mutliple nodules found and ACTH question

[mrswillie]

Hi
Well I had my first visit with the endo yesterday. He was pretty nice and he listened for a long time. He did not ever say anything about all my symptoms being from menopause Yay! (I am 44 and had a complete hysterectomy at 42 and have been brused off with the menopause diagnosis several times) He felt my neck while I was drinking a glass of water and then told me he needed to take some pictures of my thyroid. He did a short ultrasound and then showed me the photos. He told me I had multiple nodules and then showed me at least 3, and showed me the ultrasounds of what a normal thyroid looks like. Then he told me He suspects I have thyroiditis and probably need to start on some meds to feel better. I was happy because that is mainly what I want to feel better. I would especially like the horrible fatigue to subside. (Just a reminder of my symptom list... These symptoms are fatigue, intermittent bouts of vertigo, intermittent sinus headaches or headaches when I am hungry, frequent dropping things, weight gain, inability to concentrate when really fatigued, intermittent tingling in hand, constipation, weak arms, and what I describe as no temperature regulation. Meaning that most of the time I am cold, and quite sensitive to cold, but when I get hot such as if I am in a car and a heat vent is blowing on me it will make me feel ill.) (Dad has hypothroidism)

Then he tells me that he should biopsy these nodules just to make sure they are benign and he explains the procedure. I agree that is fine and he begins to write in my chart. After a few minutes he says he wants to wait a bit on the biopsy and try to get me feeling better first and then we will do the biopsy. Again, this sounds great to me because my goal is to feel better. Next, he asks me can I come back and see him next week first appt in the morning. I say sure. He then tells me he is going to do an ACTH stim test. He says he will take some blood, inject the synthetic ACTH and then he can have a better picture of how my pituitary, adrenals etc are working. I say ok and then he says great, hands me my chart and sends me off with his nurse who takes a urine sample, three vials of blood, and sets up an appt for me at 8 am next friday. No prescription nothing to change the way I am feeling. :(  Does this sound right?? Has anyone had this test?? Oh I forgot to add that early in the appt I asked him if he would run tests on FT3 and FT4 and he said he would. What questions should I ask Friday?? Is it possible to have nodules and not have a problem that would be helpeed by meds??

I feel like such a wreck. Any ideas/suggestions would be greatly appreciated. Thanks for your help and support.

[mrswillie]

That does make sense and you are right I want to figure out the best option to feel better that is my main goal. I will ask him about vitamin D when I go back next Friday.

[KB1205]

The reason he has not given the medication yet is because if you have adrenal problems you will have to get treatment for that before you start on thyroid medication.
The rule of thumb with thyroid is no one reacts exactly the same with medication and you may have to play around with treatment options and see which option makes you feel the best. Remember that when you are very stressed or are ill your meds may have to be adjusted.
My endo has me on Vitamin C and Vitamin D tablets as well. It may be worthwhile testing these as well if the endo has not done so already.

[mrswillie]

Thanks. Did you ever end up getting any meds after all that testing? Did it help?

[jjohnson5409]

I have thyroid nodules and i had the cortisol test.  your doctor is doing the right thing, well if he test your frees.  but he is testing your adrenal glands w/ the stimulation test.  be prepared to sit there 3 hours.  bring a book.  they take your first blood, then inject, wait 30 minutes, take blood , wait one hour take blood.  your levels should increase both times.  my results were  starting 6, 18, 20.  he said i had no adrenal problems.