Thyroid Issues?

[greeneyes333]

Hi all, I have finally decided to make a post myself. I am a 25 year old female, no kids. I've been trying to figure out for about 2 years now why I feel so crappy all the time. My main symptoms are: fatigued/weak/no energy; muscle & joint pain, stiff; my feet freeze for hours, when it isn't cold; night sweats (only the 10 nights before my period); sensitivity to heat & hot flashes, increased oil production; greatly reduced sex drive. For the last 4 months, I've felt like someone is slightly choking me and swallowing hurts. I've had it swabbed and tested & I don't have strept or anything like that. My vit D was very low a couple years ago & I took prescription vit D for about 6 months until it was normal again. My thyroid labs come back normal. I do have some nodules but from what I've found, they are too small to worry about. My thyroid size is normal per an ultrasound even though every doctor says they can't believe how inflamed it is when they feel it. My lab results are below. I have appointments with a new ENT & endo but I just wanted to see if anything stood out to your guys. Also, my progesterone levels were twice as high as the maximum range when they were tested earlier this month.


TSH:
0.81 mU/L (12/16/10)
1.15 mU/L (9/8/2011)

FREE T4:
1.2 ng/dL (6/19/10)
1.06 ng/dL (12/16/10)
1.4 ng/dL (9/8/2011)

FREE T3:
2.26 pg/mL (12/16/2010)
3.4 pg/mL (9/8/2010)






ULTRASOUND:

12/17/10:
RIGHT LOBE: 4.2 X 1.2 X 1.6cm
Lower lobe, multiple small hypoechoic nodules, largest is 2mm.

LEFT LOBE: 4.3 X 0.3 X 1.8CM
In mid & lower poles, similar 1-2mm sized, low density, well-defines nodules

Isthmus: 3mm in thickness

CONCLUSION:
1) Normal size gland with multiple subcentimeter hypoechoic nodules.
2) Multiplicity of findings suggests a benign diagnosis, but short-term follow up at 6-12 months is recommended.









8/1/2011:
RIGHT LOBE: 4.4 X 1.6 X 1.6cm
There are two subcentimeter nodules in the lower pole w/ low level internal echoes. The largest is 5 x 2mm.

LEFT LOBE: 4.4 X 1.7 X 1.2cm
There is a solitary hypoechoic nodule measuring 2 x 2mm in size

Isthmus: 0.4cm & normal


CONCLUSION:
1) Stable low-density subcentimeter nodules in both lower poles of the gland.
2) No gross change compared with previous exam of 12/17/2010.

[Barb135]

Your FT4 is relatively high in the range, while your latest FT3 is right at mid range, which may not be high enough for you, or could be too high.  Experience tells me, though, that the doctors will most likely consider your thyroid "fine" because your levels are within the ranges.  

You really need to be tested for the thyroid antibodies to test for both Hashimoto's and Graves Disease.  Hypothyroidism and hyperthyroidism can share many of the same symptoms.

[greeneyes333]

Thanks for replying. The ranges are:


FREE T4:
1.2 ng/dL (6/19/10) (RANGE: 0.8-1.7ng/dL)
1.06 ng/dL (12/16/10) (RANGE: .71-1.85 ng/dL
1.4 ng/dL (9/8/2011) (RANGE: 0.8-1.7ng/dL)

FREE T3:
2.26 pg/mL (12/16/2010) (RANGE: 1.45-3.48 pg/mL)
3.4 pg/mL (9/8/2010) (RANGE: 2-4.8 pg/mL)


I will look into having all of that tested. Thank you so much.

[Barb135]

What are the reference ranges for the Free T3 and Free T4?  Ranges vary from lab to lab, so must come from your own lab report.

You should request to be tested for thyroid antibodies to see if you have either Hashimoto's Thyroiditis or Graves Disease.  Both are autoimmune diseases in which the body see the thyroid as foreign and produces antibodies to attack and destroy it.  

To test for Hashimoto's you need Thyroid Peroxidase Antibodies (TPOab) and Thyroglobuin Antibodies (TGab); make sure you ask for both of those because Hashimoto's can't be ruled out without, since some people have TPOab and other have TGab, and still others have them both.  

Inflammation is common with nodules and nodules are very common with Hashimoto's.  It's very possible that you have Hashimoto's, which is generally associated with hypothyroidism, and your labs just haven't caught up with your symptoms yet.

You should also have your vitamin D tested again, along with vitamin B12.  



To test for Graves Disease, you need to have a Thyroid Stimulating Immunoglobulin (TSI) test.