Lab Results - Newbie

[Live2Love]

Hey All,
I recently went in to see my PCP for a physical I needed for massage school. While my doc evaluated- she noticed my left thyroid seemed enlarged. She ordered lab work, and a sonogram. 2 weeks later (today) I had my follow up appointment. My results are listed below. After reviewing everything my doc has ordered a I 123 thyroid uptake & scan - scheduled for next Thursday / Friday.

Lab Results
TSH 8.60 (.40-5.00)
Free T4 0.98 (.93-1.70)

Sonogram Results
An echogenic and cystic nodule on the right measures 0.8 x 0.7 x 0.6 cm.
The far interior right solid nodule measures 0.8 x 1.0 x 0.8 cm.

The left lobe has an inferior hypoechoic nodule measuring 1.5 x 1.0 x 0.8 cm. Far inferior solid nodules on the left measures 0.8 x 0.8 x 0.8 cm, and 1.0 x 0.9 x 0.8 cm.

Impression:
1) The isthmus is thickened w/ out frank thyromegaly.
2) Both lobes are very heterogenenous and hypervascular with multiple bilateral nodules likely representing multinodular goiter.


Now, I understand the thyroid uptake & scan is to determine how the thyroid is absorbing iodine and to look for cold/hot spots. No big deal. But I think there is more than meets the eye on this. I had previously been seeing a hollistic chiropractor, and he did a muscle test to check my adrenal glands. My muscle did not perform well, and he placed me on a mega vitamin. Now, my PCP has told me to discontinue use, and I really do think the chiro really knew what he was talking about... So not only do I think I have the hypo issue, but I think I have adrenal issues as well. Can the adrenals be related to Hashimotos? I personally think I have Hashimoto's because my symptoms have not only been hypo but hyper. I have pale skin, hair shedding, difficulty concentrating, dry skin, fatigue, cold intolerance, headaches, poor memory, muscle weakness, and slight weight gain. I also have, anxiousness, racing heart at times, adrenaline rushes (at times), nervousness, heat intolerance (depending on the day) etc. I can't even have coffee in the morning anymore because I just feel too sensitive to it. :sad0047:

Also, not sure if body temp has anything to do with all of this, but my 1st check up 2 weeks ago I was 98.5, and this morning I was 99.4. - Nurse/Doc didn't seem concerend- just that I was a "little warm this morning".

Any thoughts, suggestions, etc would be greatly appreciated! I'm new to all of this!

[Andros]

Hey All,
I recently went in to see my PCP for a physical I needed for massage school. While my doc evaluated- she noticed my left thyroid seemed enlarged. She ordered lab work, and a sonogram. 2 weeks later (today) I had my follow up appointment. My results are listed below. After reviewing everything my doc has ordered a I 123 thyroid uptake & scan - scheduled for next Thursday / Friday.

Lab Results
TSH 8.60 (.40-5.00)
Free T4 0.98 (.93-1.70)

Sonogram Results
An echogenic and cystic nodule on the right measures 0.8 x 0.7 x 0.6 cm.
The far interior right solid nodule measures 0.8 x 1.0 x 0.8 cm.

The left lobe has an inferior hypoechoic nodule measuring 1.5 x 1.0 x 0.8 cm. Far inferior solid nodules on the left measures 0.8 x 0.8 x 0.8 cm, and 1.0 x 0.9 x 0.8 cm.

Impression:
1) The isthmus is thickened w/ out frank thyromegaly.
2) Both lobes are very heterogenenous and hypervascular with multiple bilateral nodules likely representing multinodular goiter.


Now, I understand the thyroid uptake & scan is to determine how the thyroid is absorbing iodine and to look for cold/hot spots. No big deal. But I think there is more than meets the eye on this. I had previously been seeing a hollistic chiropractor, and he did a muscle test to check my adrenal glands. My muscle did not perform well, and he placed me on a mega vitamin. Now, my PCP has told me to discontinue use, and I really do think the chiro really knew what he was talking about... So not only do I think I have the hypo issue, but I think I have adrenal issues as well. Can the adrenals be related to Hashimotos? I personally think I have Hashimoto's because my symptoms have not only been hypo but hyper. I have pale skin, hair shedding, difficulty concentrating, dry skin, fatigue, cold intolerance, headaches, poor memory, muscle weakness, and slight weight gain. I also have, anxiousness, racing heart at times, adrenaline rushes (at times), nervousness, heat intolerance (depending on the day) etc. I can't even have coffee in the morning anymore because I just feel too sensitive to it. :sad0047:

Also, not sure if body temp has anything to do with all of this, but my 1st check up 2 weeks ago I was 98.5, and this morning I was 99.4. - Nurse/Doc didn't seem concerend- just that I was a "little warm this morning".

Any thoughts, suggestions, etc would be greatly appreciated! I'm new to all of this!

Welcome aboard.

I must say that I am very very impressed with your doctor. Clearly something is afoot. I am so so glad you are going to take a radioactive uptake scan. It is very very important to firstly rule out cancer.



It could very well be that you do have Hashimoto's and that the adrenals are being taxed. And, it is not at all unusual to flit back and forth between hypo and hyper.

Has this doctor done any antibodies' tests such as TPO (antimicrosomal antibodies), Thyroglobulin Ab, TSI (thyroid stimulating immunoglobulin?)

I truly think you lucked out here w/ a wonderful doctor who is very very well informed about the thyroid.

Here is some info about echogenicity....

http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1665239

Please let us know how your uptake scan goes and in the meantime, we are here for you.

[nasdaqphil]

Your muscles are not going to perform as normal because you are hypo so personally I would take that particular test with a grain of salt.

What you probably have is hashi's or perhaps one of those nodules is "hot" and putting out some extra thyroid hormone at odd times causing that "rush" feeling. I get that all the time too.

Testing adrenals is pretty straightforward with some blood tests - ACTH, Cortisol, 24 hour catecholamine and a few others.

What you need is a good endo to run a battery of tests but in your case, I do agree the uptake scan is a perfect place to start so you can find out exactly what those nodules are doing and if any are in fact "hot" - the sono cannot pick this up.

Im not against hollistic healing but can tell you with most certainty, vitamins are probably not going to fix this any time soon, although good nutrition is also extremely important to those with thyroid problems.

[Live2Love]

Welcome aboard.

I must say that I am very very impressed with your doctor. Clearly something is afoot. I am so so glad you are going to take a radioactive uptake scan. It is very very important to firstly rule out cancer.



It could very well be that you do have Hashimoto's and that the adrenals are being taxed. And, it is not at all unusual to flit back and forth between hypo and hyper.

Has this doctor done any antibodies' tests such as TPO (antimicrosomal antibodies), Thyroglobulin Ab, TSI (thyroid stimulating immunoglobulin?)

I truly think you lucked out here w/ a wonderful doctor who is very very well informed about the thyroid.

Here is some info about echogenicity....

http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1665239

Please let us know how your uptake scan goes and in the meantime, we are here for you.

I really like the article you posted...in particular:

Echogenicity
The incidence of malignancy is 4% when a solid thyroid nodule is hyperechoic. If the lesion is hypoechoic (Fig. 1Figure 1), the incidence of malignancy rises to 26% [29]. However, hypoechogenicity alone is inaccurate in predicting malignancy, and if used as a sole predictive sign, it has a relatively poor specificity (49%) and positive predictive value (40%)

*It was nice to see that the left side is of concern- because it does have hypoechoic & my chance for malignancy is higher. Interesting.

&

Multinodularity
It is a myth that multinodularity implies benignity, as approximately 10%–20% of papillary carcinomas may be multicentric [31, 34]. In those with true solitary nodules confirmed at surgery the risk of cancer is the same as in those with multinodular goitres [35]. Therefore against a background of multinodular changes, extra caution should be taken not to miss a suspicious nodule.

*Very interesting with this is as well. I have read posts on here where people have thought that multi-nodular meant a less risk of cancer. This article clearly states that - that is not the case.


I didn't read the cancer stuff yet. Don't want to get myself worked up. Although I have heard thyroid cancer is the best cancer to have. Ha! That's what my doctor said. I enjoyed the article very much. Thanks so much!

[Andros]

I really like the article you posted...in particular:

Echogenicity
The incidence of malignancy is 4% when a solid thyroid nodule is hyperechoic. If the lesion is hypoechoic (Fig. 1Figure 1), the incidence of malignancy rises to 26% [29]. However, hypoechogenicity alone is inaccurate in predicting malignancy, and if used as a sole predictive sign, it has a relatively poor specificity (49%) and positive predictive value (40%)

*It was nice to see that the left side is of concern- because it does have hypoechoic & my chance for malignancy is higher. Interesting.

&

Multinodularity
It is a myth that multinodularity implies benignity, as approximately 10%–20% of papillary carcinomas may be multicentric [31, 34]. In those with true solitary nodules confirmed at surgery the risk of cancer is the same as in those with multinodular goitres [35]. Therefore against a background of multinodular changes, extra caution should be taken not to miss a suspicious nodule.

*Very interesting with this is as well. I have read posts on here where people have thought that multi-nodular meant a less risk of cancer. This article clearly states that - that is not the case.


I didn't read the cancer stuff yet. Don't want to get myself worked up. Although I have heard thyroid cancer is the best cancer to have. Ha! That's what my doctor said. I enjoyed the article very much. Thanks so much!

I am so glad you found the information informative. I don't like assuming or guessing when it comes to someone's health. The "rule in or rule out" system is always a wise course to follow.

