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Please help with thyroid scan results, etc.
Right gland measures 4.0 cm in length by 1.4 cm in anterior/posterior by 1.6 cm in transverse dimension for a volume of 4.8 cc.
Isthmus measures 3 mm in thickness.
Left gland measures 4.0 cm in length by 0.8 cm in anterior/posterior dimeter by 1.3 cm in transverse dimension for a volume of 2.4 cc.
Within the right the superior gland, there is a 1.1 x 0.8 cm nodule, mildly hypoechoic, which has increased in size compared to the earlier examination. An additional small nodule measuring 4 mm is seen superiorly within the gland, mildly hypoechoic, not clearly evident previously. Within the right mid gland, there is a 5 mm nodule, hypoechoic, and a fourth nodule seen within the right mid gland measuring 5 mm. Within the right inferior gland, there is a 6 mm hypoechoic nodule.
Evaluation of the left gland inferiorly demonstrates likely an elongated lymph node versus parathyroid gland measuring 0.8 x 0.2 cm in size.
IMPRESSION:
1.) Multiple right gland nodules with interval increase in size of the right upper pole nodule and multiple new left gland nodules.
2.) Left inferior pole regional lymph node versus prominent parathyroid gland.
January 2012 bloodwork:
Thyroid Peroxidase (TPO) Ab 176 (range 0-34)
Antithyroglobulin Ab 208 (range 0-49)
TSH 3.73 (range .45-4.5)
Free T4 1.29 (range .82-1.77)
Recent bloodwork:
Thyroid Peroxidase (TPO) Ab 91 (range 0-34)
Antithyroglobulin Ab 64.3 (range0.0-0.9)
TSH 5.62 (range .45-4.5)
Free T4 1.23 (range .82-1.77)
Thyroxine T4 9.8 (range 4.5-12.0)
T3 Uptake 23 (range 24-29)
Free Thyroxine index 2.3 (range 1.2-4.9)
Feeling some discomfort while swallowing pills. Have felt terrible (too much to list), for so long, I've forgotten what feeling good was like. I'm thinking I need an endocrinologist and FNA and biopsy at this point. My doctor never mentioned Hashimoto's, even though I tested positive for the two antibody tests used for diagnosis (two times already).
Please help me in anyway possible. Thank you.
Isthmus measures 3 mm in thickness.
Left gland measures 4.0 cm in length by 0.8 cm in anterior/posterior dimeter by 1.3 cm in transverse dimension for a volume of 2.4 cc.
Within the right the superior gland, there is a 1.1 x 0.8 cm nodule, mildly hypoechoic, which has increased in size compared to the earlier examination. An additional small nodule measuring 4 mm is seen superiorly within the gland, mildly hypoechoic, not clearly evident previously. Within the right mid gland, there is a 5 mm nodule, hypoechoic, and a fourth nodule seen within the right mid gland measuring 5 mm. Within the right inferior gland, there is a 6 mm hypoechoic nodule.
Evaluation of the left gland inferiorly demonstrates likely an elongated lymph node versus parathyroid gland measuring 0.8 x 0.2 cm in size.
IMPRESSION:
1.) Multiple right gland nodules with interval increase in size of the right upper pole nodule and multiple new left gland nodules.
2.) Left inferior pole regional lymph node versus prominent parathyroid gland.
January 2012 bloodwork:
Thyroid Peroxidase (TPO) Ab 176 (range 0-34)
Antithyroglobulin Ab 208 (range 0-49)
TSH 3.73 (range .45-4.5)
Free T4 1.29 (range .82-1.77)
Recent bloodwork:
Thyroid Peroxidase (TPO) Ab 91 (range 0-34)
Antithyroglobulin Ab 64.3 (range0.0-0.9)
TSH 5.62 (range .45-4.5)
Free T4 1.23 (range .82-1.77)
Thyroxine T4 9.8 (range 4.5-12.0)
T3 Uptake 23 (range 24-29)
Free Thyroxine index 2.3 (range 1.2-4.9)
Feeling some discomfort while swallowing pills. Have felt terrible (too much to list), for so long, I've forgotten what feeling good was like. I'm thinking I need an endocrinologist and FNA and biopsy at this point. My doctor never mentioned Hashimoto's, even though I tested positive for the two antibody tests used for diagnosis (two times already).
