Hey Barb, when my mother went into remission for Hashi's her thyroid nodules also reduced in size and some nodules disappeared. It looks like you were in remission (mistaken for a "dead" thyroid gland) and Hashi's has been retriggered for whatever reason (I found various reasons below) and affecting the size of your thyroid nodule.
You mention adrenal tumours and cortisol. Have you been tested for Cushing's Syndrome?
Except from the article from Restartmed: How Hashimoto's symptoms change over time + "flare" up symptoms...
"List of Hashimoto's flare up sources:
Extreme physiological or emotional stress (death of a loved one, divorce, problems at home/school/work, etc.)
Physical trauma such as car accident or even repetitive physical trauma from extreme exercising/sports
Chronic nutrient deficiencies
Viral infections (CMV, EBV, etc.)
Other hormone imbalances that may alter immune system function
Exposure to endocrine disrupting chemicals
Exposure to heavy metals (the removal of dental amalgams has been shown to reduce thyroid antibodies in some patients)
Increased intestinal permeability due to overgrowth syndromes or intestinal dysbiosis"
Very interesting thread... sorry I had to bow out for a bit. I never did have elevated TgAb, though I did have elevated TPOab, which did go down after I started on thyroid hormones. I was told that was because my thyroid was "dead" and there was nothing left for the antibodies to attack, so they went into remission. They stopped testing antibodies for several years and as I noted above, my new NP just tested them and they're elevated again, so apparently, there's "something" left to attack...
I've also always had small nodules, never any dominant nodules though. That's changed now and I have one dominant nodule that's 1.1 X 1.0 X 0.8 cm. The ultrasound report stated that could be a thyroid or parathyroid nodule. Not sure how they could not tell the difference... I'll be sent to an ENT for follow up on that.
I've tried diet changes a couple of times, but it's been pretty difficult for a couple of reasons, mostly because it wasn't "doctor ordered", so family cooperation was slight to non-existent. It has been now doctor ordered, so it's going a bit easier. I've been asked to give up wheat, dairy, soy (which I ever eat anyway), sugar, processed foods (which I also don't eat much of), etc. I've only been trying it for a week, so haven't made a lot of progress and the sugar part of it is really difficult... :-(
I'm supposed to do an extensive stool sample, to check for a variety of parasites, since I did have H. Pylori at the beginning of the year, but that's all they tested for. I'll get that done this week.
Acid reflux has been one of my most prevalent symptoms for years - off and on. I've done the HCL with pepsin, which pretty well took care of the acid reflux. When I get it back, now, I take peppermint oil, dill pickle juice, etc to help restore acid.
My cortisol levels are also messed up, so that seems to be having an over-all effect, as well. In spite of having bi-lateral adrenal adenomas, the NP is the only one who has checked cortisol levels or thought it important to pay attention to them.
I'm finding it somewhat odd that after all these years, these things (dominant nodule, high TPOab, etc) would show up again after my thyroid was supposed to have been "dead".
My first autoimmune disease showed up when I was baby. Not sure of the trigger but there are many possible triggers mentioned such as environmental toxins. I don't suffer from acid reflux regardless of stomach acid levels. I have to put that down to chewing my food excessively (B12 malabsorption damaged my gag reflex).
Conventional medicine (anyone for that matter) really needs to get to he bottom of autoimmune illnesses. We are seeing the tip of the iceberg from the natural or functional medicine side- but its full of guesses. Its part genetics and seems to be influenced by diet. We know its not diet alone- cause a great part modern/western society would be ill from modern convenience/ junk food.
I tried a anti-oxalic acid diet (Dr suggest) for three months, which excludes nightshades, nuts ect. It did nothing so I checked that off the list.
I'll try my HCL again (even though I digest great) due to my candida past.
I found this in regards to nightshades and inflammation...
Excerpt from the article What are Nightshades and Do They Cause Inflammation?...
"Because nightshades are only a problem for a small number of people, it’s overkill to suggest that everyone should avoid them.
People with arthritis are sometimes advised to avoid all nightshade plants because they are said to cause inflammation. But this advice really only applies to people who have a sensitivity to solanine. For these folks, eating nightshade plants causes an inflammatory reaction—including joint pain.
Because most people are not sensitive to solanine, however, I think it’s misleading to characterize nightshade plants as “inflammatory,” and it’s certainly overkill to suggest that everyone with arthritis should avoid them—especially because they have so much going for them nutritionally.
Nightshade plants are high in antioxidants, which actually help reduce inflammation. And chili peppers also contain capsaicin, a strongly anti-inflammatory compound. So, if you’re an arthritis sufferer, I’d think these would be foods you’d want to eat more of—unless, of course, you are among the minority that is sensitive to them."
**
I checked lab ranges and my mother's TgAb levels are always <10 (lab range is normal <60). When I first had Hashimoto's thyroiditis my TgAb was 150 but went back to <10 for 5 years until my most recent lab result (up to 120).
I'm not surprised at the increase in TgAb since I have severely depleted stomach acid due to chronic stress (causing a lot of deficiency states including iron deficiency anaemia) and stomach acid is crucial to good digestion/absorption and immune health. I need to start taking my mother's Betaine HCL with pepsin supplements.
My mother had severe systematic candida until she started betaine HCL with pepsin supplements and increased her stomach acid. Candida does not like an acidic environment. Probiotics are also acidic as well.
Red Star- interesting about the alkaloid in night shades decreasing TgAb (the antibody I still have).. I say interesting because there are also sources that say nightshades should be eliminated in a "anti-inflammatory autoimmune diet". I might read up on that more, since my TgAb was still elevated. Confusing.
That said, I still eat nightshades like sweet peppers but replaced white potatoes with sweet potatoes. Guess that's where Paleo and Autoimmune diets differ.
My main quest was to see if there was anything I could through diet to help boost my immune system to rid whatever lyme or candida I have left....the natural way. The fact that it normalized my TPO was a coincidental surprise.