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Hyperthyroidism with Multinodular Goiter

Dear Dr. Lupo;
I am a 48yo traumanurse at a level one hospital. I started feeling hyper and had an enourmous weight gain of 40 lbs from 12/26/2010 saw Internist on 12/27/2010 labs were drawn and I was admitted to the hospital with Hyperthyroidism & Severe HTN 240/140.They used large amounts of Lasix q4hours IV to decrease fluid retention. Labs were as follows TSH 0.006  very low ( critical level) Normal Range .450-4.50 ,Free T4 2.36 high- Normal range 0.78-2.19, Free T3 6.02 high Normal Range 2.77-5.27, T3 Total 2.42 high normal range -0.97-1.69, T4 18.6 high , Normal range 5.5-11.0,Ca+ 8.3 low, normal range 8.4-10.2, eGFR 35 Low, Normal Range >59 eGFR African American ( I am Caucasion) 42 low, normal range >59
Thyroid Ultrasound- Right Lobe 4.2x2x1.9 cm and the left, 3.9x0.8x1.6. There is a dominant 2cm solid mass within the right upper pole, also a second solid nodule 1.1x 1.1cm  within the right midpole and a 3rd 5mmx6mm also in the right midpole. Thyroid Uptake scan was abnormal  Cold nodules - AT 4HOURS 14.3% UPTAKE (NORMAL 3-11%)  and at 24 HOURS 31.2% (normal 8-25%). Saw 2 Endocrine Specialist eyes were measured for Graves normal measurement. Both want to do a Fine Needle Biopsy which is okay with me.Then either start Radioactive Iodine (1 thinks it will take too long to get to normal with RAI) The other wants to use Tapazole a drug that causes incresed Liver Damage and Functions and also causes an increase in infections.As a patient with CVID I donot think adding a drug that will further suppress my immune system is a great idea, both state we will watch your White Cell Count by the time that shows up decreased I could be on a Vent. Not going to happen have already done that 3 times  spending 31/2 weeks on vent each time. Never Again! If they are both trying to put me into hypothroidism why not just remove the thyroid gland and supplement with Synthroid or Levoxyl? If there is a canerous lesion I would assume that treatment would be different? I am sorry that my question is so long but I felt that you needed all the info to make a good reccomendation or idea. Do you know of any Endocrinologist on the East Coast of Florida near the Boca Raton area to refer to? My Hospital is 50 miles each way and would be difficult for my husband and child to visit and be part of a support team. THanks Raini234
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Avatar universal
I too am a trauma nurse. I had a multinodular goiter at age 42 (i'm 56 now) and took tapazole for a year then took the radioactive iodine (one pill is all it takes) I am now on levothyroxine and doing well.  The problems i do have now are, dry skin, thining hair and trouble lossing weight.  My Dr test my levels once a year and say they are normal but i wounder if i should be on a higher dose to elevate the symptoms i have (dry skin etc).  I also live in rual NM 175 miles from any "major" medical facility.  This treatment was painless. and i only had to sleep on the couch and use a private toilet for 24 hrs.
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649848 tn?1534633700
COMMUNITY LEADER
You  have once again reached the patient forum, not the expert forum, and Dr Lupo does not monitor this forum.
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