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Learning about Thyroid Disorders

Hello all!
I'm very new to learning about my thyroid.
I went to my family doctor during the cold winter months because my hands were going numb, turning white, losing feeling, etc. He ordered ultrasounds of my arms to test for circulation problems and those results came back showing no irregularities.
So our next step was lots of blood work, CBC, Comprehensive Metabolic Panel and TSH. This is where the whirlwind of learning about my thyroid started. My TSH level was 138.
This prompted a second round of testing. A second TSH, Free T4, TPO Ab, and Thyroglobulin Antibody. TSH 122, Free T4 0.09, TPO 5641, and Thyroglobulin >2250. My doctor commented he had never seen results like this.
These results prompted a thyroid ultrasound and Thyroid Uptake and Scan. The ultrasound results were: Diffusely heterogeneous enlarged thyroid with 2 solid echogenic nodules on the left; follow-up ultrasound versus nuclear medicine imaging suggested. I'm still awaiting the results from the uptake and scan.
So what does all this mean, in English? :-)
I have learned through my research that I definitely have some hypothyroid issues going on. So much of this explains many problems that I've recently been experiencing but ignoring or attributing to "just getting older." I just want to be well informed when I visit my doctor again this week to discuss all these results and know what questions to ask.
I also have an appointment scheduled with an ENT in a couple weeks.
Any and all help would be greatly appreciated. Thanks in advance!!
2 Responses
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649848 tn?1534633700
COMMUNITY LEADER
Your TSH of 138 and 122, typically, mean that you are very hypo, as I'm sure you've already figured out... The TPOab and Thyroglobulin (which is really Thyroglobulin Antibodies) indicate that you have Hashimoto's Thyroiditis... I can't believe your doctor didn't diagnose that as soon as he saw those results!!

Hashimoto's is an autoimmune thyroid disease in which the body sees the thyroid gland as foreign and produces antibodies to destroy it... As the destruction progresses, the thyroid produces less and less thyroid hormones, which in turn causes TSH to rise higher and higher, which is exactly what yours has done...

My next question is what the reference range is for the Free T4...Reference ranges vary lab to lab and have to come from your own report... your FT4 seems quite low, though not as low as I might expect with a TSH as high as yours.

I'm not sure of the benefit of a thyroid uptake... that's typically done when one has hyperthyroidism, not hypo and I assume the scan is a radioactive scan?  Again, I'm not sure of the benefit of that, but if it's done, it's done...

I'd see a whole lot more benefit in a Free T3 test to go along with that Free T4 test... those are the actual thyroid hormones and tell a lot more than most of the other tests being done.

Do you have symptoms of hypothyroidism? If so, which ones?  Has your doctor even considered starting you on thyroid replacement hormones?  If so, what medication, what dosage?  If you've never had a Free T3 test and your doctor has not considered starting you on replacement hormones, with TSH levels as high as yours, I'd suggest you might need a different doctor.  

We have a lot of information to give you; all you have to do is ask the questions. We might even give answers to questions you don't ask... LOL
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Avatar universal
The reference range on the FT4 was 0.47-4.69. I'm not sure why the FT3 was not run as I do seem to recall my Dr. requesting it.
The uptake and scan was radioactive iodine. As the technician explained it to me it was too see how much of the iodine my thyroid was taking in and how much was being dispersed throughout the rest of my body.
Hindsight is always 20/20. I wish I had known about hypothyroid a couple years ago!! Nearly every symptom I've recently read about is present. I'm ALWAYS tired. I could sleep 10 hours yet wake up the next day feeling as if I haven't slept a wink. I've been packing on the pounds over the past couple years, despite my attempts to eat right and lose weight. Some days the pain in my joints is unbearable. If I sit still longer than 15 minutes, I can barely stand up and walk due to the pain and the fact that my hips simply do not want to function. (I toss and turn all night for the same reason.) I'm always cold. I typically dress in 3 to 4 layers and carry a jacket or sweater or sweatshirt with me everywhere I go. (The backseat of my car is littered clothing of all different weights.) Constipation. Absolutely no sex drive or interest. Going from being a pretty strong and tough girl to being very weak. Scratchy voice. Slower heart rate. Dry skin. And I'm sure there are others that I'm forgetting. --Oh yeah, isn't forgetfulness yet another symptom??
I understand that the lab results clearly indicate Hashimoto's. My new concern is the findings from the ultrasound.
My Dr. and I have not yet discussed treatment options. I think he wanted to see results from all the tests ordered before moving forward. Or maybe he's not comfortable with making a diagnosis and prescribing treatment? He has referred me to an ENT. Unfortunately, their first available appointment is still 3 weeks out.  But I've also been noticing that many people reference an endocrinologist. Should I see an endo vs an ENT?
Thank you for the response and your willingness to help me make sense of all this.
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