .97-1.69 I came in at 2.42 high. I have been tested for Graves and eye measurements are completly normal Thank G-d for something normal.Hashimoto's Thyroiditis is just and inflamation of the Thyroid gland where the levels begin to even out or normal as the "infection or virus" begins to go away. I have seen 2 Endocrinologists both suggest a Fine Needle Biopsy, and medication either Radioactive iodine ( which may take too long to notmalize me ) and Tapazole- a drug with my immune suppression history is only asking for trouble as the side effects are increase in infection with a decrease in White Blood Cells( they guys who fight off infection) Tapazole also has a high risk of liver damage, both MDs want to destroy the thyroid if it is non-cancerous if cancer I assume a whole different approach.
Either way they want to destroy my thyroid to make me hypothyroid and place me on synthroid or levoxyl. So I think why dont they just remove the thyroid and dont risk the side effects which for me can be lifethreating? I was hoping to find and Endocrinologist who treats, does there own biopsies and treats the cancer if it is there.
I live in Boca Raton Fl East Coast of the State and we have great MDs at my hospital it is 50 miles one way, tough on family and child. This happened so fast nobody can explain what happened. I feel like I am unable to sleep and eat ( that should be my biggest problem) I have hand tremors and palitations ( Heart Rate runs about 110 beats per minute) any you feel so hyperactive and scattered in thought you feel like you are going CRAZY!! Its horrible. Thanks For you interest and assistance.
Thanks for your response. Normal ranges for the following are as follows: T4 - 5.5-11.0,I
came in at 18.6 high, TSH normal range is 047-4.68 I came in at 0.006 very low almost nonexsistant ,T3 Free 2.77-5.27 I came in at 6.02 High ,T4 Free normal range .78-2.19 I came in at 2.36 high ,T3 Total normal range .97-1.69 I came in at 2.42 high. I have been tested for Graves and eye measurements are completly normal Thank G-d for something normal.Hashimoto's Thyroiditis is just and inflamation of the Thyroid gland where the levels begin to even out or normal as the "infection or virus" begins to go away. I have seen 2 Endocrinologists both suggest a Fine Needle Biopsy, and medication either Radioactive iodine ( which may take too long to notmalize me ) and Tapazole- a drug with my immune suppression history is only asking for trouble as the side effects are increase in infection with a decrease in White Blood Cells( they guys who fight off infection) Tapazole also has a high risk of liver damage, both MDs want to destroy the thyroid if it is non-cancerous if cancer I assume a whole different approach.
Either way they want to destroy my thyroid to make me hypothyroid and place me on synthroid or levoxyl. So I think why dont they just remove the thyroid and dont risk the side effects which for me can be lifethreating? I was hoping to find and Endocrinologist who treats, does there own biopsies and treats the cancer if it is there.
I live in Boca Raton Fl East Coast of the State and we have great MDs at my hospital it is 50 miles one way, tough on family and child. This happened so fast nobody can explain what happened. I feel like I am unable to sleep and eat ( that should be my biggest problem) I have hand tremors and palitations ( Heart Rate runs about 110 beats per minute) any you feel so hyperactive and scattered in thought you feel like you are going CRAZY!! Its horrible. Thanks For you interest and assistance.
COMMUNITY LEADER
Dr Lupo does not monitor this forum, so it's unlikely that he will respond to your questions. You can repost them in the expert forum; however, if you'd like our members to try to help you, I'm sure they will.
I'm not real familiar with hyperthyroidism, so I can't comment too much. I do know that it's necessary to post a reference range for the Free T3 and Free T4 in order for us to be able to tell where you fall within that range.
Have you been tested for Graves Disease and Hashimoto's Thyroiditis?
I'm not real familiar with hyperthyroidism, so I can't comment too much. I do know that it's necessary to post a reference range for the Free T3 and Free T4 in order for us to be able to tell where you fall within that range.
Have you been tested for Graves Disease and Hashimoto's Thyroiditis?
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