More confused now than EVER! Help?

[mammasluv2]

Hello everyone, I will give a rundown about my situation, some of you may have read it before, sorry.  I found out that I have Hashimoto's Thyroiditis and my thyroid is enlarged with innumeral multiple nodules. Right lobe is 6.4cm x 2.1cm x 2.0cm and left is around normal size. The isthumus is 7mm.  I went to the Endocrinologist and he didn't seem concerned about it.  He said he would take it out if I wanted him to but that he doesn't like to take it out if you can shrink it... it isn't shrinking.  I am on 150 mcg of Synthroid and have been on (name brand) Synthroid for about 10 years for hypo. Last month my TSH was 2.67, this month it was 3.25. Even after seeing that my level is rising while on 150, he says my dose is fine and that he doesn't see any problems. I have had all the symptoms and then some, plus some of them have gotten worse and some new added (hair loss, more fatigue, trouble breathing which he doesn't think is associated with my thyroid, and dry-brittle nails).  
I was sooo frustrated and I am SOOOO tired of feeling like this that I doubled up on my Synthroid on Saturday and by Saturday evening and ALL day yesterday I felt GREAT with the exception of a small headache! lol  I know it wasn't the smartest thing to do, but like I said, I am so fed up.  
Grant it, the endo did say he was waiting to look at my ultrasound (which I had done at another office) and then he'd decide what to do, I just can't take it. I am a 34 year old mother of two and I have an in-home daycare and I don't even have the energy or motivation to read them a story. And he has the nerve to tell me nothing is wrong! I am leaning toward just having him take it out and trying to level me out afterwards.  Would really like some advise on how to deal with this. Should I ask for a total thyroidectomy since my thyroid is dying anyway and not functioning well or should I just ask him to go ahead and change my dose to a higher level?  
I am trying to be patient here but it is just not easy and I don't go back to him until July 21st. Thank you all for your help.

[Totie]

If it were me & we are all different in how we handle & tolerate things, so that being said, I would do what he asked & see how that goes. If your symptoms do not change I would then talk to him about maybe possibly doing the surgery. Of course surgery is something that you want too hold off on as long as possible. Your TSH indicates you are going hypo so you would need more medication.

Now if things in your ct scan are showing growth I would do the surgery, but like I said, that is just me. Please do not waiver from you medications instructions, it is never a good thing.

Hope it all works out for you...

[mammasluv2]

I know it was a really dumb thing to do, I was just desparate. I am still feeling really good today, but I haven't taken more than my normal dose since then. Thank you very much for your concern.  My Dr. did tell me to take an extra HALF a pill one day a week and see if we could get the goiter to shrink. So that is what I am going to do...no more dumb or desparate actions : ). I just get tired of feeling like such crap but I know that God will get it all worked out and I have to be patient. Thank you again! :)

[JKenton]

I'm not a doctor or anything but Synthroid has a long half life and so a cumulative effect in the system. If you doubled up and felt the effects of it that quickly, if it is not a placebo effect then I would be very worried that you will develop thyrotoxicosis if you continue the dose you have upped yourself to. Please cut your dose back down and talk to your doctor about slowly upping the dose.

[gimel]

I can't relate to that T3 number you gave.  Is that supposed to be total T3 or free T3?  Need to know which,  and also the reference range used by the lab, since it varies from lab to lab.  If you could get a copy of the lab report and post all results and reference ranges it would help members give you the best response.

[mammasluv2]

I left out that yes he has, but I don't honestly remember all the numbers. My t-3 was 1.06.  I just checked my email again and it was weird but I had an email from him. Here is what it said:

"I have reviewed your thyroid US from Dr. Hospital. Your thyroid is enlarged bilaterally. It has numerous small nodules on both sides but I do not see a dominant enlarged nodules. Your thyroid US shows that your thyroid is consistent with something called multinodular goiter. Sounds scary but it is not. Just meens numerous nodules in your thyroid. Your thyroid was pretty generous though.
There is some older data that suggests perhaps a slightly higher dose of Synthroid may help try to decrease the size of your goiter. It very likely may not though. However, it is a pretty easy thing to try and with your TSH over 3, it would not be harmful to try. I recommend you take one extra HALF a tablet of your Synthroid ONE day a week. Please have thyroid labs performed again a day or 2 before your next appointment."

So, he does recommend we up my dose.  I don't think it will decrease my goiter, so my question now is, should I push for the surgery if it doesn't?  Would my levels be easier to manage without such a large thyroid?  I guess I should just wait until the 21st of July and see how things are then. I just know that I want to feel better!~  Thank you so much for your advise. I really appreciate it ~.

[gimel]

Hasn't your doctor done any testing beyond TSH?  If not, you should insist that he check levels of the actual biologically active thyroid hormones, which are free T3 and free T4 (not to be confused with total T3 and total T4).  FT3 is the most important because it is four times as active as FT4.  FT3 largely regulates metabolism and many other body functions, plus it correlates best with hypo symptoms.  Symptom relief should be all important, not your TSH level.

In my opinion the best way to treat a thyroid patient is to test and adjust FT3 and FT4 levels with whatever type of medication is necessary to relieve symptoms, without being constrained by resultant TSH levels.  Many members here have reported that symptom relief for them required FT3 to be adjusted into the upper part of its range and FT4 adjusted to at least midpoint of its range.  If your doctor is not willing to treat your symptoms in this manner, then you need to either pressure him to change his approach, or find a good thyroid doctor that will do so.

Here is a link that you may find useful.

http://www.hormonerestoration.com/Thyroid.html