Goiter, Normal TSH, sent to surgeon

[mandyisme]

I am scared.  I am 29 yr old female.  My hormone test was abnormal 5 years ago and they performed a thyroid uptake and a gallbladder scan.  Uptake was normal, but gallbladder was only working 1%.  Gallbladder was removed.  OBGYN doc notices how large my thyroid is every annual but my TSH always was fine.  After this annual and blood test  I was sent to regular doctor because triglycerides were so high, good cholesterol very low.  Doc gave me meds for this even though I am already on blood pressure meds, mirgraine meds, allergy meds, depression meds, acne meds, cholesterol meds.  To be safe since my OBGYN keeps complaining that my thyroid feels too large, my family doc sends me for a thyroid ultrasound remember 5 years ago they did the uptake and it was normal.   They call me back in a littler over a day after the test and schedule me for a surgical evaluation.  They say I have a goiter.  What about medication?  Don't they treat thyroid problems with meds?  If there is something wrong, why have the other tests been normal?  I have been overweight my entire life even after trying dieting and exercise.  My tsh has been tested many times coming back normal.    In fact this last time it was under 1 something like .9 I think.   I stay busy, but in the past year or so have been extremely fatigued.  Lately I have been having alot of eye pain, but I think it is allery/sinus related.  Any other symtoms you may be interested in are thin hair, thin nails, sore throat, but not a tightness, headaches alot.   Why would they send me directly for a surgical evaluation with a surgeon not a thyroid specialist?  I can't stand being so young and having all these problems.  It is so frustrating.  Any advice or similar experiences or anything from you would be appreciated.  I am still gong to go see the surgeon but in the meantime I am scared.  

[blsdnsvd]

Request a copy of your sonogram report because it is possible that abnormal cells were detected. Most abnormal sonograms are followed by a scan then a fna. My 2nd opinion was by a specialist who is a surgeon. He evaluated my situation, did a fna biopsy and ordered a cat scan. He was very thorough in explaining everything. In the Midst, you should find a EndoCrin because they are the specific docs for Thyroid Issues. Hope this helped.

[mandyisme]

I so much appreciate all of your comments.  Why though would the family regular doc send me directly to a surgeon after the thryroid ultrasound?  It just seems more logical that he would have sent me to a endo doc.  I ask the nurse this when she called me and she didn't seem to know.  So then I call where they made my appt at with the surgeon to ask them and they were like...well the suregon just wants to talk to you about whether or not you should have surgery.  I am going to ask the surgeon when I go next week why they are not running more tests before a surgical evaluation.  After many normal tests, the ultrasound turns out abnormal with a goiter why all of a sudden is surgery an option for a disease that has never even been treated?  It doesn't sound very logical to me.  I am little afriad that they saw something specific in the ultrasound.  Of course I always imagine the worst.

[TKIngalls]

I am 29 also and was diagnosed with Graves disease within the past year. I saw 3 doctors before finding an endocrinologist who actually listened to me. One doc (the 1st endo I went to) recommended I see a therapist because he thought my problems were mental and I was making up symptoms. I have learned the hard way that just because there's an MD after a person's name it doesn't mean that they are qualified to treat YOU. Each person is different and will require different treatment. Find a doctor who not only listens to you but also explains treatment options instead of proclaiming you need this or that.

TK

[Smilerdeb]

You dont mention being tested for thyroid antibodies?
Ask to be tested for Graves and hashi's antibodies.
Dont do surgery until you know WHY they want to do it.
The thyroid is a gland that controls just about every organ in your body and also metabolism.
I wouldnt have no surgery until the Doc or Endo told me WHY I had to have surgery.

[KelDC]

I'm sorry you are having such a tough time.  You are right, thyroid problems can be treated with medicine, BUT they have to know what's causing them first. Did the ultrasounds show nodules or anything? I would think by going to a surgeon they will want to do a biopsy and see if they can tell what is making your thyroid grow so large.  The surgeon who handled my biopsy and performed my surgery was not a thyroid specialist, but he had a lot of experience with them so I was very comfortable. Just do not be afraid to ask questions (write them down so you don't forget anything!) or to request a second opinion if you want one. Good luck!

[gakat61]

You have a lot of the same symtoms that I do. I have a goiter now ...... had surgery to remove the majority of a goiter when I was two days old. I was on meds before I started elementary school, taken off in my late teens. The doctors told me that I was fine when my test results would come back. No one had tested me for Reverse T3 until recently. I have started on Liothyronine which also treats goiters. I've only been on the med a week ...... trying to find out if the generic form (Liothyronine) or cytomel is better.

[TamraW]

Goiter is common in people with Graves (hyperthyroid) disease and in people with Hashimoto's disease (hypothryoid). Personally, I wouldn't do surgery unless, of course, the goiter gets too big and it affects our quality of life, or if my nodules grow bigger. I take meds (Synthroid) for my Hashimoto's. It has helped tremendously.

People with Graves supposedly have abnormally low TSH. People with Hashi have high TSH.

Supposedly.

But this is not a perfect world and we are not lab slips. My TSH has been 2.69/2.74. My first two doctors said that was 'normal'. The problem with Hashimoto's is that during the early years of this disease, our values flip-flop as our thyroid fights these antibodies. Based on your weight problems, and not your TSH, you look more hypo. I would demand these blood tests:

TSH
FT4
FT3
Anti-TPO (Hashi antibody)
TGab (Hashi antibody)

BTW, here are my Hashimoto symptoms:

Mild weight gain even while dieting
Extreme fatigue/napping
GERD/Heartburn/chest pain
Mostly constipation mixed with diarrhea
Depression/anxiety/forgetfulness/brain fog
Abdomen swells for no apparent reason
Neck/jaw pain/swelling/pressure
Scratchy voice
Migraines, dizziness and back of neck/head pain
Very cold feet and hands and sometimes a feeling like ants are biting my feet
Endometriosis (2 years ago – cured after one year of birth control)
Irregular/heavy periods and menstrual-like cramping in between periods
Ear pressure/pain
Voice is sometimes hoarse
Knee/joint pains – finger swelling and pain
Rash or scaly skin on neck, head, chest, chin, nose, right armpit down to waist
Dry eyes and sometimes soreness
Occasionally I have a mild hot flashes or chills
Night throbbing/pounding in ears that wakes me
Toe nails feel painful and brittle
Muscles in legs sometimes go wobbly and weak when I am standing
Tingling feet/hands/lips
Body temp ranges 97-97.5
Hair clumps in shower
goiter/four nodules

If you do opt for surgery, please look around for an experienced thyroid surgeon. Surgeons are not all the same.

Take care...
:) Tamra