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I have a multi nodular enlarged thyroid with a cold spot.

My first blood test came back normal...i pushed my Gp for another test..it came back with TSH 0.141..I am not sure what this indicates ..any input would be appreciated
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649848 tn?1534633700
COMMUNITY LEADER
Do you mean that one of the nodules showed as a cold nodule?  

Here's an explanation of hot and cold nodules:
"What is a Cold or Hot Nodule?
Nodules detected by thyroid scans are classified as cold, hot, or warm. Thyroid cells absorb iodine so they can make thyroid hormone out of it. When radioactive iodine is given, a butterfly image will be obtained on x-ray film showing the outline of the thyroid. If a nodule is composed of cells that do not make thyroid hormone (don't absorb iodine), then it will appear "cold" on the x-ray film. A nodule that is producing too much hormone will show up darker and is called "hot."

85% of thyroid nodules are cold, 10% are warm, and 5% are hot. Remember that 85% of cold nodules are benign, 90% of warm nodules are benign, and 95% of hot nodules are benign."

Only 5% of all thyroid nodules turn out to be cancer, so it's really quite rare.  Testing for TSH can't tell you whether you have cancer or not; it can only indicate whether or not your thyroid is producing too much/too little thyroid hormones.

Your TSH of 0.141 indicates that you might have hyperthyroidism, though... Is that the only test you've had done?  What about Free T4 and Free T3?  Those are the actual thyroid hormones and tell exactly what the thyroid is producing.  TSH is a pituitary hormone and is an indicator, at best.  

You should also ask for thyroid antibodies to determine if you have an autoimmune thyroid condition, such as Hashimoto's Thyroiditis or Graves Disease.  Hashimoto's is, typically, associated with hypothyroidism, but is often associated with hyperthyroidism in the beginning stages as one alternates between hyper and hypo while the thyroid sputters before finally dying out.  The antibody tests to confirm/rule out Hashimoto's are Thyroid Peroxidase Antibodies (TPOab) and Thyroglobulin Antibodies (TgAb).  You need them both, as some of us have one or the other and some have them both.

Graves Disease is always associated with hyperthyroidism.  The definitive test for Graves is Thyroid Stimulating Immunoglobulin (TSI).
5 Comments
I forgot to mention that symptoms are the most important thing to consider... What, if any, symptoms do you have?  What prompted the tests in the first place?
Hi Barb thankyou for the information...
I have had a stiff neck and a sore throat on the left and extreme fatigue and mood swings...
My T4 and T3 came back in the normal range.
I feel because I have a history of anxiety and depression my symtoms have been dismissed I have had to push my GP .
I also have pain going up my neck to my ear and ringing in my ears I also have dry skin on my face it feels like fine sandpaper.
Hi Barb, my free T4 is 14.2 normal rand is 9.0 to 19.0
Free Tri-iodothyronine is 4.1 normal range is 2.6 to 6.0...at this point these are the only blood test results that I have..
Your levels of Free T4 and Free T3 aren't horrible; in fact, your Free T4 is good, at slightly over mid-range.  However, your Free T3 is less than mid-range, when it should be in the upper half to upper third of its range.  Free T3 is the hormone used by nearly every cell in the body and it should be higher in its range than Free T4 is in its range.

The fact that your Free T3 is on the low side, could indicate inadequate conversion of the Free T4 storage hormone to the usable Free T3.  This could be due to excess Reverse T3 or some other problem.

In addition, with your TSH as low as it is, there won't be enough to stimulate your thyroid to produce adequate T4 and T3 for very long.  I'd strongly suggest you try to get another opinion as there's a reason for that low TSH.  
649848 tn?1534633700
COMMUNITY LEADER
Just because your T4 and T3 were normal doesn't mean they're normal for you.  What were the actual results and their corresponding reference ranges?  Also, were they Free T4 and Free T3 or were they Total T4 and Total T3?  Total and Frees aren't the same tests and don't provide the same information.  

Anxiety and depression are common symptoms of thyroid malfunction.  I'm surprised your doctor would blow it off like that.

Is it possible to get another opinion?
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