And you have "heard" correctly. Once again, I do think you have a terrific doctor so I hope that helps to ease any fears you may have.

[Live2Love]

Thanks again. Now, just another week of waiting before the thyroid uptake and scan. Also, to answer your question on the antibodies testing- the only things I have been tested for have been the TSH, and T4. I think I will wait until I find out the results of the scan before I ask about the TPO, Thyroglobulin Ab, & the TSI for possible lab tests. I'll chime in next Thursday/Friday- although I don't think I'll hear anything Friday. It will probably be the following week sometime.

[Andros]

Thanks again. Now, just another week of waiting before the thyroid uptake and scan. Also, to answer your question on the antibodies testing- the only things I have been tested for have been the TSH, and T4. I think I will wait until I find out the results of the scan before I ask about the TPO, Thyroglobulin Ab, & the TSI for possible lab tests. I'll chime in next Thursday/Friday- although I don't think I'll hear anything Friday. It will probably be the following week sometime.

That sounds reasonable enough and we will look forward to hearing from you when you can.

[Live2Love]

I'm officially radioactive today. I took the radioactive iodine pill. I go back tomorrow for the uptake and scan. The nurse said I could expect results next week. I really dislike waiting.

Maybe I'll glow in the dark tonight. Ha!

[Andros]

I'm officially radioactive today. I took the radioactive iodine pill. I go back tomorrow for the uptake and scan. The nurse said I could expect results next week. I really dislike waiting.

Maybe I'll glow in the dark tonight. Ha!

Hey.................so good to hear from you and Hubba, hubba!! How do you feel right now this minute? Anxious?? I know I was.

Otherwise, are you doing okay??

Can't wait to hear the results and thank you for touching bases w/ us. We will be waiting w/ bated breath!

[Live2Love]

Well, I feel okay. The whole experience today made me anxious. The nurse was just nervous around me or something. Must have been my good looks :) We practically sprinted to the lab area of the building, and I had to do a UA to confirm that I was not pregnant. Must be mandatory. We sprinted back to the radioactive "closet", and down my throat the pill went. He told me to avoid seafood, and milk, and iodized salt. So, I've resorted to chicken, and edamame this evening. I'm a bit nervous, but I'm mostly irritated about not receiving any news until the following week. This week has been pretty trying as I had to discontinue vitamin use (since last Friday), and that seemed to give me just a little bump in energy.

[Andros]

Well, I feel okay. The whole experience today made me anxious. The nurse was just nervous around me or something. Must have been my good looks :) We practically sprinted to the lab area of the building, and I had to do a UA to confirm that I was not pregnant. Must be mandatory. We sprinted back to the radioactive "closet", and down my throat the pill went. He told me to avoid seafood, and milk, and iodized salt. So, I've resorted to chicken, and edamame this evening. I'm a bit nervous, but I'm mostly irritated about not receiving any news until the following week. This week has been pretty trying as I had to discontinue vitamin use (since last Friday), and that seemed to give me just a little bump in energy.

Ah; yes. One must be certain there is no pregnancy!! I wonder why you were not told to avoid soy products which are goitrogenic and may slow down your thyroid?

Hopefully you will get the results soon and share them with us. In the meantime, pamper yourself.

[Live2Love]

Good question. I only had a small package of edamame. They are meant for kids to take in their lunches, and they have Dora the Explorer all over them. Ha. It makes for an easy snack for me.

Well, the scan is complete. They took a picture of my thigh. The tech said the normal range for that would be between 10 and 30%. I was at 28%. The tech said that number really meant nothing until they matched it up with the scan. Apparently they take the number from the thigh,and subtract it from the number they get from the scanned pictures. Soooo,at this point. I don't know anything lol.

The hardest part of the whole thing was trying not to swallow during the scan. There were a series of 4 different angles at 10 minutes a piece. I kept falling asleep! I had to keep waking myself up to ensure I didn't move during the process.

The data will be passed off to the radiologist, and the passed off to my doctor. I will have to wait up to 7 days. Boo!

[Andros]

Good question. I only had a small package of edamame. They are meant for kids to take in their lunches, and they have Dora the Explorer all over them. Ha. It makes for an easy snack for me.

Well, the scan is complete. They took a picture of my thigh. The tech said the normal range for that would be between 10 and 30%. I was at 28%. The tech said that number really meant nothing until they matched it up with the scan. Apparently they take the number from the thigh,and subtract it from the number they get from the scanned pictures. Soooo,at this point. I don't know anything lol.

The hardest part of the whole thing was trying not to swallow during the scan. There were a series of 4 different angles at 10 minutes a piece. I kept falling asleep! I had to keep waking myself up to ensure I didn't move during the process.

The data will be passed off to the radiologist, and the passed off to my doctor. I will have to wait up to 7 days. Boo!

For a minute, I actually thought they took a picture of your leg. Ha, ha! The jokes on me.:anim_63: Then I realized you were referring to your thyroid?

Please do let us know the minute you hear anything.

[Live2Love]

Well, I guess it wasn't a picture of my thigh. They scanned my thigh (actual leg) with this machine, and obtained some data. Apparently not all of the iodine is absorbed by the thyroid, so they subtract the percentage of iodine absorbed in my thigh area...from the percentage they obtain from my actual thyroid. I guess it helps them obtain a more accurate reading. Does that make sense?

[Andros]

Well, I guess it wasn't a picture of my thigh. They scanned my thigh (actual leg) with this machine, and obtained some data. Apparently not all of the iodine is absorbed by the thyroid, so they subtract the percentage of iodine absorbed in my thigh area...from the percentage they obtain from my actual thyroid. I guess it helps them obtain a more accurate reading. Does that make sense?

Must be some new fangled techique; I have never heard of this. Goes to show you my age.:anim_63:

Interesting to say the least.

Please let us know.

[GD Women]

They scanned both of my knees, as well as my neck (thyroid). With something that looked like ice cream sticks.

[Andros]

They scanned both of my knees, as well as my neck (thyroid). With something that looked like ice cream sticks.

That is most interesting. I am going to see if I can find this "new and improved" technique in radiology on the Internet. They have made great advances in many medical fields over the years. It is hard to keep up w/ everything.

Thank you for the description.

And how are you doing? Are you on antithyroid meds right now?

[Live2Love]

UGH! The waiting is driving me crazy!!! It will be 5 days tomorrow since my uptake and scan. My little piece of paper says they will call in up to 7 days, and if they don't to go ahead and call the nurse's line. I hope I have some news before the weekend.

[nasdaqphil]

There's nothing wrong with being impatient. If it were me, I would have called on Day 2....and then Day 3, Day 4, etc. I don't care if anyone thinks Im a pain in their butt.

[GD Women]

That is most interesting. I am going to see if I can find this "new and improved" technique in radiology on the Internet. They have made great advances in many medical fields over the years. It is hard to keep up w/ everything.

Thank you for the description.

And how are you doing? Are you on antithyroid meds right now?

This was 12 years ago. I am on levoxyl since day one.

[Live2Love]

Well, I know my doctor leaves at noon on Fridays. So if they don't call by 10am- I'm calling them. I think I've been patient enough!

[Andros]

Well, I know my doctor leaves at noon on Fridays. So if they don't call by 10am- I'm calling them. I think I've been patient enough!

I agree; sometimes being a patient patient can just go too far. Please do let us know.

Thanks for checking in....

[Live2Love]

Here are my results. I am being referred to an endo.

Indications: Multinodular gland.

Thyroid scan and uptake is performed following oral administration of 232 microcuries of iodine 123. A comparison is made to a thyroid ultrasound exam of Sept. 11, 2009.

Anterior RAO and LAO planar views are obtained. The 24 hour uptake is 28.7% which is within the normal limits of 10-30%. There is signal dropout consistent with a cold nodule at the superior right thyroid lobe and to a lesser degree at the inferior right thyroid lobe. The left lobe appears unremarkable.

Impression:
1) Normal 24 hour uptake of 28.7%
2) Findings are suspicious for cold nodules of the right thyroid gland, and follow up with fine needle aspiration of the superior and inferior right thyroid nodules is recommended.

Interestingly enough - my neck feels most enlarged on my left. But the concern is on the right.

Comments? Thoughts?

[Live2Love]

*Update. The doctor I am being referred to is a surgeon, not an endo. I'm guessing this is because of the fine needle aspiration procedure.

[Andros]

*Update. The doctor I am being referred to is a surgeon, not an endo. I'm guessing this is because of the fine needle aspiration procedure.



And this is a good thing in my opinion. Sometimes the surgeon knows much more about the thyroid than the endo does.

Do keep us posted on this.

[GD Women]

Make sure the surgeon has done or does, a lot of thyroid surgeries and/or FNA per year.

If you are going for FNA, sometimes it takes two for conformation.

Good luck and keep us up dated.

[Andros]

Here are my results. I am being referred to an endo.

Indications: Multinodular gland.

Thyroid scan and uptake is performed following oral administration of 232 microcuries of iodine 123. A comparison is made to a thyroid ultrasound exam of Sept. 11, 2009.

Anterior RAO and LAO planar views are obtained. The 24 hour uptake is 28.7% which is within the normal limits of 10-30%. There is signal dropout consistent with a cold nodule at the superior right thyroid lobe and to a lesser degree at the inferior right thyroid lobe. The left lobe appears unremarkable.

