Normal Labs - Hyperthyroidism and Nodules

[kountrygirl03]

Sorry if this is a long post, but need to post all so that it makes more sense.

In November I was diagnosed with hyperthyroidism. Had an u/s that detected several nodules with one measuring 1.0 cm and one measuring 2.9 cm. Had a nuclear scan performed in December, that detected a hot nodule on the right lobe that is measuring 1.6 cm (instead of the 2.9 cm) that is suppressing the function of my left lobe which also has a cold nodule that is measuring 1.0 cm. Have not had a biopsy as of yet on either.

I had my first endo appointment last week. Since I had only had a TSH and a Free T3 done back in November, the dr wanted to do his own and check my levels to see if anything had changed.  Mainly to have a record of the Free T3 and Free T4 and I had never had a TSI done before, so they wanted to check for grave's too.

The PA said that they usually didn't biopsy anything that small and since the hot nodule was hyperfunctioning they may just do the radioiodine treatment. Now, with normal labs, I'm afraid they won't do anything.  My symptoms are:  night sweats, chocking when eating/drinking, anxiety, hair falling out (more than normal, but not awful lot), easy weight gain (yes, with hyperthyroidism I gain weight unless I really watch what I eat), and irratibility.

How has others been treated with normal labs with hyperthyroidism? I currently do not take any meds.

[Barb135]

I would not recommend Natural Source Raw Thyroid extract for kountrygirl; she is hypER, not hypo and the product you are referring to is not regulated by anyone, so you really have no idea what's actually in it.

Ashwagandha is an adaptogen, commonly used for adrenal support; may not be warranted in this situation either.

[ggma1000]

For about 5 years, I had not been able to swallow any pills or capsules. Also had night sweats, thinning hair, lost outside half of eyebrows, etc. but had no idea those & many other symptoms had anything to do with my thyroid. To make a long story short, my thyroid gland was swollen to the inside...was not at all noticable, and had nodules, too, although I thought they were just swollen lymph glands. Finally got to the endo (my GP referred) in September after the swelling had gone down & only the tiny lump was left one one side where they had been almost marble size on both sides. He said the lump was not a lymph node, but a nodule on my thyroid gland which he said was still slightly swollen. How did they shrink? With Natural Source Raw thyroid extract, OTC, & Ashwagandha (an adaptogenic herb). Now I can swallow pills just fine again and my throat does not feel tight anymore. My night sweats stopped, too. I had my blood checked again yesterday by my GP, but have not found out the results, yet. Whether I have been hypo the whole 5 years without knowing it or hyper & hypo off & on during that time as I did have some fast weight swings up & down. In retrospect, I am glad that I didn't get to an endo earlier when the nodules were so large, because I haven't seen anywhere that they would go away on natural supplements.
Peace,  ggma1000

[stella5349]

Since you have an appt coming up you could get a jump on thigs and call - requesting to have NEW labs done in time for the new doctor to see you.

They may comply with your request and actuall like the idea having new labs done for a fresh visit. - However it may be difficult to get exactly what you would need to know all there would be through blood.

Still, give it a shot and see if new labs can be done on these:

TPOab
TgAb
TSH
FREE ( only free) T3
FREE ( only free) T4
Vit D

[kountrygirl03]

Stella...I feel as if I always have something in my throat and when I eat, it feels like it gets stuck. When I can finally relax and drink a gulp of water to push the feeling down, it's like something clicks and that really hurts.

My TSH was .285 (or something along those lines) and the nurse told me what the Free T3 was when I had it checked in November, BUT I don't remember what she said. I"ll have to get copies when I go back to the dr on 2/21.  

The PA hasn't been in this office long, she came from a obgyn office, so she's not really had much dealings with the thyroid, YET.

From what I've read about RAI, it may not do what they want/expect it to do, which is shrink the thyroid. So my problems may not be fixed even with the RAI.  

Barb...when I was first reading up on hyper/hypo, I wondered how the heck dr's knew the difference. The symptoms looked the same to me. My mom said she used to swing from hypo to hyper, but she said she hasn't had problems since the 80s.  Can't get too much info from her and my dad hasn't offered up much of anything. What I am learning from my aunt tho, is there was lots of cancer on my paternal grandfathers side, including him. Not thyroid tho.

