Tapazole

[Mucka]

I am taking Tapazole preop for thyroidectomy as my T3 was elevated x2 normal range.  After only 10 days at 10 mg bid it is back within the normal range and Sx is scheduled.  I didn't have a hyperthyroid symptom at all.  TSH is totally supressed (still is) and T4 within normal range all along.  I have a very large predominant solid nodule that has inhomogenous distribution with a photopenic area and psammomamous calcification noted throughout, which sprouted in a three week span.  I am feeling very tired, my feet are freezing but sweating and I am very foggy (per say).  My salivary gland is very inflammed also. My question is.....is it normal for the T3 to come down that quickly?  From what I read..it usually takes about 4-6 weeks??  Immuno assays are also normal.

Thanks in advance!!

[Mucka]

Thanks again.

[Mucka]

I did have a biopsy.  It came back benign with folllicular cells. My doctor is still suspicious and states he just doesn't like the appearance.  Psammoma-like calcification came from an u/s and with the radiologist remarking that on ultrasonic grounds, it is high suspicion for malignancy.  The photopenic area came from the uptake scan which did show uptake in the nodule with absolutely no uptake with the rest of the thyroid. The small photopenic area was just below this nodule.   I did have a CT with contrast also not two weeks before this.  Sx is in three weeks.

[Mark Lupo, M.D.]

Yes - it can be that quick.  With the negative antibodies and a large noduel, the nodule is likely the source of over-activity -- did you have a biopsy as the concerning part is "psammoma-like calcification" -- this is suggestive of papillary thyroid cancer -- but if the nodule is hot (not sure exactly if the photopenic comment was based on ultrasound or nuclear scanning) - then not likely cancer.