Blood test and ultrasound help please :)

[andrea085]

Hi all,

A couple of months ago I felt a lump in my neck and my doctor sent me for an ultrasound which showed multinodular goiter with 6 nodules. The largest is 5cmx2cm. It showed no trachea deviation. This week I had a CT on my spine which incidentally showed the goiter now with posterior extension adjacent to esophagus and trachea deviation to the right. I am not on any medication. The latest blood test results are:

TSH 2.5 (0.4-4)
Free T3 4.3 (3.5-6.5)
Free T4 18.1 (9.8-18.8)
Reverse T3 544 (230-540)
RT3:FT3 Ratio 7.9 (<20)
TG - Ab 11.9 (<60)
TSH Receptor Anti <1 (<1.5)
TPO - Ab 16.5 (<60)
Thyroglobulin 213 (1.6-50)
Anti Thyroglobulin <1 (<5)

I mainly want to know what the CT means.. Is it likely I'll need to have it removed as it is clearly still growing. And with the blood test results, why would Thyroglobulin be so high? And T4 is high yet T3 is low. Any reason for that?

Thanks for any help :)

Andrea

[Red_Star]

When reverse T3 is elevated the T3 and T4 may still appear to be within the normal range but you can also see a free T3 result in the lower end of normal. Some common causes of elevated reverse T3 include stress, extreme dieting, insulin resistance, diabetes, low vitamin B12 levels.

Elevated thyroglobulin levels are found with thyroid cancer, hyperthyroidism, subacute thyroiditis, and some cases of benign adenoma. The risk of cancer increases when a thyroid nodule is larger then 2 cm.  A FNA (fine needle aspiration) biopsy would be recommended.