Impression:
1) Normal 24 hour uptake of 28.7%
2) Findings are suspicious for cold nodules of the right thyroid gland, and follow up with fine needle aspiration of the superior and inferior right thyroid nodules is recommended.

Interestingly enough - my neck feels most enlarged on my left. But the concern is on the right.

Comments? Thoughts?

Well; with this, FNA is definitely in order. We don't like to see those cold nodules. Maybe the nodules on the right are displacing the left? I don't know but in any case I am glad you have some good doctors here. They are on top of this.

Have you set the date for the FNA (fine needle aspiration?) Please let us know.

Meanwhile, here is some info.......... http://www.thyroid.ca/Articles/EngE2C.html

Just remember that 85% of cold nodules are benign.

You "do" have some great docs from the sounds of it.

[Live2Love]

No date yet for the FNA. Scheduling is supposed to call me next week to set up an appointment. Hopefully it's sooner rather than later. These appointments stress me out!

Thanks GD Women - I'll make sure I do some research on this doctor, and also ask about experience before I see her. The nice thing about this one is my great-aunt saw her when she had breast cancer. She says she is really good, and explains things thoroughly.

I'm doing my best to stay positive. Quick question- My left ear always feels like it's clogged up, and it's not from ear wax. Can the multinodular goiter on the left side be pressing on a muscle and it is effecting the way my ear feels? It's really annoying.

[Andros]

No date yet for the FNA. Scheduling is supposed to call me next week to set up an appointment. Hopefully it's sooner rather than later. These appointments stress me out!

Thanks GD Women - I'll make sure I do some research on this doctor, and also ask about experience before I see her. The nice thing about this one is my great-aunt saw her when she had breast cancer. She says she is really good, and explains things thoroughly.

I'm doing my best to stay positive. Quick question- My left ear always feels like it's clogged up, and it's not from ear wax. Can the multinodular goiter on the left side be pressing on a muscle and it is effecting the way my ear feels? It's really annoying.

I am glad that this woman is highly recommended and well worth the short wait, I am sure.

Yes, yes. It could be a nerve impingement from a goiter. Many of us have at the very least experienced ear pain and some have hearing loss.

So, that makes me wonder if you should see an ENT (Ear, Nose, Throat) as well? Maybe you could ask the endo when you see her and see what she thinks?

[Live2Love]

Okay, my appointment for the FNA is next Thursday at 9:30 in the morning. I will ask the surgeon about visiting with a ENT doctor. I notice it is not just my ear on a day to day basis, but sometimes my jaw.

I think I'm in a hypo stage right now. I have not had the adrenaline rushes, or heat intolerance as much lately...it's actually kind of nice.

[Andros]

Okay, my appointment for the FNA is next Thursday at 9:30 in the morning. I will ask the surgeon about visiting with a ENT doctor. I notice it is not just my ear on a day to day basis, but sometimes my jaw.

I think I'm in a hypo stage right now. I have not had the adrenaline rushes, or heat intolerance as much lately...it's actually kind of nice.

It is typical to flit back and forth. I am glad you are feeling a bit better. Is that Thurs. the 15th. of October?

[Live2Love]

Yes, the 15th. I fee like such a failure at work some days :( I slept plenty last night, and I have been trying to ignore my fatigue so that I can be productive at work. Unfortunately, if I am fatigued I have a harder time concentrating. I requested to leave early today to rest. I'm going to eat some lunch, and hit the sack for a bit. Thyroid issues, plus working full time, plus going to school full time in the evenings is taking its toll. It is disappointing to me. I feel that since I am so young (24) that I should have all the energy in the world. Boo.

[Andros]

Yes, the 15th. I fee like such a failure at work some days :( I slept plenty last night, and I have been trying to ignore my fatigue so that I can be productive at work. Unfortunately, if I am fatigued I have a harder time concentrating. I requested to leave early today to rest. I'm going to eat some lunch, and hit the sack for a bit. Thyroid issues, plus working full time, plus going to school full time in the evenings is taking its toll. It is disappointing to me. I feel that since I am so young (24) that I should have all the energy in the world. Boo.

You feel correctly!! And when you get the proper treatment for your thyroid problem, you normal life and energy will return to you.

ADD is common with thyroid disease.

Please don't beat yourself up; you just hit a little rough spot here. Life will be merry again.

[Live2Love]

Good Morning! I have been doing some thinking, and I've got a question. I have been on the Ortho Evra patch for several years, and I decided to take a look at the information packet in the box again. By using the patch, I am being exposed to 60% more estrogen than a woman who takes the pill. I was also a vegetarian for almost 2 years. Do you think the high combination of estrogen / high combination of soy- may partially have caused the thyroid problems?

About 2 months ago, I re-introduced chicken into my life, and have significantly cut down my soy product usage. I had been omitting chicken/beef/pork. I still consumed/consume dairy & seafood. I have also been contemplating for the last month or so about going off of the patch all together due to the increased risks of blood clots & heart attack.

[Andros]

Good Morning! I have been doing some thinking, and I've got a question. I have been on the Ortho Evra patch for several years, and I decided to take a look at the information packet in the box again. By using the patch, I am being exposed to 60% more estrogen than a woman who takes the pill. I was also a vegetarian for almost 2 years. Do you think the high combination of estrogen / high combination of soy- may partially have caused the thyroid problems?

About 2 months ago, I re-introduced chicken into my life, and have significantly cut down my soy product usage. I had been omitting chicken/beef/pork. I still consumed/consume dairy & seafood. I have also been contemplating for the last month or so about going off of the patch all together due to the increased risks of blood clots & heart attack.

It is possible for estrogen dominance does interfere w/ the thyroid.

And of course, soy is a goitrogen.

Do a "Google" on estrogen dominance, thyroid

[Andros]

*Update. The doctor I am being referred to is a surgeon, not an endo. I'm guessing this is because of the fine needle aspiration procedure.

Hope the FNA goes well today. Please let us know when you are able. Sending hugs................

[Live2Love]

Hello! Well, my appointment was a mess today. My PCP's office did not send over the sonogram or lab results to surgeon's office. So the new doc only had the results of the uptake and scan. So she relied heavily on my knowledge. I'll make sure to take all my lab results and stuff w/ me to future appointments. Just in case.

Anyways, I love the surgeon. She is so good about explaining things, and let me ask all the questions I wanted. She did her own sonogram on me, and talked me through what she was seeing. She said that I just have a lumpy/bumpy thyroid. She did not find any nodules that looked suspicious. She did ask me if I had any trouble swallowing. I told her that I do feel like my food catches on something on the way down, but I don't notice it every time.

My diagnosis is Hashimoto's. I was SO glad to hear this. This is what I have been thinking the whole time. She said she wants me to go ahead on the thyroid replacement meds, and would like to see me in 6 months. She will then re-check the thyroid, and perform another sonogram. If it has gotten larger- she will suggest surgery to remove. She said it could affect my breathing if it gets too large, and since it is not functioning correctly- we mind as well take it out. I agree. I also asked her about my concern that auto immune diseases usually come in conjunction with another disease. I told her that I do have extreme thirst. Not every day, but quite a few. And this symptom is new. Probably within the last few months. Next time I have my labs read- I will request a blood sugar test. This will help rule out Diabetes.

So I guess tomorrow I start levothyroxine. It appears to be a very small dose. Only 0.05 mg (50 mcg). Walgreens stapled this prescription to another prescription I picked up several weeks ago. So the pharmacist didn't tell me much about how/when to take this. I guess the pamphlet says 1 hr before breakfast. Don't take an antacid or product that has iron or calcium in it within 4 hours. There are a lot of things that have calcium and iron in them. So does that mean no morning cereal? Any other things I should know about taking these meds. Also, I was talking to my mom about the dosage. It looks like this bottle is only a month supply, but the bottle says I have one more refill. So should I call for a lab test to check TSH before I run out so my doc can either up my dose or refill at current dosage?

[Andros]

Hello! Well, my appointment was a mess today. My PCP's office did not send over the sonogram or lab results to surgeon's office. So the new doc only had the results of the uptake and scan. So she relied heavily on my knowledge. I'll make sure to take all my lab results and stuff w/ me to future appointments. Just in case.

Anyways, I love the surgeon. She is so good about explaining things, and let me ask all the questions I wanted. She did her own sonogram on me, and talked me through what she was seeing. She said that I just have a lumpy/bumpy thyroid. She did not find any nodules that looked suspicious. She did ask me if I had any trouble swallowing. I told her that I do feel like my food catches on something on the way down, but I don't notice it every time.

My diagnosis is Hashimoto's. I was SO glad to hear this. This is what I have been thinking the whole time. She said she wants me to go ahead on the thyroid replacement meds, and would like to see me in 6 months. She will then re-check the thyroid, and perform another sonogram. If it has gotten larger- she will suggest surgery to remove. She said it could affect my breathing if it gets too large, and since it is not functioning correctly- we mind as well take it out. I agree. I also asked her about my concern that auto immune diseases usually come in conjunction with another disease. I told her that I do have extreme thirst. Not every day, but quite a few. And this symptom is new. Probably within the last few months. Next time I have my labs read- I will request a blood sugar test. This will help rule out Diabetes.

