Are you taking thyroid meds?
Your November FT4 is way too low. It's below range, and FT4 guideline is midrange.
Unfortunately, we don't know what your FT3 is doing. Your symptoms seem kind of mixed, hypo and hyper, though leaning toward hyper at the moment???
I think the very first thing to do is repeat FT4 and TSH and add in FT3.
How did the nodules appear on ultrasound?
Have you had thyroid antibody tests done?
Actually I did find the T3 results on the November results. It is:
126 with a Normal Range of 71-180. So that appears normal. I have the Thyroglobulin Antibody on here as well. It is: <1.0 IU/mL Normal Range 0.00-0.9.
The one I had in August 2013. The results read: Impression: A multinodular thyroid appearance is again demonstrated with the larger and more complex nodules on the right side. The dominant right nodule is amenable to fine needle aspiration should be considered given it's size. The adjacent nodule with central echogenic foci should also be consideration for sampling given the appearance of possible calcifications versus colloid foci.
The current Dr. has not given me a copy of the results of the scan done in his office in Nov except to tell me the day I was there that nothing has changed so really no need for FNA.
It was two weeks later that he sent a message over his Portal to me that I need a FNA and we will talk about surgery if the pressure is too much on my wind pipe. I have no idea why the change of heart as the entire message was what I stated above.
On 07-25-11 I had a Nuclear Medicine Thyroid Scan.
IMPRESSION: THE GENERAL APPEARANCE OF THE GLANDS SUGGEST A MULTINODULAR GOITER, HOWEVER, THE VERY INTENSE ACTIVITY IN THE RIGHT MID POLE SUGGESTS ADENOMA WITH DEVELOPING SUPPRESSION OF ACTIVITY IN THE REMAINDER OF THE GLAND, PATCHY AS NOTED.
IMPRESSION: HYPERTHYROID STATE.
On 09-06-11 I had a FNA with Result Benign thyroid Nodule. I hope this additional information helps and you can steer me in a good direction.
Thanks for taking the time to answer this.
I am taking no Thyroid meds of any kind. I have been constantly told I do not need any.
My thought would be to think of the possibility of a periodic "hot nodule".
That is a nodule that periodically "leaks" out hormone. During these times you would be in hyper state. While when the nodule is inactive, then you fall into Hypo state.
This would explain in theory the roller coaster.
Another possibility is Hashimoto's which also can lead to roller coaster ride of Hyper to Hypo depending upon the fluctuating activity of the antibodies attack on the thyroid gland.
Or it could be a combination of both of the above.
The indication that the gland looks: "THE VERY INTENSE ACTIVITY IN THE RIGHT MID POLE SUGGESTS ADENOMA WITH DEVELOPING SUPPRESSION OF ACTIVITY IN THE REMAINDER OF THE GLAND,"
This seems to me would indicate damage to the thyroid gland due to Hashimoto's. "suppression of activity" would indicate the thryoid is producing less hormone. However your symptoms are mostly Hyper at least at the moment. So again this would be consistent with a "hot nodule".
Understand I am NOT a Dr and do not claim to be. I'm just a "regular" person reading what is posted and trying to make a judgement as to what would or could be consistent with those posted symptoms and information provided.
If indeed there is a hot nodule, then surgery could remove this. And at least your roller coaster ride will be over but would leave you with a consistent Hypo state and thus need for finding the correct dosage to counter no longer having a thyroid gland.
So just my 2 cents that actually cost nothing. So take my advice with the weight that you paid for it :)
Thank you for your reply. I most certainly appreciate any and all thoughts and advice that I am able to glean from my post so I am able to make informed thoughts and decisions. You two cents worth is worth a lot more to me. Again thanks.
Your T3 result is total T3, not free T3. FT3 is considered a lot more useful test. However, that being said, your TT3 looks good. It's right in the middle of the range.
I agree with flyingfool that it looks like you might have a toxic nodule or toxic adenoma, which I think is what he meant rather than "hot" nodule. A toxic nodule is kind of like a mini thyroid within your thyroid. It produces thyroid hormone independent of pituitary control. It also puts out more T3 than the thyroid ordinarily does.
Was thyroid peroxidase antibody (TPOab or microsomal) ever tested? Many more of us who have Hashi's are TPOab positive than TGab positive.