gastroparesis & Thyroid

[mlrckm1]

My daughter has been suffering for over a year with what they thought was gallbladder disease....well it all ended her up in the hospital with pain, nausea, etc....they ran every test in the book for digestive problems  and when they scoped her they found undigested food in her stomach!  She had been NPO for over 12 hours!  They indicated that she had gastroparesis!  They started her on Reglan with terrible side effects so they change her to Erthemycin (sp??).   At the doctors appointment to discuss the Reglan issue, he felt a nodule on her thyroid....it has been ultrasounded but all he would tell me was that it was 3.2 centimeters big!  He is a gastro man so he has forwarded me to her regular doctor.......could her nodule be the cause of her gastroparesis?  She also suffers from fatigue....after school she has no energy....never wants to go anywhere etc......but then sometimes it is light a switch goes on and she is in full motion, then she bottoms out again...could this be caused by the nodule also?   I just wanted to know what to ask the doctor when I see him......Any help you  can give me would be greatly appreciated.

[mlrckm1]

I understand...I just saw it online that sometimes an issue with the thyroid can cause this problem...She does not have diabetes, irritable bowel or depression....Her doctors were surprised to find this as she does not fit the mold.

Her gastro dr did find a nodule and ordered an ultrasound...here are the results...

My daugher had an ultrasound and the doctor upon seeing the report is sending her to Centennial Hospital in Nashville, TN   to see the best endocrinologist in Middle Tennessee.   He really didn't say anything except he will call us tomorrow with an appointment for our daughter.   This is making me really nervous.....I am going to type in her report and would appreciate any insight you may have.

Tiny hypechoic nodule in the medial lower pole.  (this may represent a small cyst).  It measures 1-2 mm.  There is a heterogeneous lower pole nodule that measures 3.2 x1.6x2.3 cm.  An adjacent 1.2 cm nodule is also present.  Impression:  Complex bilobed nodule in the lower pole left thryoid glad.  Pathology consult for biopsy is suggested.

Any help would be great!

[Mark Lupo, M.D.]

A nodule would not cause gastroparesis -- an underactive thyroid could however so testing TSH, T4 and T3 would be useful -- but in most cases the nodules do not effect thyroid function.  So regarding the nodule, if the TSH is normal, the next step is biopsy (using a very small, "fine" needle) -- NOT an I-123 nuclear medicine scan as if often recommended but not in the current guidelines for routine nodule evaluation.

There seems to be an increase in gastroparesis that is hard to explain.  Diabetes is the most common connection usually.  But I think there may be a connection with irritable bowel and a relation to anxiety/depression in some patients -- so if this sounds right, look into these issues as well.