Question for all you Dis Doctors...

[WDWDancer]

I'm already under a Doctors treatment but so frustrated I wanted to see if anyone else had opinions.....

Hi all I am 24 and recently started seeing an Endo because a CT of my neck showed enlarged lymph nodes and a possible goiter on my thryoid. I had a ultrasound of the thryoid which showed a 1.4cm nodule along with other smaller nodule's on the thryoid. My family doctor had run lab work and my TSH came back at 3.13 she sent me to the Endo for further evaluation. I've been extremely fatigued, muscle weakness, trouble swolling, always feel like a sore throat, cold intorlerent, hair falling out...you get the picture :dizzy: This wasn't the first time my thryoid was checked its been done numerous times in the past and always came back total TSH between 1.1-2 which ever doctor said was normal.

So the Endo saw me talked about possibly Hashimotos...she ordered a FNA Biopsy ultrasound guidance of the 1.4 cm nodule which came *back abundant colloid, hemosiderin-laden histiocystes and scattered follicular cell nuclei with hemmorrhage* the Endo said that its mostly good news and we will follow up in 6-12 mts. The most recent labs she ran came back Total T3 = 1.58TSH = 5.53T-Uptake= 29%T4= 10.6FTI = 3.07

I'm on no medication and every week am feeling worse...is this normal treatment option watch and wait???? I'm also 5'8 and 132 pds I use to work out heavy and eat a very clean diet but for the last month it takes all my energy to even do a easy workout THANK YOU FOR ANY HELP

 

[golfgal]

A normal TSH is between .3-3 so you are within the normal range, however that doesn't always tell the complete story. The nodules on your thyroid could be causing the problems or not. It might be worth looking into other causes but rule out Hashimoto's first.

Since your numbers are in the normal range, giving you medication could make your condition worse. Did they test you for anything else, diabetes??

It is possible your thyroid is on the decline and not registering yet and then yes, it is a wait and see type deal. Even if they put you on meds it would be at least 2 months before they tested you again.

 

[Christine]

Your TSH is right on the edge of being hypothyroid based on the revised scale.

Based on your symptoms, I believe that most decent endos might give you a several month course of levothyroxine to see how you response. A TSH of 3.+ isn't horrific but it might be bad for *you.* Have you asked if they will give you a trial run of the thyroid medication?

I also have to ask, have you had other things checked like your iron levels (ferritin test) and/or Vitamin D. Both of these deficiencies, which are very common can also cause all the symptoms you describe. I have thyroid issues so I always RUN to the endo thinking it's the souce of all my problems. Once I make sure I'm optimal there, sometimes I still have the same old issues. For me, I was not anemic but I had a terribly low, almost non-existant ferritin level which means I had no iron stores. I felt horrible.

 

[crz4mm2]

Your repeat TSH is 5.53?????? You need some meds. Find a new doc.

 

[Christine]

Your repeat TSH is 5.53?????? You need some meds. Find a new doc.

Oh, I missed that! Yeah, that's a problem.

 

[WDWDancer]

Ya thats what I don't get the repeat TSH is 5.53 it went up that much in less then a month!!! Yesterday I saw the DR and they said since my T3 and T4 are "normal" they don't want to start me on meds yet; they also took another 9 vials of blood to run more test so we'll see. I figured I'll find out what this blood work reveals and go from there.

My Vitamin D is outstanding according to the Dr's its 73 I think "normal" is 30-100.

Tomorrow I go to an oncologist that the Endo referred me to she wants to check for any low grade lymphoma?? Its getting to a point where I feel like she is trying to turn me into a lab rat

 

[Christine]

Ya thats what I don't get the repeat TSH is 5.53 it went up that much in less then a month!!! Yesterday I saw the DR and they said since my T3 and T4 are "normal" they don't want to start me on meds yet; they also took another 9 vials of blood to run more test so we'll see. I figured I'll find out what this blood work reveals and go from there.

My Vitamin D is outstanding according to the Dr's its 73 I think "normal" is 30-100.