ThyroidHunter....this was my first visit with the endo's office. My GP wouldn't/didn't tell me anything about any of the tests that I had, he just referred me. So, when this is over with...I'll be finding another GP for sure. I will see a regular endo on 2/21, so hopefully he'll go more into detail with me about everything. I don't like to deal much with PA's for something that is more detailed that what she/he studied. And for what it's worth, she was an obgyn PA, that's the other end, but she was super nice.

I did have an earlier post on the expert forum about the labs, but I'll have to go back and find it.

Thanks so much for your knowledge. This board has helped to answer so many questions that I've had.  I read daily trying to find answers/suggestions, but just post every now and again.

[stella5349]

I  sure would like to see the lastest labs too on this post.  Dealing with a hypervascular nodule can be decieving on numerous levels.

I will say I am not totally impressed with the doctors rush to go for RAI on this without a proper analaysis in complete lab work. RAI will kill of the gland function and that is confirmed for decades but the research is still out on how effective it takes out the hot nodule function.

Quick RAI as a "cure" should not be reccommended here so fast.

Another quick thought is besides what you listed as thyroid symptoms.. do you have any enlargement or tightnes in your throat also?

[Barb135]

Sometimes symptoms of hyper and hypo can overlap particularly "anxiety, night sweats, hair loss, and irritability" - I had all of these while VERY hypo.  

In order to help you further, we would need to know what thyroid labs were done for you, along with the results and reference ranges (these ranges vary lab to lab, so must come from your own report).

If you've never been tested for thyroid antibodies, you need to have that done; if you have Hashimoto's Thyroiditis, it's not unusual to swing from hyper to hypo numerous times. Aside from that, nodules can produce hormones independently of the thyroid. You may have been dx'd hyper, but maybe didn't have labs done during the hypO phase; that would be when you gained weight........   this happened to me several times during my 30's, 40's and early 50's -- I'd suddenly gain 20-30 lbs, then a few months later, they would fall off, plus some.......During this time, I didn't know enough about thyroid issues to even suggest being tested, plus I trusted my doctors and felt they should know what tests to run.

I've since realized that while my weight was swinging back and forth (extremely), the other symptoms I had (even those that put me in the hyper category) indicated Hashimoto's...... it was only 2 yrs ago that I got the dx and my treatment moved forward.  

All of that said, please post whatever current labs you have, along with the reference ranges, since these vary lab to lab.......

[ThyroidHunter]

I am still hyperthyroid even though I am in the last stages of Hashimoto's. The reasons for this are not known by any of the Docs I have seen in 3 states, including MD Anderson Hospital in Houston. We don't know all there is to know about the gland at the research level yet, so we can't possibly know all the reasons some of the thyroid actions/reactions occur.

I am glad you posted the weight issue with "HYPER" thyroidism, because like hair loss (51.1% of hyperthyroids, not "statistically significant"), I have had several periods in my life of weight gain, despite advanced hyperthyroidism. This also occurred to my mother later in life.

Your symptoms are correct for hyper - anxiety, night sweats, hair loss, and irritability. How are your temps of feet and hands? Do you sweat easily, or just at night?

Have you had a detailed discussion of this with any of your physician's, asking how and why this is occurring and how they plan to treat your symtoms with no medication?

I do not take PA or MA opinions either, for what that's worth. I find a Doc who has time to see me personally. Many people have written into this Board with similar comments, that once the labs are "normal" or "in range", the symptoms will not be treated and many are told it is "all in their head" - strange, a pyschiatric referral never seems to go along with that analysis.

If you can post your results, many are more expert in blood test analysis than I am, but your Ultrasound/Sonogram says it all already. You have multiple tumors on your gland which (admittedly) are supressing proper function of your gland.

You need a second opinon, and a new physician perspective I think. Try a recommended GP soon, take a written list of your symptoms and all test results with you. Tell him you need medical relief for the anxiety and irritability. If you don't get what you need from your insurance agent, you fire them. It's the same with Docs, and nobody's perfect, not even your Endo.

Get at least 2 additional opinions before you consider ANY radioactive treatment. You wouldn't re-do the house on your roof on one person's bid or opinion, radioiodine is much, much more significant. If you can get your symptoms under control, it will be much easier to be patient and get multiple opinions as well as research on your own to make an informed decision - not one based when you are in an anxious and unsure position.

Best of luck and I hope this helps some.

[kountrygirl03]

Oh I forgot to mention that sometimes my eyes will not focus and seems like I'm in a tunnel or have a blind spot on my eye. I wear glasses for reading and such, but they don't help if my eyes will not focus.