Questioning Endrocronology

[noneck]

I am male age 58. 4 years ago my feet started being cold all the time. In the summer they would not bother me as much, in the winter they are freezing. Last October The only way I can describe it is "it went in my whole body". I woke up sweating and freezing and it lasted for almost 3 months. Having to stay wrapped in a blanket or under the covers. I was seating and freezing, my PCP just pretty much did nothing until I insisted he did and well that ended a 20 year doctor, patient relationship. I went to another PCP for a second opinion, (this DID end that 20 doctor I had) he gave me a ultrasound that showed four nodules and it is a little large. This alarms no one and is just blown off by two Endcrin. doctors, very rudely in my opinion. Yes, I understand it may or may not be a problem because people can have them and have no problem or symptoms. The first Endcrin did do his own blood work, TSH ranges 0.300-4.120, mine is 0.424, Free T4 ranges 0.8-1.9 mine is 1.1, Free T3 ranges 1.5-4.1 mine is 5.2. Beside still feeling cold all over especially my feet, it is summer and not as bad like it always was with just my feet, this will turn back to what it was when winter comes, I'm sure. Also for what I even don't understand is I'm also hot at times, (this statement even gets rude remarks from the doctors like "that's impossible") my chest is beat red all the time and will leave finger prints when I touch it. What ever this is this what is causing the sweating, I think. Now since It's summer I go barefoot and wear short pants. I have noticed that from my shin down my skins looks pale white. The skin is dry and scaly, and my hair is falling out of my lower leg. I am noticing dry skin moving up my leg. This can be seen and not just me telling some doctor "I'm cold all the time". The Endocrin I am seeing now when I mentioned it to him in a e-mail and asked "do I need to see a dermatologist or someone else, something is wrong" he said, "there is no one to show this to, no one to tell, and as the Mafia said "foget about it". Why is this the way these doctors react to these symptoms that are as serious as a heat attack. They just blow it off and don't even look or touch or EXAMINE MY FEET AND LEGS period. From what I have read there is a game being play in this field of medicine by doctors governing treatment themselves. Not treating people with symptoms, but treating people without symptoms but have blood work that is where they want it. Who says OUR NUMBERS aren't to low for US!

[goolarra]

I just wanted to give you a bump up so your thread didn't get lost.  I haven't had any luck contacting the imaging person.

[noneck]

In addition to, I don't know either, maybe the nodules?

As far as the numbers go I don't think I'll ever know if they drop or change because they aren't checking my thyroid anymore they don't think it's a problem.

They just seem to be concerned with testosterone which has ZERO effect on me in way shape or form with the symptoms I have. I have gone off it for blood work started it again for blood work and it's doesn't matter, there is no change in my symptoms weather I use testosterone or not.

I am in a predicament with doctors for some reason, like I said I have no PCP over this. One specialist just blew me off, this one just doesn't see any problem with my thyroid at all. He does prescribe the testosterone and ordered blood work for it for my next follow up, no thyroid blood work was ordered. He is not looking at my thyroid. I got a problem and it's my damn thyroid, and I guess I just need to live with it. This will never be known for me, because all three did say, "we may never know what this is". That's the only thing all three said the same. Thanks for helping me but What would I do with it, actually I don't think they believe I'm having these symptoms.

[goolarra]

I understand "thyrotoxicosis", but the whole sentence doesn't make sense..."also", "in addition to" what?

Yes, I think you're right.  He meant that your TSH only has to drop a little for you to be "hyper" according to labs.  Many doctors treat by TSH alone.  Endos seem to be especially in awe of TSH.  BUT, not all of them do that...

Let me send a message to the person who is good with imaging.  Hopefully, we can get him in on this, too.

[noneck]

Yes, on the TSI question that's all they gave.

No typo "thyrotoxicosis"

Both Endo doctors said I don't have a thyroid problem. The first one said during my first visit, he wanted to repeat the ultrasound himself in 6 months and that he expected in time my labs would go over, he actually said I'm one number away. I think he meant the TSH number of 0.424 when to low is 0.300 on this report. Do you assume that also considering what he did say to me in person. After 2 month into a four month follow up I called and reported "I'm just not doing any better", his nurse called me back the next day and told me I didn't have a problem with my thyroid or an endo problem and to just go back to my PCP for more tests.

I went to another endo on my own who also said I have no thyroid problem and to "foget (sic) about it".

The ENT doctor is the one who just bad mouthed the ultrasound and said " that shouldn't have been said" I think he's talking about the word thyrotoxicosis and where it says "diffuse thyroid enlargement and hyperemia".

What I have been told by four doctors has me so confused and just don't understand the rejection of symptoms as just live with it and shut up. I'm ranting again, lol. Thanks for helping!

[goolarra]

So, they didn't give you an exact result for TSI...just less-than 89%?  Ugh...

"The patient also in addition to thyrotoxicosis "  I think there's a typo in there somewhere, and I can't decipher it.  Please clarify, and then I'll get in touch with a member I know is good with imaging to take a look at it.

[noneck]

Thanks and I yes I know what you said in your rant, lol. All I have to say is negligent, in my opinion. Symptoms are present for a reason and need to be treated. End of my rant, lol. My ENT doctor was the worst he said the ultrasound report should not say what it does and means nothing at all. Thanks for responding!

To your other question my TSI <89, <140% baseline.
My TPO 20 is in range of 0-35.

My ultrasound says,
right gland measures 5x2.1x1.7,
left 5.2x2x2.2
The patient also in addition to thyrotoxicosis
On the right gland mid pole, 4mm hypoechoic mass
Mid pole left gland, 4mm hypoechoic mass
Istmus has two 5mm masses.
By size and imaging none appear particularly suspicious.
Doppler of gland shows marked hyperemia.

Impression;
four nonspecific hypoechoic masses
diffuse thyroid enlargement and hyperemia

[goolarra]

Excellent point...we all have our own personal comfort range, which usually, but not always, falls within the population range.  Ultimately, treatment should be symptom driven, but treating symptoms, when non-subjective indicators (lab numbers) are "in range" can get you into court in a heartbeat.  Most of the medical industry (you notice I didn't say health "care") is more concerned with staying out of court than with the patient.  End of rant...LOL

So, to your thyroid labs.  You're not on any meds, correct?  Your FT4, at 1.1 is a little on the low side (hypO).  It's 27% of range, and due to thyroid test ranges being very flawed, many of us find that we have hypo symptoms until FT4 is about 50% of range.  On the other hand, FT3 is well over range, which indicates hyper.  This could explain your mixed symptoms.

Do you have your U/S report to post?  It would be good to see the specifics of the composition of the nodules.

Have you ever had antibody testing to see if you have an autoimmune thyroid disease?  These would be TPOab (thyroid peroxidase antibody), TGab (thyroglobulin antibody) and TSI (thyroid stimulating immunoglobulin).