Please help me in anyway possible. Thank you.
I think that's a really good list to start on.
All the thyroid labs are there. You might get some resistance from your doctor to the RT3 test, so be prepared. Many mainstream doctors "don't believe" in RT3 or dismiss it as irrelevant.
The iron panel is important. (TIBC = total iron binding capacity) Iron is necessary to the proper metabolism of thyroid hormones. Deficiency can also cause some hypo-like symptoms.
You've already tested low on D several years ago. This is the time of year when D deficiency really rears its ugly, little head. Be aware that many people find that D has to be well up into range before feeling well. B-12 is another that can mimic/exacerbate some hypo symptoms, especially fatigue and brain fog.
I think that will get you started...
All the thyroid labs are there. You might get some resistance from your doctor to the RT3 test, so be prepared. Many mainstream doctors "don't believe" in RT3 or dismiss it as irrelevant.
The iron panel is important. (TIBC = total iron binding capacity) Iron is necessary to the proper metabolism of thyroid hormones. Deficiency can also cause some hypo-like symptoms.
You've already tested low on D several years ago. This is the time of year when D deficiency really rears its ugly, little head. Be aware that many people find that D has to be well up into range before feeling well. B-12 is another that can mimic/exacerbate some hypo symptoms, especially fatigue and brain fog.
I think that will get you started...
Hi Goolarra,
Thanks for your help. It makes me feel better :) I'm going to my husband's gp tomorrow, he is a D.O. I'm bringing all my bloodwork and scan results. I am going to ask him for the following tests:
TSH
Free T3
FreeT4
Reverse T3
Iron Ferritin
TIBC (?)
Iron Sat
Vit D
Vit B12
I got that list from somewhere, my fog keeps me from keeping good records of what I read where lol. Is all of that necessary in your opinion, amd I missing anything? I appreciate all your input.
Thanks for your help. It makes me feel better :) I'm going to my husband's gp tomorrow, he is a D.O. I'm bringing all my bloodwork and scan results. I am going to ask him for the following tests:
TSH
Free T3
FreeT4
Reverse T3
Iron Ferritin
TIBC (?)
Iron Sat
Vit D
Vit B12
I got that list from somewhere, my fog keeps me from keeping good records of what I read where lol. Is all of that necessary in your opinion, amd I missing anything? I appreciate all your input.
NT has quite a bit of T3 in it, and T3 is faster acting than T4. So, you can feel better more immediately.
High LDL is a symptom of hypo, not Hashi's. It probably indicates that you were undermedicated at the time. I didn't realize when I wrote my comment above that you were on meds. In that case, your FT4 at 43% of range is on the low side since 50% is the target. Your doctor should be testing FT3 as well. Now that you're on NT, insist that he monitor FT3 ever time you have blood work. NT should not be taken before the blood draw.
Your doctor does seem to be at a bit of a loss. Total T4, T3 uptake and FTI are considered obsolete and of little value in ongoing management of thyroid meds. Replace those with FREE T3, and you'll be in good shape.
You should probably have vitamin D tested again. That's a long time ago.
Good luck with the NT.
High LDL is a symptom of hypo, not Hashi's. It probably indicates that you were undermedicated at the time. I didn't realize when I wrote my comment above that you were on meds. In that case, your FT4 at 43% of range is on the low side since 50% is the target. Your doctor should be testing FT3 as well. Now that you're on NT, insist that he monitor FT3 ever time you have blood work. NT should not be taken before the blood draw.