Tomorrow I go to an oncologist that the Endo referred me to she wants to check for any low grade lymphoma?? Its getting to a point where I feel like she is trying to turn me into a lab rat

I'm so jealous. Just HOW do you have such a great Vitamin D level. Mine was something like 23.

That is odd that your other labs are normal but the TSH is off. Sometimes people feel bad and their TSH is normal but their T3 and T4 are off (the TSH doesn't tell the whole story). Your TSH is definitely hypo. Even a few years ago the hypo scale started at 5.0. Now it is about 3.5. But a good endo does know to look at your other numbers (and this endo apparently did that). I wonder what other tests they ran.

 

[WDWDancer]

Thanks Christine My Vitamin D was horrid when I first moved to VA last October (the first DR I found here was a gyno and he ran it) I was 21 he told me to get that number up start taking Vitamin D...so I did!! I have been taking 2 Vitamin D capsules from Trader Joes every day along with B12.

The next test are a CBC again....some more in-depth Thyroid test....a repeat TSH..and she said they are also testing the pituitary.

 

[crz4mm2]

Ya thats what I don't get the repeat TSH is 5.53 it went up that much in less then a month!!! Yesterday I saw the DR and they said since my T3 and T4 are "normal" they don't want to start me on meds yet; they also took another 9 vials of blood to run more test so we'll see. I figured I'll find out what this blood work reveals and go from there.

My Vitamin D is outstanding according to the Dr's its 73 I think "normal" is 30-100.

Tomorrow I go to an oncologist that the Endo referred me to she wants to check for any low grade lymphoma?? Its getting to a point where I feel like she is trying to turn me into a lab rat

So, your endo would not treat you since your T3 and T4 are normal... hummm.
Again, you need a new doc....

 

[Christine]

So, your endo would not treat you since your T3 and T4 are normal... hummm.
Again, you need a new doc....

Well, to be fair to the doctor, her actual thyroid numbers are normal. Her TSH, which is a function of the pituitary gland, is not normal. If a TSH is normal and the patient feels bad, they will then test the other thyroid numbers T3 and Free T4. If they are off, then they will treat even though a TSH may be normal. In the reverse situation like the OP has, the thyroid numbers actually look good (I don't have the lab values, I'm just assuming). So the TSH is "off" for some other reason that cannot be attributed to the thyroid gland. Her pituitary gland could actually be malfunctioning and be non-thyroid related. If her T3 and T4 are good, it could be harmful to add levothyroxine.

 

[JessicaR]

Based on your symptoms it wouldnt hurt to have a rheumatologist evaluation. Also, I would ask your Endo if he treats more diabetics than thyroid patients. You could also do some research to find one that specializes in Thyroids only.

Your TSH is climbing and you should be on some replacement. I would feel AWFUL at that level but everyone is different. Do you happen to have the lab values for the T3 and T4 results? And do you know if they were total or free?

Hope you get some answers soon! Its terrible to not feel well.

I just re-read and see you had a total T3, request a Free T3. Total T3 tests are pretty useless for diagnosing. Free T3 is more accurate representation of your clinical status.

Thyroid Blood Tests
http://thyroid.about.com/od/gettestedanddiagnosed/a/bloodtests.htm

 

[crz4mm2]

Well, to be fair to the doctor, her actual thyroid numbers are normal. Her TSH, which is a function of the pituitary gland, is not normal. If a TSH is normal and the patient feels bad, they will then test the other thyroid numbers T3 and Free T4. If they are off, then they will treat even though a TSH may be normal. In the reverse situation like the OP has, the thyroid numbers actually look good (I don't have the lab values, I'm just assuming). So the TSH is "off" for some other reason that cannot be attributed to the thyroid gland. Her pituitary gland could actually be malfunctioning and be non-thyroid related. If her T3 and T4 are good, it could be harmful to add levothyroxine.

MILD hypothyroidism frequently shows with an elevated TSH only.