So I guess tomorrow I start levothyroxine. It appears to be a very small dose. Only 0.05 mg (50 mcg). Walgreens stapled this prescription to another prescription I picked up several weeks ago. So the pharmacist didn't tell me much about how/when to take this. I guess the pamphlet says 1 hr before breakfast. Don't take an antacid or product that has iron or calcium in it within 4 hours. There are a lot of things that have calcium and iron in them. So does that mean no morning cereal? Any other things I should know about taking these meds. Also, I was talking to my mom about the dosage. It looks like this bottle is only a month supply, but the bottle says I have one more refill. So should I call for a lab test to check TSH before I run out so my doc can either up my dose or refill at current dosage?

Wow!! More than we all wanted to know, huh!:eek: I like your surgeon also. You got very very lucky w/ this lady. 50 mcg. is the usual stating dose for T4 and yes, it would be wise to get labs every 8 weeks prior to seeing the doctor so that the levothyroxine can be titrated according to your needs either up or down.

Now..................If you are taking a calcium supplement or iron supplement, it is good to take it 4 to 5 hours away. I for one like heavy real cream in my coffee in the morning and have done this all my life. I take my thyroxine replacement between the first and second cup. Never had a problem because we go back to the titration process. If you are habitual in all you do, your meds will be titrated to that.

I take it that you did "not" have the FNA as planned?

[Live2Love]

No. I was highly certain that what the plan was today. That was what I was being referred for, but apparently the surgeon decided against it. Which is fine with me. And, I am very comfortable with the idea of taking the thyroid out if we need to. So, other than taking the new meds, and getting my labs every 8 weeks- I finally have a sense of closure. I can't wait to start feeling more like me again.

Now, I get to research and read up on Hashi's. Let's just hope I don't have Diabetes along with it!

[Andros]

No. I was highly certain that what the plan was today. That was what I was being referred for, but apparently the surgeon decided against it. Which is fine with me. And, I am very comfortable with the idea of taking the thyroid out if we need to. So, other than taking the new meds, and getting my labs every 8 weeks- I finally have a sense of closure. I can't wait to start feeling more like me again.

Now, I get to research and read up on Hashi's. Let's just hope I don't have Diabetes along with it!

I hope you don't have diabetes but it is better to know than to not know. Most of "us" do have more than one autoimmune thing going on as you can see in my own siggie. I also have insulin resistance.

Here is a very credible source of info for Hashi's..................

http://www.thyroidmanager.org/

Some of this stuff is complicated and I sure do not purport to understand it all but you will get the gist of it.

[Live2Love]

Thanks for everything. You have been SO helpful, and it heart warming to know that you genuinely care about each and everyone one of us! I will continue to post during this journey!

P.S. Do you think you will ever have a chat room added to site? Might be a nice addition.

[Andros]

Thanks for everything. You have been SO helpful, and it heart warming to know that you genuinely care about each and everyone one of us! I will continue to post during this journey!

P.S. Do you think you will ever have a chat room added to site? Might be a nice addition.

You are so welcome and it is totally my pleasure. I happen to think that hugs and love go a long way in the course of healing. Medical intervention "is" important but being validated as a human being is an important part of the process too.

I don't know about a chat room. You would have to ask the administrator about that (Nasdaqphil) and I do know that I probably would not have time for that myself. It is very hard to monitor a chat room.

[Live2Love]

Another question. I'm going to try and get into the lab next week to have the tests ran for diabetes. Do you think I should have the TPOAb lab test ran- even though the surgeon already confirmed Hashi's?

[Andros]

Another question. I'm going to try and get into the lab next week to have the tests ran for diabetes. Do you think I should have the TPOAb lab test ran- even though the surgeon already confirmed Hashi's?

I do. Because you need a "baseline" to know if the medical intervention is helping or not. If it is, the antibodies should decrease. If they are running amok, it is likely that treatment is not helping and that could be due to a myriad of reasons.

[Live2Love]

Just checking in. I haven't had my TPOAb lab test ran yet, but I think I will go ahead and get it checked the next time I go in for testing. I thought I would touch base and let you know how my journey has been.

Looks like my first lab posting was September 17th, 2009
TSH 8.60 (.40-5.00)
Free T4 0.98 (.93-1.70)

My readings after being on .05 mg of Synthroid for 6 weeks are:
(I know the dates don't match up, but they didn't put me on synthroid until after I saw the surgeon for FNA and her diagnosis was Hashi's)
TSH 0.17 (.40-5.00) - Low
T4 14.2 (4.6-12.0) - High

I wonder why they didn't test my Free T4 like they did last time. Well anyways, doctor said my lab results showed that my dosage was too high. This would completely make sense as I have been feeling very anxious, and have had a racing heart and palps lately. It is amazing too me how quickly my body responded. I mean, I went from one end of the spectrum to another.

Just wanted to update a bit on my symptoms- since I have started meds I have noticed a tremendous difference. My hair has stopped falling out. I am not nearly as tired. My heat and cold intolerance has stopped. I used to continuously crave putting my hands on something cold. My hands and feet always felt like they were on fire. That symptom has discontinued too! I also have gained a little bit of color back in my skin. Overall, not feeling too bad.

However; these are the symptoms that I still have: Anxiety, Heart Racing, Heart Palps, Dry Skin.

The list has shortened up a bit!

[Andros]

Just checking in. I haven't had my TPOAb lab test ran yet, but I think I will go ahead and get it checked the next time I go in for testing. I thought I would touch base and let you know how my journey has been.

Looks like my first lab posting was September 17th, 2009
TSH 8.60 (.40-5.00)
Free T4 0.98 (.93-1.70)

My readings after being on .05 mg of Synthroid for 6 weeks are:
(I know the dates don't match up, but they didn't put me on synthroid until after I saw the surgeon for FNA and her diagnosis was Hashi's)
TSH 0.17 (.40-5.00) - Low
T4 14.2 (4.6-12.0) - High

I wonder why they didn't test my Free T4 like they did last time. Well anyways, doctor said my lab results showed that my dosage was too high. This would completely make sense as I have been feeling very anxious, and have had a racing heart and palps lately. It is amazing too me how quickly my body responded. I mean, I went from one end of the spectrum to another.

Just wanted to update a bit on my symptoms- since I have started meds I have noticed a tremendous difference. My hair has stopped falling out. I am not nearly as tired. My heat and cold intolerance has stopped. I used to continuously crave putting my hands on something cold. My hands and feet always felt like they were on fire. That symptom has discontinued too! I also have gained a little bit of color back in my skin. Overall, not feeling too bad.

However; these are the symptoms that I still have: Anxiety, Heart Racing, Heart Palps, Dry Skin.

The list has shortened up a bit!

How much did the doc cut back on your thyroxine replacement. To be honest w/ you, w/o the Free T4 it is really hard to know if you are over medicated or if something else is going on like low ferritin which would mimick those same symptoms.

Good to hear from you.

[Live2Love]

Well, I was taking .050 mg daily. Now I am taking a full .050 mg pill one day, and then the next day half a pill. And so on and so forth- alternating.

[Andros]

Well, I was taking .050 mg daily. Now I am taking a full .050 mg pill one day, and then the next day half a pill. And so on and so forth- alternating.

That should work rather well for you because the T4 does build up in the system. Good.

Hope you start to feel better.

[Live2Love]

Ugh. I scheduled an appointment with my doctor today. It is scheduled for Monday. This heart racing, skipping and continued shortness of breath is taking over me. I am starting to wonder if something is wrong with my heart. My paternal grandmother had heart disease, went in for surgery,and came back out and ended up going into cardiac arrest. She was in her 50's. My mother's sister had a massive stroke in her early thirties she survived. She ended up having heart surgery to put in a catheter to fix her problem. SO, heart problems are around. If you look at the symptoms of Hashi's, and heart disease...well, they're strikingly similar.

I'm sick of having a resting heart rate of 100+. This is not going to consume my life!

I will let you know what the doctor says after my appointment.

[Andros]

Ugh. I scheduled an appointment with my doctor today. It is scheduled for Monday. This heart racing, skipping and continued shortness of breath is taking over me. I am starting to wonder if something is wrong with my heart. My paternal grandmother had heart disease, went in for surgery,and came back out and ended up going into cardiac arrest. She was in her 50's. My mother's sister had a massive stroke in her early thirties she survived. She ended up having heart surgery to put in a catheter to fix her problem. SO, heart problems are around. If you look at the symptoms of Hashi's, and heart disease...well, they're strikingly similar.

I'm sick of having a resting heart rate of 100+. This is not going to consume my life!

I will let you know what the doctor says after my appointment.

We will all be waiting to hear about your appt.. I hope it goes as expected and you get some medical intervention here. You are right, you can't go on like this, nor should you.

Please let us hear from you when convenient.

[Live2Love]

I had my appointment this morning. Originally, I think the nurse was trying to pin my chest pressure, soreness, shortness of breath, heart racing & skipping on anxiety alone. I do think that anxiety would make sense as my readings in December showed that my TSH was 0.17. However; my chest feels like an elephant is resting its foot on it, and my heart feels like I'm running a race- all the time. It doesn't come and go. The only time I don't notice either is right when I get up in the morning. Anyways, she took my pulse it was 126. So, she went ahead and ordered an EKG. Once I laid down, and they got me hooked up- the EKG results showed my heart rate at 95. So, at this point she thinks I have tachycardia and nothing underlying. I am starting a beta blocker tomorrow. I go back in 10 days to have my thyroid levels checked. It will have been about 6 weeks since she switched me up. At that time, I am sure she will revisit my heart & decide what we need to do with medicine. I still don't think my levothyroxine levels is correct. I will not let this disease ruin my quality of life!

