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11250735 tn?1417186714

Roller Coaster Ride is getting WORSE

Thyroid issues were discovered in 2011. The last three tests done, two at one place and one at another Lab are as follows:
April 17 2013
   FT3   3.6        Normal Range   2.3-4.2
   FT4   1.14      Normal Range   0.62-1.57
   TSH   0.585   Normal Range    0.350-5.500

July 16 2013
   FT4    0.98     Normal Range    0.62-1.57
   TSH    0.307  Normal Range     0.350-5.500

November 03 2014  (Different Lab)
   TSH    0.831   Normal Range   0.450-4.500  
   FT4     0.76     Normal Range   0.82-1.77
Lmyphs   3.5      Normal Range   0.7-3.1
No T3 run in last two tests.

I have a larger than 2.3cm dominant nodule on the right side and numerous smaller nodules with the next largest on the left side. I had a FNAB done in 2011 with no cancer evident.

The Dr. of the last results is new.

Added symptoms. Heart racing periodically, heart beats over 100 on normal sitting quietly. Extreme Sweating. 20 degrees outside I am hot. Any exercise, I am profusely sweating. Night time I am cold and turn on bed heat in winter. Mood swings, too the point I sometimes wonder why I am even on this earth. Luckily I know who I am and can shake these thoughts off with effort and telling myself to stop these stupid thoughts. Weigh gain in huge amounts. 135lb normal weight to 186lbs in three years. Now reverse, loss from 186lbs to 158lbs in 4 months. Low energy for several days and sudden high energy again and clear thoughts. On low energy days I go about the day totally confused at what I am doing. Start a project, stop, go to something else and then suddenly forget what I was doing at all. Have to stop and regroup, try to clear my head and start over. Loss of memory and time is becoming permanent. Mood changes to anger with no real reason.. On good energy days I focus and accomplish much with good and clear short term memory. Happy with no mood change.

I am 62 and have a very busy Lifestyle in the Companion Animal Field, Groomer, Trainer, Used to show, my day starts at 5am and ends at 10pm of which I used to be active throughout the day. On good days that is still the case. I do all the repair work on the fencing, shovel gravel and am still extremely strong for my age.

My current Dr. answers to latest blood levels is do another FNAB and look at surgery to stop the pressure on my windpipe when I sleep. First off I DON'T want surgery, secondly the pressure is there but not enough to warrant surgery. I want to control the Roller Coaster ride. I want to know how to approach the Dr. about taking care of these symptoms because not one of them hears me when I speak. They look at the blood results and tell me that it is not the Thyroid causing these. I have no other medical issues except for DJD and Spondyolothesis of which I both control because I am so active. A little arthritis is setting in due to age. I feel like I am headed for Dementia if I don't get this under control and find a Dr. that is willing to treat symptoms. I never know when I wake up what type of day and energy this day will bring to me. Shaking inside is a new symptom for me the last month.

I need help in finding a Dr. that will listen to me.. We live in Lexington, Tennessee.  

12 Responses
Avatar universal
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?
11250735 tn?1417186714
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.
The Results:
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.
11250735 tn?1417186714
I am taking no Thyroid meds of any kind. I have been constantly told I do not need any.
Avatar universal
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 :)

11250735 tn?1417186714
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.
Avatar universal
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.  
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