Need Help Elevated Anti-Thyroid Peroxidase

[perky88]

My FNP felt a nodule in my thyroid gland.I was sent for a thyroid ultrasound with the results being focal 7x10 mm mass is questioned at the junction of the right lobe of the thyroid isthmus and this would be a dominate mass if genuine.Recommended correlation with thyroid function studies and nuclear thyroid imaging.Nuclear imaging was normal with right side being larger the function studies was TSH 1.85,Free T4 0.81 and Antithyroid Peroxidase 227 with a normal being less than 35.I went to a endocrinologist today with them just drawing more blood and saying its nothing to be alarmed about see you in 6 months.I am very concerned because I have had hair breakage and joint pain mostly in my ankles for the last 5 years.

[Mark Lupo, M.D.]

Nuclear scan was not indicated in this situation - the nodule is too small to see and the TSH was normal.

You have TPO antibodies suggesting Hashimoto's with currently normal looking thyroid function but higher risk of developing hypothyroidism in the future. These nodules at the junction on the isthmus should be evaluated more closely and possibly biopsied based on ultrasound appearance.  

If joint pains are increasing, then consider seeing a rheumatologist.  The TSH suggests low probabilty (but not zero) of benefit with levothyroxine (thyroid hormone) treatment.

[perky88]

Thank you this is what my FNP also thought but she wanted me to see a specialist.