[Andros]

I had my appointment this morning. Originally, I think the nurse was trying to pin my chest pressure, soreness, shortness of breath, heart racing & skipping on anxiety alone. I do think that anxiety would make sense as my readings in December showed that my TSH was 0.17. However; my chest feels like an elephant is resting its foot on it, and my heart feels like I'm running a race- all the time. It doesn't come and go. The only time I don't notice either is right when I get up in the morning. Anyways, she took my pulse it was 126. So, she went ahead and ordered an EKG. Once I laid down, and they got me hooked up- the EKG results showed my heart rate at 95. So, at this point she thinks I have tachycardia and nothing underlying. I am starting a beta blocker tomorrow. I go back in 10 days to have my thyroid levels checked. It will have been about 6 weeks since she switched me up. At that time, I am sure she will revisit my heart & decide what we need to do with medicine. I still don't think my levothyroxine levels is correct. I will not let this disease ruin my quality of life!

I am glad you are on a beta blocker. When you had labs last, what were the results and the ranges? Are those the ones listed after Sept.? You know, the T4 tells us nothing really. That is total which is bound, unbound and rT3 hormone all piled together. Free is the unbound available for cellular uptake.

She should have run the Free T4. You could also have these symptoms from low ferritin. Ferritin should be 50 to 100 and the closer to 100, the better. Ferritin is the protein that stores iron for cellular uptake.

I am upset for you; truly!

[Live2Love]

My readings after being on .05 mg of Synthroid for 6 weeks are:

TSH 0.17 (.40-5.00) - Low
T4 14.2 (4.6-12.0) - High

She switched me to a full pill one day, and a half the next and so on and so forth.

I am glad I'm on a beta blocker too. I truly thought my heart was out of control. I am not happy about being on a second medicine though. Hopefully it will be temporary.

I could call and leave a message on the nurse's line to request that the FreeT4, and ferritin tests be ran. What would my reasons be for requesting those 2 tests? Free T4 will show what I have available for cellular uptake, and ferritin will show the protein that stores iron for cellular uptake. And I want to see those 2 levels to determine what? If I'm low in Ferritin, how do I increase my levels? By diet? Sorry, I must not understand the whole circle. I know she'll check the TSH and T4 as always. I think she uses the TSH reading to make the determination on my meds & combines it with how I'm feeling.

I'm hanging in there!!

[Andros]

My readings after being on .05 mg of Synthroid for 6 weeks are:

TSH 0.17 (.40-5.00) - Low
T4 14.2 (4.6-12.0) - High

She switched me to a full pill one day, and a half the next and so on and so forth.

I am glad I'm on a beta blocker too. I truly thought my heart was out of control. I am not happy about being on a second medicine though. Hopefully it will be temporary.

I could call and leave a message on the nurse's line to request that the FreeT4, and ferritin tests be ran. What would my reasons be for requesting those 2 tests? Free T4 will show what I have available for cellular uptake, and ferritin will show the protein that stores iron for cellular uptake. And I want to see those 2 levels to determine what? If I'm low in Ferritin, how do I increase my levels? By diet? Sorry, I must not understand the whole circle. I know she'll check the TSH and T4 as always. I think she uses the TSH reading to make the determination on my meds & combines it with how I'm feeling.

I'm hanging in there!!

What you would like to determine since your syptoms could also be caused by low ferritin it that is it or if you are over medicated. I really don't think you are over medicated.

As we discussed, with T4 (Total 4), this is bound, unbound and possible rT4 as well.

"If" you are low (it should be 50 to 100 and the closer to 100 the better), my advice would be to cook w/ cast iron, take liquid Floradix for better asorption and yes; consume foods high in iron. You must take iron 4 to 5 hours away from your thyroxine replacement as it impedes the efficacy of your thyroxine replacement and by the way, being deficient in ferritin does the same thing.

So..............if ferritin is good, then it is possible that you are over medicated.

We can tell that by getting the Free T4, Free T3 and TSH all at the same time. If you do this, the ranges will be essential to have as different labs use different ranges.

[Live2Love]

Good Morning! Thanks for the basic explanation. I will make a phone call today to request the FreeT4 and Ferritin tests. I don't think it's an unreasonable request. :confused0006:

I also just looked at the liquid vitamin that I take. It is so high in everything (almost 3000% in some things), but iron. I guess it is because we are supposed to get most of our iron from our diet. I was just talking with my mom about how I've been feeling. And, I really have decided that massage school and working full time really demanded a lot from my body. I was going nonstop from 8am to 9:30pm almost 5 days a week. And, I didn't take care of my body the way I should have. Not only do I think this thyroid problem is making daily life difficult, I think the lack of exercise and lack of proper nutrition both play major roles in how I feel. I am just trying to take things a day at a time, and to make adjustments gradually.

I think the beta blocker has already started working. I find that my body is very sensitive to meds. I checked my heart rate last night as I was laying on the couch watching tv, and it was down to 80! Wow!

[Andros]

Good Morning! Thanks for the basic explanation. I will make a phone call today to request the FreeT4 and Ferritin tests. I don't think it's an unreasonable request. :confused0006:

I also just looked at the liquid vitamin that I take. It is so high in everything (almost 3000% in some things), but iron. I guess it is because we are supposed to get most of our iron from our diet. I was just talking with my mom about how I've been feeling. And, I really have decided that massage school and working full time really demanded a lot from my body. I was going nonstop from 8am to 9:30pm almost 5 days a week. And, I didn't take care of my body the way I should have. Not only do I think this thyroid problem is making daily life difficult, I think the lack of exercise and lack of proper nutrition both play major roles in how I feel. I am just trying to take things a day at a time, and to make adjustments gradually.

I think the beta blocker has already started working. I find that my body is very sensitive to meds. I checked my heart rate last night as I was laying on the couch watching tv, and it was down to 80! Wow!

Those are not at all unreasonable requests.

Glad you are feeling better on the Beta Blocker. That is good news. We don't want that heart damaged.

One day at a time is the best way to go. A good scientist usually only makes one change at a time so as to not confuse things and to narrow the field.

Let me know if your doc will order those tests. If not, you can go to Lab Quest and order your own if they have a lab near you.

[Live2Love]

Okay, waiting on the doctor to call me about checking my iron levels. I think you're on to something Andros. I took a 20mg pill of slow iron Saturday, and I felt like I could conquer the world. I wasn't even tired at my usual 10pm. I was a vegetarian for 2 years, and I am sure my iron levels weren't the greatest during that time. I think consuming all the soy I did - was what triggered my Hashi's. So anyways- I hope she either gives me the go ahead on the daily iron, or checks my levels when I see her Friday.

[Andros]

Okay, waiting on the doctor to call me about checking my iron levels. I think you're on to something Andros. I took a 20mg pill of slow iron Saturday, and I felt like I could conquer the world. I wasn't even tired at my usual 10pm. I was a vegetarian for 2 years, and I am sure my iron levels weren't the greatest during that time. I think consuming all the soy I did - was what triggered my Hashi's. So anyways- I hope she either gives me the go ahead on the daily iron, or checks my levels when I see her Friday.

Do make sure it is the Ferritin test that you ask for. As explained, Ferritin is the protein that stores the iron for cellular uptake. Your hemo can come back fine but if the Ferritin is low then you are iron deficient.

Yep; Soy is estrogenic and goitrogenic. I resent that it is in practically everything we buy ready made. I resent it so much, I do not buy ready made food products. Not to mention MSG and other undesirable chemicals. That and Aspartame is a thorn in my side. You cannot even buy regular chewing gum w/o it now. That way they use less sugar. We have no laws to protect us. It is all about the money.

We now have pre-pubescent children at a very early age and men w/ breasts all thanks to soy!

Aaaaaaaaaaaaack; getting off my platform now.:anim_03:

[Live2Love]

Well, the nurse called me yesterday afternoon. They would like to do a CBC when I go in Friday to get my thyroid levels checked. She told me to "remind" the technician. So, I think I'll "remind" the technician that Ferritin is also included in that last. Hope to find out everything Friday, but knowing my Doc's office- it will probably be late next week.

[Andros]

Well, the nurse called me yesterday afternoon. They would like to do a CBC when I go in Friday to get my thyroid levels checked. She told me to "remind" the technician. So, I think I'll "remind" the technician that Ferritin is also included in that last. Hope to find out everything Friday, but knowing my Doc's office- it will probably be late next week.

That is a diplomatic way to put it about the ferritin. It might fly!! I hope so and we cannot wait to hear all the results.

How are you doing on the beta-blocker?

[Live2Love]

The beta blocker is amazing. My heart rate went from 100+ to high 60s early 70s. My breathing has slowed down, any anxiety I had is gone. I should have called my doc sooner! I am still feeling tired, but overall I feel like I've come a long way. Now to find out if anemia is a cause of my problems.

My mom just got her levels checked. They were unchanged after 6 weeks on 50 mcg. So they are upping her dose. She was thinking about switching to Armour, but found out by a coworker of hers that it is being discontinued. Is that true?

[Andros]

The beta blocker is amazing. My heart rate went from 100+ to high 60s early 70s. My breathing has slowed down, any anxiety I had is gone. I should have called my doc sooner! I am still feeling tired, but overall I feel like I've come a long way. Now to find out if anemia is a cause of my problems.

My mom just got her levels checked. They were unchanged after 6 weeks on 50 mcg. So they are upping her dose. She was thinking about switching to Armour, but found out by a coworker of hers that it is being discontinued. Is that true?

