If one of the nodules is producing hormones independently of the thyroid, they could possibly drive the TSH down that low. However, due to your weight gain and other symptoms, which sound hypo, not hyper, I'd have to wonder about Central hypothyroidism, which is a pituitary problem, not a thyroid problem. Nodules are quite common, though, but yours is quite large.
With central hypothyroidism, the pituitary can't produce enough TSH to stimulate the thyroid to produce the thyroid hormones.
Once you get back the thyroid tests, you can post the results here and we can better tell you what the issue is... Hopefully, the endo ordered Free T3 and Free T4, which are the actual thyroid hormones that your body uses. If they, particularly, Free T3 is too low, your metabolism will be low and you'll have trouble losing weight.
When you get those test results, please post them, so we can tell you more about what's happening. With luck, the endo also ordered antibody testing to determine if you have an autoimmune thyroid condition, so we'll be able to tell that from your blood work, as well.
My Total T3 and free T4 came back, as well as the retest of the TSH. Also, for some reason, my Vitamin D went from Normal, to Insufficient in 18 days, dropped from 30-22
Vitamin D, 25 Hydroxy = 22 ng/mL
TSH = 0.64 uIU/mL
T4 aka Free Thyroxine = 0.80 ng/dL (Normal range 0.60 - 1.50 ng/dL)
T3, Total = 177 ng/dL (Normal range 87 - 190 ng/dL
I was really hoping for my TSH to jump to above 1.0 but it still remains low, albeit better than before
Not sure how to interpret the Low normal for Free T4 or the High normal for the Total T3. Im thinking optimum ranges would be near the middle for both?
As for free T3, not sure why it wasnt tested
Hope the info I provided helps and thank you for your reply.
Your Vitamin D was too low at 30, even though it was in the "normal" range... 50-60 is considered optimal, so at 22, you're really low... I hope your doctor advises you to start supplementing.
Does the report actually say "Free Thyroxine" or does it say just T4? That can make a huge difference, because if it says just T4, then it's Total T4, which is obsolete and of little use; if it says Free Thyroxine, then it's really Free T4 and what we're looking for...
Most of us find that we need Free T4 to be about mid range and yours is only at 22% of its range, so it's really quite low. With that low of Free T4, we'd expect to see TSH considerably higher than it is. This could bear out my thoughts on central hypothyroidism, because it shows that the pituitary isn't producing adequate TSH to stimulate the thyroid.
The Total T3 is obsolete and really doesn't mean much of anything, since most (90-95%) of that is bound by protein and can't be used anyway... The doctor should have ordered Free T3, so we could see how much of that is unbound (Free) and available to individual cells for use.
In a perfect world, Free T3 would be in the upper half to upper third of its range, but since you don't have an FT3 test, we don't know where yours is.
It's entirely possible that your endo will say that your TSH and FT4 are "in range" so everything is fine, but don't let him get by with that, because you do have symptoms of hypothyroidism and it's entirely possible to be hypo even when labs are in normal ranges. Don't wait for the endo to bring up the possibility of central hypothyroidism... you mention it, if s/he doesn't and insist that it be ruled out.
Also insist that Hashimoto's Thyroiditis be ruled out by having the thyroid antibodies, Thyroid Peroxidase Antibodies (TPOab) and Thyroglobulin Antibodies (TgAb) tested... It's also possible to have it and symptoms can be present for years before labs go out of range. Just don't let them tell you there's "nothing wrong"...
Thank you again Barb. I see my endo again on Friday for the biopsy so hopefully I can bring it all up to him them.
I wanted to update people on my biopsy today
the Endo did another ultrasound and while he was reading the findings to a women who was there (to collect the samples), he found that the nodule that was 3cm, is now 3.2cm. He didnt tell me it grew, just told the lady as she wrote it down.
After the biopsy, he said the results would be in by February 19 (2 weeks time). Is this normal?
Yes, I think 2 weeks is about right for the results. Do you have an appointment to go back in to get them?
You really should ask your endo to updated Free T3 and Free T4 tests to recheck your thyroid status. Often taking thyroid hormones can decrease the size of nodules.
If you have central hypothyroidism, this could benefit you.
You should never be afraid to ask for "too much"... you pay doctors to make you well and when they don't it's time to find another doctor, no matter how many you've gone through... I once grabbed a doctor by the coat tail, as he was walking out of the exam room, because he didn't fully answer my questions...
The doctors can't do anything if you aren't clear and precise about what you're seeing them for... when they come in and ask what you're there for, don't hesitate to tell them, even if you already told the nurse and you think they should have read your file - there's a good chance they didn't or they want you to tell them in your own words.
Your thyroid controls so many of your body functions that having your levels off even a little bit, can cause a lot of havoc in your body. Even an endo may not think this is important, but it is...
If you have central hypothyroidism, you don't have enough TSH to stimulate your thyroid to produce thyroid hormones and you'll need to take medication to replace what your thyroid isn't producing. Too little thyroid hormones can cause a lot of various symptoms.
Another thing to keep in mind is that if your pituitary isn't producing enough TSH, it's possible that it's not producing enough of other hormones either, including female sex hormones, and this could be contributing to your heat rash issues. These are all things that should be addressed by the endocrinologist, because these are all endocrine hormones.