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Thyroid Question for Doctor Mark Lupo
Hello Dr. Lupo,
I am a 27 year old, healthy female. As a registered nurse, I believed that the "more than usual" fatigue I was experiencing approx 7 months ago coupled with insomnia and an approx weight gain of 8 pounds was related to the physical toll a night-shift schedule demands.
(1). However, in late April I noticed an enlarged submandibular lymph node and was sent for an neck ultrasound and bloodwork in Ocotober '08. All lab values were within normal range (including the Free T4) except for TSH which was at 8.53 on October 17/2008.
(2). Another Thyroid lab level taken on October 22/08 revealed normal Free T4 but a TSH level decrease to 4.61. An neck ultrasound done at this same time revelealed multiple lymph nodes (largest measured at 2.2 x 1.5 x 0.5cm) which is entirely non-specific. Another physician ordered a Chest xray which found everything within normal limits and no acute process was identified.
(3). The last labs drawn Oct 31/08 found normal lab values (including Free T4) except the TSH now increased to 6.85 (from 4.61). I am now to do a thyroid antibodies and prolactin levels ( due to greenish-gray nipple discharge on one breast which occurs only on manipulation, not spontaneously). The GP suspects this is hypothyroidism but will not look at treatment till the lab values come back.
Dr. Lupo, I would greatly appreciate your clinical insight into the above mentioned. At this time, a family gp is following this but should this be dealt with by an endocrinologist? Are my fluctuating TSH levels indicative of Hashimotos? As well, once a hypothyroid female begin thyroid medication, is there weight gain attributed to the thyroid medications? Which thyroid medication do you judge to be most beneficial in my scenario?
I thank you for your valued feedback.
I am a 27 year old, healthy female. As a registered nurse, I believed that the "more than usual" fatigue I was experiencing approx 7 months ago coupled with insomnia and an approx weight gain of 8 pounds was related to the physical toll a night-shift schedule demands.
(1). However, in late April I noticed an enlarged submandibular lymph node and was sent for an neck ultrasound and bloodwork in Ocotober '08. All lab values were within normal range (including the Free T4) except for TSH which was at 8.53 on October 17/2008.
(2). Another Thyroid lab level taken on October 22/08 revealed normal Free T4 but a TSH level decrease to 4.61. An neck ultrasound done at this same time revelealed multiple lymph nodes (largest measured at 2.2 x 1.5 x 0.5cm) which is entirely non-specific. Another physician ordered a Chest xray which found everything within normal limits and no acute process was identified.
(3). The last labs drawn Oct 31/08 found normal lab values (including Free T4) except the TSH now increased to 6.85 (from 4.61). I am now to do a thyroid antibodies and prolactin levels ( due to greenish-gray nipple discharge on one breast which occurs only on manipulation, not spontaneously). The GP suspects this is hypothyroidism but will not look at treatment till the lab values come back.
Dr. Lupo, I would greatly appreciate your clinical insight into the above mentioned. At this time, a family gp is following this but should this be dealt with by an endocrinologist? Are my fluctuating TSH levels indicative of Hashimotos? As well, once a hypothyroid female begin thyroid medication, is there weight gain attributed to the thyroid medications? Which thyroid medication do you judge to be most beneficial in my scenario?
I thank you for your valued feedback.
Dr. Lupo is no longer active on the expert forum, and this is a very old thread.
If you go to the top of the page, you can click the "Post a question" button and start your own new thread. When you do, please post the reference ranges for your T4 test.
Also, tell us if you have any other symptoms.
If you go to the top of the page, you can click the "Post a question" button and start your own new thread. When you do, please post the reference ranges for your T4 test.
Also, tell us if you have any other symptoms.
My labs results came (T4-8.53) and (TSH-3rd generation-0.979) it's ok this results.Also i had a condition of swelling feer on top and a burning hot feet with this,but legs aren't swelled,please help me understand what's going on with my health and any possible treatment.Thanks.Sincerely:MV68.
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