Yes about the Armour. Hopefully it will be back on the market soon. I have to start on Cytomel Sunday as I have run out of my stash of Armour which I have been on for years and is wonderful.

Thousands of us are being left in the lurch and are becoming symptomatic. It does not take long.

So glad you are feeling better and I cannot wait to find out about the Ferritin as well. It should be 50 to 100 and the closer to 100 the better.

[Live2Love]

Well, no Ferritin on this round. I asked the tech, but an order was not placed for it. Darn! However; good news is - I'm feeling pppppretty good. I starting working out with the Wii- I bought EA Active. I worked out Saturday, Sunday and last night. I wear a heart monitor, and check it often to be sure I stay around 150. That game has me roller blading, resistance training, boxing, and all sorts of stuff. It is great! I do feel like my TSH is a little high- just because I get that weird feeling again where I need to put my palms, and the soles of my feet on something cold. Lol- I don't know why that is, but I get it when my TSH is up there.

Anyways, here are the lab results from the last 2 rounds, and the most recent:

9/4/09 (Started Meds 10/16)
TSH - 8.60 (0.40-5.00)
Free T4- 0.98 (0.93-1.70)

12/2/09
TSH - 0.17 (0.40-5.00)
T4 - 14.2 (4.60-12.0)

1/15/10
TSH 6.30 (0.40-5.00)
Free T4- 1.02 (0.93-1.70)

Everything was normal on my CBC except a few areas:
E0% 5.4 (0.0-3.0) HIGH
E0# 0.3 (0.0-0.2) HIGH
BA% 1.2 (0.0-1.0) HIGH
RDW 11.1 (11.5-15.5) LOW

So my TSH has gone from one end of the spectrum to the other, and then back up. What a ride! Could my partially functioning thyroid be affecting my doctor's abilities to find a suitable level for me? For instance, would it be any easier to titrate up and down if the thyroid had/has been surgically removed? Does that make sense? The only thing I could find on those levels from the CBC was that the majority of them had to do with inflammation, and allergy levels. So, I don't think they are much to worry about. What do you think?

[Andros]

Well, no Ferritin on this round. I asked the tech, but an order was not placed for it. Darn! However; good news is - I'm feeling pppppretty good. I starting working out with the Wii- I bought EA Active. I worked out Saturday, Sunday and last night. I wear a heart monitor, and check it often to be sure I stay around 150. That game has me roller blading, resistance training, boxing, and all sorts of stuff. It is great! I do feel like my TSH is a little high- just because I get that weird feeling again where I need to put my palms, and the soles of my feet on something cold. Lol- I don't know why that is, but I get it when my TSH is up there.

Anyways, here are the lab results from the last 2 rounds, and the most recent:

9/4/09 (Started Meds 10/16)
TSH - 8.60 (0.40-5.00)
Free T4- 0.98 (0.93-1.70)

12/2/09
TSH - 0.17 (0.40-5.00)
T4 - 14.2 (4.60-12.0)

1/15/10
TSH 6.30 (0.40-5.00)
Free T4- 1.02 (0.93-1.70)

Everything was normal on my CBC except a few areas:
E0% 5.4 (0.0-3.0) HIGH
E0# 0.3 (0.0-0.2) HIGH
BA% 1.2 (0.0-1.0) HIGH
RDW 11.1 (11.5-15.5) LOW

So my TSH has gone from one end of the spectrum to the other, and then back up. What a ride! Could my partially functioning thyroid be affecting my doctor's abilities to find a suitable level for me? For instance, would it be any easier to titrate up and down if the thyroid had/has been surgically removed? Does that make sense? The only thing I could find on those levels from the CBC was that the majority of them had to do with inflammation, and allergy levels. So, I don't think they are much to worry about. What do you think?

Have you had a cold or virus? Some infection going on? That would account for the high EO. Also arthritis would elevate the EO.

Yes; that makes sense and I am a proponent of that but it may be too early in the game yet.

Did you not ever have that FNA? I was reading through the whole thread but I may have missed the info?

Your doc could try "Block and Replace" which could help better stabilize you.

http://www.endocrine-abstracts.org/ea/0016/ea0016s1.1.htm

[Live2Love]

No cold or virus so far this year. Knock on wood! I went to see the surgeon this past fall, and she did her own sonogram, and could not find a single nodule that was considered suspicious. She told me she could just drop the needle in my thyroid somewhere, and biopsy it - but that would not be very accurate. She described my thyroid as being large and inflamed and having a very lumpy bumpy texture, but that there weren't any nodules during the sono that she thought were concerning. Her diagnosis was Hashi's. I am due to see her in April again.

I think I will see how I feel after this next 6 weeks. If my TSH does not lower any further, and/or I don't feel any better- then I may suggest the block/replace method. I am wondering after this dose though- if it is not any better...if she will refer me to an endo.

[Andros]

No cold or virus so far this year. Knock on wood! I went to see the surgeon this past fall, and she did her own sonogram, and could not find a single nodule that was considered suspicious. She told me she could just drop the needle in my thyroid somewhere, and biopsy it - but that would not be very accurate. She described my thyroid as being large and inflamed and having a very lumpy bumpy texture, but that there weren't any nodules during the sono that she thought were concerning. Her diagnosis was Hashi's. I am due to see her in April again.

I think I will see how I feel after this next 6 weeks. If my TSH does not lower any further, and/or I don't feel any better- then I may suggest the block/replace method. I am wondering after this dose though- if it is not any better...if she will refer me to an endo.

Okay...........your sonogram results are as follows as per your previous post........

Sonogram Results
An echogenic and cystic nodule on the right measures 0.8 x 0.7 x 0.6 cm.
The far interior right solid nodule measures 0.8 x 1.0 x 0.8 cm.

The left lobe has an inferior hypoechoic nodule measuring 1.5 x 1.0 x 0.8 cm. Far inferior solid nodules on the left measures 0.8 x 0.8 x 0.8 cm, and 1.0 x 0.9 x 0.8 cm.

Impression:
1) The isthmus is thickened w/ out frank thyromegaly.
2) Both lobes are very heterogenenous and hypervascular with multiple bilateral nodules likely representing multinodular goiter.


I am very worried about this and I really do advise FNA or at the very least a radioactive uptake scan. The radioactive uptake scan would pick up stuff the sonogram was not able to do.

Solid nodules are NOT good.

Please read...........
http://www.merck.com/pubs/mmanual_ha/sec3/ch33/ch33d.html

http://www.wisegeek.com/what-is-a-solid-thyroid-nodule.htm

I am such a nag.......:anim_03:

Just want you to feel well and lead a happy life. Please check back w/ us as often as you can.

[Live2Love]

Hey Andros,
I already had the uptake & scan. I'll post my results as I don't think I did previously. My purpose to see the surgeon this April is to do yet another sonogram. So, I will do my best to push for the FNA. She didn't seem to concerned as she couldn't find a suspicious nodule to biopsy.

Anterior RAo and LAO planar views are obtained. The 24 hour uptake is 28.7% which is within the normal limits of 10-30%. There is signal dropout consistent with a cold nodule at the superior right thyroid lobe and to a lesser degree at the inferior right thyroid lobe. The left lobe appears unremarkable.

Impression:
1. Normal 24 hour uptake of 28.7%
2. Findings are suspicious for cold nodules of the right thyroid gland and follow up with fine need aspiration of the superior and inferior right thyroid nodules are recommended.

Refer to surgeon.

Andros- you've got me thinking. When I went to the surgeon- my PCP's office had not sent over my file. So, the nurse interviewed me thoroughly, as they were attempting to get things faxed over. Now I'm wondering..............if the surgeon never really saw my results from the uptake and scan. Therefore; she decided to do her own sonogram, but wasn't sure where to look for the suspicious nodules. And....hence why I'm going back in April. Everytime I have my levels checked- I have them fax over my results. I also have a copy of my sonogram, and FNA results. Sooooo I think it would be in my best interest to take all of these documents with me to that appointment. What do you think?

[Andros]

Hey Andros,
I already had the uptake & scan. I'll post my results as I don't think I did previously. My purpose to see the surgeon this April is to do yet another sonogram. So, I will do my best to push for the FNA. She didn't seem to concerned as she couldn't find a suspicious nodule to biopsy.

Anterior RAo and LAO planar views are obtained. The 24 hour uptake is 28.7% which is within the normal limits of 10-30%. There is signal dropout consistent with a cold nodule at the superior right thyroid lobe and to a lesser degree at the inferior right thyroid lobe. The left lobe appears unremarkable.

Impression:
1. Normal 24 hour uptake of 28.7%
2. Findings are suspicious for cold nodules of the right thyroid gland and follow up with fine need aspiration of the superior and inferior right thyroid nodules are recommended.

Refer to surgeon.

Andros- you've got me thinking. When I went to the surgeon- my PCP's office had not sent over my file. So, the nurse interviewed me thoroughly, as they were attempting to get things faxed over. Now I'm wondering..............if the surgeon never really saw my results from the uptake and scan. Therefore; she decided to do her own sonogram, but wasn't sure where to look for the suspicious nodules. And....hence why I'm going back in April. Everytime I have my levels checked- I have them fax over my results. I also have a copy of my sonogram, and FNA results. Sooooo I think it would be in my best interest to take all of these documents with me to that appointment. What do you think?

I think yes; that you should take your medical portfolio with you and I also think that it might be a good idea for you to get on the "cancellation" list and get in sooner. April is a long way off.

