help with lab numbers. low tsh

[sickof_bn_sick]

I have been diagnosed (in the past) with a Toxic multinodular goiter. Having said that, my labs were normal. This was 7 yrs. ago. I began to develop symptoms of both hyper and hypo in the last 6 months...they are becoming severe. My TSH is 0.19, range(0.4-4.5), my T3 uptake 31% range(22-35), my T4 8.9 range(4.5-12.0), free T3 2.8 range(1.4-3.8)...being in the medical field, I realize this inicates hyperthyroidism. However, unsure what the next course of treatment might be. I am scheduled for another uptake scan Mon. And Tue....I am also worried about thyroid storm, since I am short of breath lately. Does anyone have a similar pattern and what was done?  BTW...my last uptake scan showed both solid and colliod nodules, along with several toxic (hot) nodules...one being much larger than the others....help if you have any advice, thanks.

[898_1]

Technetium-99m is radioactive isotope that accumulates in thyroid like iodine but it cannot be used by thyroid to make hormones, so itis safer to use because iodine can cause thyroid storm in some cases.
PEI is injection of ethanol into the nodule; it causes tissue to die.

[Guppy70]

What is technetium (instead of iodine) and what is PEI?

[sickof_bn_sick]

Wish you the best with your situation as well. I know how you feel. Good luck.

[sickof_bn_sick]

My primary is treating some of the symptoms, High blood pressure and insomnia. Cholesterol is out the roof as well. My endo. doesn't except my Ins. anymore and there is no appts until late July. for the new endo I chose. I'm kind of between a rock and a hard place.  I have read about Thyroid storm...that is what concerns me the most. With the SOB I'm experiencing now...not sure when it is emergent.  I have the nuclear injection tomorrow and the scan the next day. I suppose I'll have to wait for that test.

[898_1]

In case of TSH below .3 and multiple nodules the technetium must be used instead of iodine in order to avoid thyroid storm.
Hot nodules can be treated with PEI if they are meeting certain criteria.

[Guppy70]

I just went to an ENT, I have something similar to you. Very low TSH but FT3 and FT4 within their range. And a lump on my thyroid that really hurts.

He said he thought it was a hot nodule but now I'm being referred to an Endo that will test me further.

The ENT said that sometimes they just wait for these hot nodules to just burn out. And they might give you meds to treat the hyper symptoms.

I have no idea, this is all so new and scary. I wish you all the best and please write here and let us know what they're planning for you and how you're doing.