Your doctor does seem to be at a bit of a loss. Total T4, T3 uptake and FTI are considered obsolete and of little value in ongoing management of thyroid meds. Replace those with FREE T3, and you'll be in good shape.
You should probably have vitamin D tested again. That's a long time ago.
Good luck with the NT.
small correction: scan results above refer to ultrasound scan, not a scan with radioactive iodine.
Thank you so much for talking to me! I failed to mention that I was taking 88 mcg levothyroxine forever. After I got those labs, i talked my doctor into letting me try Nature-Throid. I'm three days in and thought I was feeling a tad better, felt a little brain fog lift, a little less sore. I don't know if I could feel a difference that quickly, but I coincidentally started no gluten four days ago too. I haven't felt the facial/eye puffiness in a couple days.
After finding the old bloodwork with the positive tests for antibodies/Hashi's, I started researching Hashi's and felt a sudden relief that I wasn't alone, that it all made sense now. Singularly all these symptoms were just eating away at my quality of life, a little bit everyday. I found Facebook groups and blogs and suddenly saw myself in all these other people and I have hope now.
In the bloodwork I posted, my urinalysis had RBC of 4-10 (range 0-3), Trace of Occult Blood and cloudy appearance. My docs only question to me was did i have my period. My LDL cholesterol is high (hashi's right?). I also tested high for Lyme Ab/Western Blot Reflex-Lyme IgG/IgM Ab .95 (range equivocal 0.91-1.09), but all other IgG and IgM tests came back absent or negative. So therefore, I am considered negative I guess. Honestly, as you can see what was ordered to look at the hypo situation, my doctor doesn't seen to know what to look for. Last time my vitamin d was tested was 2010, and it was low. That was the first year I came back positive on the antibody tests.
Thanks again for listening and commenting, it is so very appreciated :)
After finding the old bloodwork with the positive tests for antibodies/Hashi's, I started researching Hashi's and felt a sudden relief that I wasn't alone, that it all made sense now. Singularly all these symptoms were just eating away at my quality of life, a little bit everyday. I found Facebook groups and blogs and suddenly saw myself in all these other people and I have hope now.
In the bloodwork I posted, my urinalysis had RBC of 4-10 (range 0-3), Trace of Occult Blood and cloudy appearance. My docs only question to me was did i have my period. My LDL cholesterol is high (hashi's right?). I also tested high for Lyme Ab/Western Blot Reflex-Lyme IgG/IgM Ab .95 (range equivocal 0.91-1.09), but all other IgG and IgM tests came back absent or negative. So therefore, I am considered negative I guess. Honestly, as you can see what was ordered to look at the hypo situation, my doctor doesn't seen to know what to look for. Last time my vitamin d was tested was 2010, and it was low. That was the first year I came back positive on the antibody tests.
Thanks again for listening and commenting, it is so very appreciated :)
We have members who are good with imaging, but they tend to be on sporadically...hang in there.
FNA is usually done on nodules greather than 1 cm, depending on characteristics viewed on U/S.
It does look like you have Hashi's. However, FT4 is still pretty good at the moment. It's 43% of range, which is good for someone not on thyroid meds. Missing is FT3. That's the test that correlates best with symptoms.
Multi-nodular goiter is VERY common with Hashi's. Don't panic yet. Hopefully, our imaging specialists will be on soon.
FNA is usually done on nodules greather than 1 cm, depending on characteristics viewed on U/S.
It does look like you have Hashi's. However, FT4 is still pretty good at the moment. It's 43% of range, which is good for someone not on thyroid meds. Missing is FT3. That's the test that correlates best with symptoms.
Multi-nodular goiter is VERY common with Hashi's. Don't panic yet. Hopefully, our imaging specialists will be on soon.
Please, I need some direction. I'm getting desperate and falling further into despair. I just want some hope to feel like me again. Please someone tell me what my doctor should be having me do next. I posted thyroid scan results yesterday, but I haven't had a response yet. At what point should I be having a FNA/biopsy of a multinodular goiter? I'm worried.
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