Glad that I have given you the impetus to re-think your situation.

http://www.endocrineweb.com/thyroidca.html

Please stay in touch; I am truly very concerned about you and for you as are our other posters.

[Live2Love]

Hey Andros,
Boy is it me, or have the thyroid boards seemed busier lately? That's a good thing though! Folks are finding us!

Just a quick update on little ol' me. I was putting together my medical portfolio, and looked at my sonogram results for the fun of it. The suggestion was for a follow up sonogram in six months. That was September 11th. So, I am due March 11th.

I also counted out my beta blocker pills- I have 16 doses left. Which would get me to March 4th.

And last but not least, March 3rd will be 7 weeks since my levels were checked.

So, I'll be calling the doctor tomorrow to find out if: A) I can get a refill on the beta blocker, B) I should come in March 3rd to discuss the refill on the beta blocker & get my labs drawn, or C) End up getting the refill, and come in March 11th for lab work and sono.

I am soooooooo interested in my new sonogram. I completely spaced this one out, and thought the next one I would be having wasn't until April w/ the surgeon. I want to find out if anything has changed, or grown for that matter. Although, I know the nodules/goiters are usually slow growing.

I am going to put all my lab work into a folder tomorrow after I get it hole punched. I was also talking to my mother about doctors in general. I think I am going to see how the sono/lab tests go with the PCP, and also go see the surgeon in April, and then ask for a referral to an endo after that. I mean, I can always go back to my PCP if the endo ends up being crappy!

I had something else to say, but I cannot remember! Ugh, stupid brain fog! Oh! I remember, can you come up with a brief talk track as to why I want them to check my TPOAb? Do you think if I just say I want to have my antibodies levels checked they will? I mean, I want to sound like I know what I'm talking about! :ashamed0001:

[Andros]

Hey Andros,
Boy is it me, or have the thyroid boards seemed busier lately? That's a good thing though! Folks are finding us!

Just a quick update on little ol' me. I was putting together my medical portfolio, and looked at my sonogram results for the fun of it. The suggestion was for a follow up sonogram in six months. That was September 11th. So, I am due March 11th.

I also counted out my beta blocker pills- I have 16 doses left. Which would get me to March 4th.

And last but not least, March 3rd will be 7 weeks since my levels were checked.

So, I'll be calling the doctor tomorrow to find out if: A) I can get a refill on the beta blocker, B) I should come in March 3rd to discuss the refill on the beta blocker & get my labs drawn, or C) End up getting the refill, and come in March 11th for lab work and sono.

I am soooooooo interested in my new sonogram. I completely spaced this one out, and thought the next one I would be having wasn't until April w/ the surgeon. I want to find out if anything has changed, or grown for that matter. Although, I know the nodules/goiters are usually slow growing.

I am going to put all my lab work into a folder tomorrow after I get it hole punched. I was also talking to my mother about doctors in general. I think I am going to see how the sono/lab tests go with the PCP, and also go see the surgeon in April, and then ask for a referral to an endo after that. I mean, I can always go back to my PCP if the endo ends up being crappy!

I had something else to say, but I cannot remember! Ugh, stupid brain fog! Oh! I remember, can you come up with a brief talk track as to why I want them to check my TPOAb? Do you think if I just say I want to have my antibodies levels checked they will? I mean, I want to sound like I know what I'm talking about! :ashamed0001:

Okay...............it is very important to have antibodies checked and some such as Thyroglobulin Ab would even hint at cancer if the titers are high.

TPO (antimicrosomal) is important because if present, it suggests autoimmune disease and more times than not, it is thyroid but TPO is present in other autoimmune diseases also.

So, if TPO is present, that means the doctor should dig deeper to narrow the field with other tests indigenous to thyroid such as those listed below.......

The lab tests listed are helpful when it comes to sorting things out.

TSH, FREE T3, FREE T4, TPO (antimicrosomal antibodies), ANA (antinuclear antibodies), TSI (thyroid stimulating immunoglobulin) and Thyroglobulin Ab as well as thyroid binding inhibitory immunoglobulins (TBII.)

You can look all of the above up here so you know what they are for........ http://www.labtestsonline.org/

And here is a good site to help everyone understand the thyroid tests.

http://www.brooksidepress.org/Products/Military_OBGYN/Lab/ThyroidFunctionTests.htm

How have you been feeling? So glad the Beta-Blocker is helping. That was very very worrisome.

[Live2Love]

Hey Andros,
I'm home on lunch. I went and and left a message on the nurse's line. However; my doctor only works a half day today. So, I doubt I will hear back from the nurse before tomorrow. I just asked if it would be possible to add the TPO to my thyroid panel as I'd like to see how my antibodies are responding to treatment. If that doesn't work- well, then I'll get those antibodies tested when I ask for a referral to an endo.

I have been feeling a little more like myself lately. Not completely, but I've come a long way! I think I have enough energy to start exercising regularly. Not sure if the doctor is planning on keeping me on the beta blocker for a while longer, or ween me off it before my lab appointment. So, we will see.

Anyways, I have to get back to work. Thanks for your post above. I will read it more thoroughly when I get home from work.

[Andros]

Hey Andros,
I'm home on lunch. I went and and left a message on the nurse's line. However; my doctor only works a half day today. So, I doubt I will hear back from the nurse before tomorrow. I just asked if it would be possible to add the TPO to my thyroid panel as I'd like to see how my antibodies are responding to treatment. If that doesn't work- well, then I'll get those antibodies tested when I ask for a referral to an endo.

I have been feeling a little more like myself lately. Not completely, but I've come a long way! I think I have enough energy to start exercising regularly. Not sure if the doctor is planning on keeping me on the beta blocker for a while longer, or ween me off it before my lab appointment. So, we will see.

Anyways, I have to get back to work. Thanks for your post above. I will read it more thoroughly when I get home from work.

You are welcome and I hope they add the TPO.

Talk to you tomorrow..........

[Live2Love]

Yay! I can't believe I'm so excited over my Doctor approving a lab request! It's the little things in life, right?

The beta blocker is being refilled. TPO will be adding to my next lab rounds which will be the 1st week of March. And, the girls will call me to schedule my follow up sonogram from September sometime this week.

I love when things go so smooth!

[Andros]

Yay! I can't believe I'm so excited over my Doctor approving a lab request! It's the little things in life, right?

The beta blocker is being refilled. TPO will be adding to my next lab rounds which will be the 1st week of March. And, the girls will call me to schedule my follow up sonogram from September sometime this week.

I love when things go so smooth!

So do I and thank you for sharing the good news with us! Also glad about the Beta Blocker as clearly it is helping you to feel better.

[Live2Love]

Well, tried watching the sonogram tech do my sonogram today. She measured out what seemed like several nodules. She would measure the length and the width, and the height. However; I never saw any of the final dimensions. So, I have no idea what she found. I also had blood drawn for my usual TSH w/ the addition of the TPO test. Wow! They take a large vial of blood for that one! Anyways, they should be getting back with me between now and next Monday. Cross your fingers!

[Live2Love]

Ugh. I am soooooooo irritated. I had my sonogram last Monday. And I am STILL waiting to hear back on the results. I called this past Thursday- no phone call back. I called Friday to check the nurse's lines voicemail- Doc left at 9:30am, Nurse left at 11:30 am. No call. And today, I called. No return call. Even if they needed extra time- it would still be nice to know. Arrrrgh.

[Live2Love]

I now know why they weren't getting back with me. My chart appeared to be misplaced, but apparently the doctor had it in her office. I finally got my results back today. It validates my feeling of "hypo" again....

[Live2Love]

Hey Andros,
If you remember * I finally received approval to get the TPO Ab test done. You will find my results listed below.

9/4/09 * Before Meds
TSH: 8.60 (0.40*5.00)
Free T4: 0.98 (0.93*1.70)

12/2/09
TSH: 0.17 (0.40*5.00)
T4: 14.2 (4.60*12.0)

1/15/10
TSH: 6.30 (0.40*5.00)
Free T4 1.02 (0.93*1.70)

2/22/10
TSH: 8.51 (0.40*5.00)
Free T4 1.06 (0.93*1.70)
TPO Ab 207 (0.00*34.0)

My doctor now wants to do an Antithyroglobulin Ab test as well. Can you tell me what the difference is between these two, and what they can tell about a person?

Also, here are my 6 month sonogram results:
Impression:
Markedly heterogenous gland w/ again the most dominant nodule on the left see along the inferior aspect is somewhat smaller then on previous study but again the normal architecture of the gland has been lost with heterogeneity and increased flow. This maybe all a multinodular gland but given the loss of the normal architecture correlation w/ thyroid antibodies as well as thyroid function test would be recommended if not all ready performed. Again the normal architecture has been compromised and thus there maybe some form of intrinsic based process or systemic process involving the thyroid gland. The largest nodule again along the left inferior aspect at 1.8cm.

Now, whats nice is the largest nodule they found is on the left. This would explain my ear pressure that I still have. Due to my thyromegally, hypo/hyperthyroid, abnormal sonogram ...my PCP wants to refer me to an endo. FINALLY!!!!! I was going to ask for one, but it looks like my PCP sees the same thing I do. I'm not getting any better. However; it will take months probably before I can get it to see the specialist, but for now she wants to start me backup on 50 mcg for 6 weeks, and I need to come in at my convenience for the antithyroglobulin ab test.

Thoughts?

