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Should I get TT ( thyroidectomy)
I have posted here a couple times in this forum. I started having thyroid issues 2008. Ultrasound was done and said it was thyroiditis or subclinical hyperthyroid. Throat felt full and sore . Uptake test was normal. Dr wanted to see if it would go away. I had tsh of .5 and had bad symptoms for a long time. It finally leveled to a .9 tsh and T3 and T4 were normal as well and symptoms were a little better. I never went hypo.
1 yr later 2009 I moved and developed symptoms again and went to new endo. Tsh came back at .3 others were within range. My heart rate was high , tremor bad symptoms again. He started me on 5 mg tapazole. I think around Sept 2009. It worked great. My symptoms were better and did not feel shaky nervous all the time. My tsh went back up to .9 - 1.3 on most tests. I did however get the pain and full feeling back about the end of 2009. He did a cat scan and it was normal and an ent put the tube down my throat and said it was ok. The pain and fullness comes and goes every 6 months or so. A tsi test was done and my antibodies came back at 101 % with a range of < 100% is normal. So I am guessing I do have graves since you should not have any antibodies if you do not have it.????
This endo stated I do have hyperthyroid graves and they are the same thing.
Now 2011 and I have moved again. I had my tsh tested and its 1.3. My new endo stated I have hyperthyroid and that I have a constant thyroiditis and she can see a goiter. She said I can keep taking meds or get a thyroidectomy since RAI will probably not work because of the low uptake test I had in 2008. My thyroid started hurting again so this keeps being an issue.
I went to my primary dr and he did a chest x ray for something else. It showed something like a possible mass pushing on my trachea on rt side and rt lymph node swollen. He made me get ultrasound and it stated thyroiditis and hypervascular. Primary called my endo and she would not do biopsy and told him to refer me to a surgeon. I went to endo surgeon. They did ultrasound and stated no nodules and my thyroid is just swollen and the lymph node does not have characteristics of cancer. He suggested I do a TT now. He said if I have had this thyroid issue this long it should probably come out. He stated the meds are not good for you over a long time and rai would probably not be an option with a normal uptake test . He said it does not matter what I have graves etc it just is not going away. He said most people there thyroid burns out eventually or they go hypo but for some reason I am not. For DX they put down thyrotoxicosis.
I am so confused. Do I really need this surgery? Do I have graves or just a constant thyroiditis or both or something totally different? I really am scared to get the surgery and do not want to take the risk of losing voice for good or losing my airway for good or parathyroid issues. I also hate to think of my levels causing me to feel out of whack for months after surgery. Please give me some opinions :)
1 yr later 2009 I moved and developed symptoms again and went to new endo. Tsh came back at .3 others were within range. My heart rate was high , tremor bad symptoms again. He started me on 5 mg tapazole. I think around Sept 2009. It worked great. My symptoms were better and did not feel shaky nervous all the time. My tsh went back up to .9 - 1.3 on most tests. I did however get the pain and full feeling back about the end of 2009. He did a cat scan and it was normal and an ent put the tube down my throat and said it was ok. The pain and fullness comes and goes every 6 months or so. A tsi test was done and my antibodies came back at 101 % with a range of < 100% is normal. So I am guessing I do have graves since you should not have any antibodies if you do not have it.????
This endo stated I do have hyperthyroid graves and they are the same thing.
Now 2011 and I have moved again. I had my tsh tested and its 1.3. My new endo stated I have hyperthyroid and that I have a constant thyroiditis and she can see a goiter. She said I can keep taking meds or get a thyroidectomy since RAI will probably not work because of the low uptake test I had in 2008. My thyroid started hurting again so this keeps being an issue.
I went to my primary dr and he did a chest x ray for something else. It showed something like a possible mass pushing on my trachea on rt side and rt lymph node swollen. He made me get ultrasound and it stated thyroiditis and hypervascular. Primary called my endo and she would not do biopsy and told him to refer me to a surgeon. I went to endo surgeon. They did ultrasound and stated no nodules and my thyroid is just swollen and the lymph node does not have characteristics of cancer. He suggested I do a TT now. He said if I have had this thyroid issue this long it should probably come out. He stated the meds are not good for you over a long time and rai would probably not be an option with a normal uptake test . He said it does not matter what I have graves etc it just is not going away. He said most people there thyroid burns out eventually or they go hypo but for some reason I am not. For DX they put down thyrotoxicosis.
I am so confused. Do I really need this surgery? Do I have graves or just a constant thyroiditis or both or something totally different? I really am scared to get the surgery and do not want to take the risk of losing voice for good or losing my airway for good or parathyroid issues. I also hate to think of my levels causing me to feel out of whack for months after surgery. Please give me some opinions :)
The Yog Pranayam will help to control thyroid. Do it twice a day, and come back to report your results. The benefit is gradual, so allow weeks.
Build up your timing gradually. If you feel tired or dizzy, stop and resume after 1 minute.
Bhastrika - Take a long deep breath into the lungs(chest not tummy) via the nose and then completely breathe out through the nose. Duration upto 5 minutes.
Kapalbhati -(Do it before eating) Push air forcefully out through the nose about once per second. Stomach will itself go in(contract in). The breathing in(through the nose) will happen automatically. Establish a rhythm and do for 15 to 30 minutes twice a day. Not for pregnant women. Seriously ill people do it gently.
Children under 15 years – do for 5 to 10 minutes.
Anulom Vilom –
Close your right nostril with thumb and deep breath-in through left nostril
then – close left nostril with two fingers and breath-out through right nostril
then -keeping the left nostril closed deep breath-in through right nostril
then - close your right nostril with thumb and breath-out through left nostril.
This is one cycle of anulom vilom.
Repeat this cycle for 15 to 30 minutes twice a day.
Children under 15 years – do for 5 to 10 minutes.
You can do this before breakfast/lunch/dinner or before bedtime or in bed.Remember to take deep long breaths into the lungs.You can do this while sitting on floor or chair or lying in bed.
Bhramri Pranayam -Close eyes. Close ears with thumb, index finger on forehead, and rest three fingers on base of nose touching eyes. Breathe in through nose. And now breathe out through nose while humming like a bee.
Duration : 5 to 21 times
Once you are better, continue the pranayam once a day.
Other thyroid exercises you can do are described below.
Ujjayi pranayam
Thyroid point
Neck exercises
Thyroid point – press (50 times) the fleshy bit on palm between the base of thumb and wrist on both hands. You will feel pain when you press.
Ujjayi Pranayam : While breathing in, tighten throat(contract glotis) and there will be sound from back of throat, then drop chin(rest chin on chest), hold breath for abour 4 seconds.Then chin up, close right nostril and slowly breath out through left nostril.
Duration: 5 – 21 times
Ujjayi pranayam detailed:
First exhale fully through the nose.
During inhalation your glottis should remain partially closed. Glottis is the opening between the vocal chords.While inhaling, produce a sound as if you are sobbing, by partially closing the glottis.(This is reverse of clearing your throat, where your are exhaling).
The face muscles should not be contracted during inhalation. Abdominal muscles should be well controlled. Inhale smoothly and uniformly.
After deep inhalation, retain your breath as long as possible. While retaining breath do Jalandhar bandh (lock your chin, touch your chin with your chest).Initially, try to retain breath for 2 to 5 seconds. Gradually increase the time of retention of breath.
After retaining breath, first open the Jalandhar bandh(chin up) and then, close right nostril and exhale slowly through left nostril. The glottis should all along remain partially closed.This is one set of ujjayi.
Do this for 5 to 21 times everyday.
Thyroid exercises
1 Neck exercise for thyroid.
Breathe in slowly while turning your head to the left, pause and hold breath for 3 seconds,
Breathe out slowly while bringing the head back to middle position,pause for 3 seconds,
Breathe in slowly while turning your head to the right, pause and hold breath for 3 seconds,
Breathe out slowly while bringing the head back to middle position.
Do this exercise 5 times.
Repeat this 5 times, with the head going up and back, and then head going down.
2 Neck exercise for thyroid
Stand on your knees with hands folded across your chest,
Lean backwards with the head falling back while breathing in, hold breath for 3 seconds,
come back to straight position, while breathing out.
Repeat this 5 times.
March 11 ,2011
Build up your timing gradually. If you feel tired or dizzy, stop and resume after 1 minute.
Bhastrika - Take a long deep breath into the lungs(chest not tummy) via the nose and then completely breathe out through the nose. Duration upto 5 minutes.
Kapalbhati -(Do it before eating) Push air forcefully out through the nose about once per second. Stomach will itself go in(contract in). The breathing in(through the nose) will happen automatically. Establish a rhythm and do for 15 to 30 minutes twice a day. Not for pregnant women. Seriously ill people do it gently.
Children under 15 years – do for 5 to 10 minutes.
Anulom Vilom –
Close your right nostril with thumb and deep breath-in through left nostril
then – close left nostril with two fingers and breath-out through right nostril
then -keeping the left nostril closed deep breath-in through right nostril
then - close your right nostril with thumb and breath-out through left nostril.