[Andros]

Ugh. I am soooooooo irritated. I had my sonogram last Monday. And I am STILL waiting to hear back on the results. I called this past Thursday* no phone call back. I called Friday to check the nurse's lines voicemail* Doc left at 9:30am, Nurse left at 11:30 am. No call. And today, I called. No return call. Even if they needed extra time* it would still be nice to know. Arrrrgh.

Wow! Yeah!! Why keep you on tenterhooks all this time? All they have to do is say. Goodness.

I am glad you have checked in w/ us and by now you know my mother board fried so I was out for over a week.

[Live2Love]

Hey Andros,
Yes, I saw that! Bummer! Do you feel like you've been gone a week? It looks like the boards have gotten way busier! When you get caught up, come by and take a look at my new results. Take care!!! Thanks for everything you do!

[Andros]

Hey Andros,
If you remember * I finally received approval to get the TPO Ab test done. You will find my results listed below.

9/4/09 * Before Meds
TSH: 8.60 (0.40*5.00)
Free T4: 0.98 (0.93*1.70)

12/2/09
TSH: 0.17 (0.40*5.00)
T4: 14.2 (4.60*12.0)

1/15/10
TSH: 6.30 (0.40*5.00)
Free T4 1.02 (0.93*1.70)

2/22/10
TSH: 8.51 (0.40*5.00)
Free T4 1.06 (0.93*1.70)
TPO Ab 207 (0.00*34.0)

My doctor now wants to do an Antithyroglobulin Ab test as well. Can you tell me what the difference is between these two, and what they can tell about a person?

Also, here are my 6 month sonogram results:
Impression:
Markedly heterogenous gland w/ again the most dominant nodule on the left see along the inferior aspect is somewhat smaller then on previous study but again the normal architecture of the gland has been lost with heterogeneity and increased flow. This maybe all a multinodular gland but given the loss of the normal architecture correlation w/ thyroid antibodies as well as thyroid function test would be recommended if not all ready performed. Again the normal architecture has been compromised and thus there maybe some form of intrinsic based process or systemic process involving the thyroid gland. The largest nodule again along the left inferior aspect at 1.8cm.

Now, whats nice is the largest nodule they found is on the left. This would explain my ear pressure that I still have. Due to my thyromegally, hypo/hyperthyroid, abnormal sonogram ...my PCP wants to refer me to an endo. FINALLY!!!!! I was going to ask for one, but it looks like my PCP sees the same thing I do. I'm not getting any better. However; it will take months probably before I can get it to see the specialist, but for now she wants to start me backup on 50 mcg for 6 weeks, and I need to come in at my convenience for the antithyroglobulin ab test.

Thoughts?

Well; holy cats!!! Look at that TPO. Thyroglobulin Ab could indicate cancer.

Here is the full monty on that......... Not every thyroid cancer will produce thyroglobulin, but the most common types, papillary and follicular thyroid cancer, frequently do, resulting in increased levels of thyroglobulin in the blood.

And I do recommend that you read the entire explanation which you will find here...........
http://www.labtestsonline.org/understanding/analytes/thyroglobulin/test.html

The test is also useful for other things such as diagnosing hyper/Graves'

Re the sonogram; there are irregularities and I personally think that a radioactive uptake scan would be in order. Sonograms do not always pick up everything.

And...............you sure are having some wide swings with that TSH!!! Oh, my gosh. You went from hyper TSH to hypo TSH so quickly! And the FT4 is barely budging unable to keep up due to mixed signals.

I see this in the following. Hashimoto's, Graves' and Cancer.

[Live2Love]

Hi Andros,
Thanks again for your input. You definitely have a gift. Helping all of us understand what's wrong with us!

My doctor's office called yesterday* I have an endo appointment March 22nd! I also went in today for the TgAb lab draw. I asked that they fax me over a copy when the test is complete. So we will see what that shows.

Now it's just wait until March 22nd. Although that wait time seems so small considering my PCP nurse said it would probably take 2 months or longer to get in. So I think I'm doing pretty good getting in same day!

[Andros]

Hi Andros,
Thanks again for your input. You definitely have a gift. Helping all of us understand what's wrong with us!

My doctor's office called yesterday* I have an endo appointment March 22nd! I also went in today for the TgAb lab draw. I asked that they fax me over a copy when the test is complete. So we will see what that shows.

Now it's just wait until March 22nd. Although that wait time seems so small considering my PCP nurse said it would probably take 2 months or longer to get in. So I think I'm doing pretty good getting in same day!

Thank you for your kind words. I love helping others (and animals too.)

Glad about the appt. and actually that is fast from what I hear on the boards and forums. Whoooooooooooooohoo!

How are you feeling?

[Live2Love]

I have a weakness for animals. If I wasn't living in an apartment, I am sure I would have accumulated several by now. I think at some point in my life I will work with animals.

I'm feeling pretty blah again. I have that silly temperature thing again w/ my hands and feet. It feels like they are hot, and if I put my hands around a cold cup of water *it feels good. Or, if I walk on my tile floor in the kitchen...same thing. Yesterday I left early from work by 2 hours. I couldn't keep my eyes open. I came home and ended up sleeping for 4 hours straight! Luckily my boss has been very understanding, and has told me to take the time I need when I need it.

[Andros]

I have a weakness for animals. If I wasn't living in an apartment, I am sure I would have accumulated several by now. I think at some point in my life I will work with animals.

I'm feeling pretty blah again. I have that silly temperature thing again w/ my hands and feet. It feels like they are hot, and if I put my hands around a cold cup of water *it feels good. Or, if I walk on my tile floor in the kitchen...same thing. Yesterday I left early from work by 2 hours. I couldn't keep my eyes open. I came home and ended up sleeping for 4 hours straight! Luckily my boss has been very understanding, and has told me to take the time I need when I need it.

You are struggling; that is quite clear.

My feet and hands used to burn(hot) so bad. I slept w/ my feet hanging off the end of the bed and could not stand to have the covers on my hands or feet. Aaaaaaaaaaaaaaaaaaargh. I remember that so well.

What a blessing to have such a nice boss.

[Live2Love]

Oh it's sound good to hear that someone else has had the heat problem. It is so annoying! Do you have any support materials that individuals w/ Hashi's can give to their family/friends? I'm finding that those around me think that Hashi's really isn't affecting me, and that I'm fine. You know, one of those *she doesn't appear to be sick so she must be fine* type of things.

[Andros]

Oh it's sound good to hear that someone else has had the heat problem. It is so annoying! Do you have any support materials that individuals w/ Hashi's can give to their family/friends? I'm finding that those around me think that Hashi's really isn't affecting me, and that I'm fine. You know, one of those *she doesn't appear to be sick so she must be fine* type of things.

I got to the point where I just plain quit talking about it. The only one that understood was my husband. Thank God for that. He's a keeper. Married 44 years.

I just plain quit talking about it; it was a lonely existence. I found out who my friends really were though and ultimately that was a good thing. I have a whole new circle of friends now and we are "compatible!" ha, ha!!!

[Live2Love]

That is what has happened to me too. I have stopped talking about it too except w/ my boyfriend & a few close friends. Sad it has to come to that! Oh well. I'll check in when I get the TgAb test back. And, I will try to help out w/ the other posts. I'm not nearly as knowledgeable as you though!!

[Andros]

That is what has happened to me too. I have stopped talking about it too except w/ my boyfriend & a few close friends. Sad it has to come to that! Oh well. I'll check in when I get the TgAb test back. And, I will try to help out w/ the other posts. I'm not nearly as knowledgeable as you though!!

Guess how I got to know things?? By answering posts and researching my answers from credible sites before replying.

Go for it!! We learn by doing.

[Live2Love]

Received my Antithyroglobulin Ab test results today.
Range: 0*40 , My Result= 29.

Now, essentially we would want this to be 0 , right? Any thyroid antibody at all shows a sign of thyroid malfunction, right? The nurse told me the above result was normal.

[Andros]

Received my Antithyroglobulin Ab test results today.
Range: 0*40 , My Result= 29.

Now, essentially we would want this to be 0 , right? Any thyroid antibody at all shows a sign of thyroid malfunction, right? The nurse told me the above result was normal.

I am with you. Antithyroglubulin is the antibody against the autoantibody thyroglobulin.

It "could" suggest cancer but not always. These are also present w/ Hashimoto's but I am not fond of assuming things when it comes to a person's health.

Here is info for you. I would get a second opinion and if you have not had a scan (preferably) uptake, I would advise that.

http://www.labtestsonline.org/understanding/analytes/thyroid_antibodies/test.html

You see endo on the 22nd.; correct?

[Live2Love]

Yes, I do see the endo on the 22nd. It's coming up!
I have another question for you, and I've been looking on the internet some myself.

I have been craving sweets a lot lately. I haven't been able to have any self control either. I'll make sure to bring this up with the endo, but have you heard of sweets cravings w/ thyroid dysfunction?

[Andros]

Yes, I do see the endo on the 22nd. It's coming up!
I have another question for you, and I've been looking on the internet some myself.

I have been craving sweets a lot lately. I haven't been able to have any self control either. I'll make sure to bring this up with the endo, but have you heard of sweets cravings w/ thyroid dysfunction?

You could be. I have insulin resistance and I find I crave sweets but I resist. I think we always want what is not good for us.

If you are having drops in glucose, you could want a sweet. Maybe you should also get a glucose test to see where you are at. I would mention this to the doctor; I surely would.