This is one cycle of anulom vilom.
Repeat this cycle for 15 to 30 minutes twice a day.
Children under 15 years – do for 5 to 10 minutes.
You can do this before breakfast/lunch/dinner or before bedtime or in bed.Remember to take deep long breaths into the lungs.You can do this while sitting on floor or chair or lying in bed.
Bhramri Pranayam -Close eyes. Close ears with thumb, index finger on forehead, and rest three fingers on base of nose touching eyes. Breathe in through nose. And now breathe out through nose while humming like a bee.
Duration : 5 to 21 times
Once you are better, continue the pranayam once a day.
Other thyroid exercises you can do are described below.
Ujjayi pranayam
Thyroid point
Neck exercises
Thyroid point – press (50 times) the fleshy bit on palm between the base of thumb and wrist on both hands. You will feel pain when you press.
Ujjayi Pranayam : While breathing in, tighten throat(contract glotis) and there will be sound from back of throat, then drop chin(rest chin on chest), hold breath for abour 4 seconds.Then chin up, close right nostril and slowly breath out through left nostril.
Duration: 5 – 21 times
Ujjayi pranayam detailed:
First exhale fully through the nose.
During inhalation your glottis should remain partially closed. Glottis is the opening between the vocal chords.While inhaling, produce a sound as if you are sobbing, by partially closing the glottis.(This is reverse of clearing your throat, where your are exhaling).
The face muscles should not be contracted during inhalation. Abdominal muscles should be well controlled. Inhale smoothly and uniformly.
After deep inhalation, retain your breath as long as possible. While retaining breath do Jalandhar bandh (lock your chin, touch your chin with your chest).Initially, try to retain breath for 2 to 5 seconds. Gradually increase the time of retention of breath.
After retaining breath, first open the Jalandhar bandh(chin up) and then, close right nostril and exhale slowly through left nostril. The glottis should all along remain partially closed.This is one set of ujjayi.
Do this for 5 to 21 times everyday.
Thyroid exercises
1 Neck exercise for thyroid.
Breathe in slowly while turning your head to the left, pause and hold breath for 3 seconds,
Breathe out slowly while bringing the head back to middle position,pause for 3 seconds,
Breathe in slowly while turning your head to the right, pause and hold breath for 3 seconds,
Breathe out slowly while bringing the head back to middle position.
Do this exercise 5 times.
Repeat this 5 times, with the head going up and back, and then head going down.
2 Neck exercise for thyroid
Stand on your knees with hands folded across your chest,
Lean backwards with the head falling back while breathing in, hold breath for 3 seconds,
come back to straight position, while breathing out.
Repeat this 5 times.
March 11 ,2011
I'm not as well-versed about things as other people on here, but I "think" your uptake at 32% at 5 hours might mean you may be able to consider RAI now. I think a higher number means you have more uptake than you did in 2008.
Can you explain more about these alternative therapies? I am looking for a way to avoid surgery or RAI. (multiple nodules and subclinical hyper).
I just had my uptake this morning and no real side effects from it. My salivary glands and neck feel a bit weird though not really bad just salivating more and a little more fullness feeling in my neck. I was exhausted this morning since I have not slept but 6 hrs over 2 days after being off my tapazole for hyperthyroid so I could get the test done. I just dont know what these numbers mean as far as uptake. My symptoms have been hyper for years.
I am having something similar to what you are, except that I was originally diagnosed with hashimoto's. I have been swinging hyper a lot though. My body is also under constant attack and my endo has recommended RAI. I haven't got the scan yet so I am interested in what that will determine. I personally would rather remove my thyroid. My doc told me that in cases like this it will keep fluctuating until the thyroid burns itself out, which could be years. I can't live with mine like this for years, but you at least are getting some relief with meds. My endo told me there is not treating mine because it fluctuates so much. If yours is under attack it might be similar, but the other people on the board know more about the treatment. Did you experience any side effects from the uptake (just out of curiosity as I have one coming up and I'm NERVOUS)?
anyone ? I talked to my endo and asked for uptake. I got off tapazole for 9 days. I had my uptake today and it was 32% at 5 hours. They do not do 24 hrs . My surgery is scheduled next week do not know what to do? There are no more endos in my town. I drive 30 min to see mine Do I have graves? Can I get Rai?
Barb,
I also had a TGAB a couple years ago and it was normal. I can ask to get tests repeated.
Friday I made an appt to see my new endo again to ask questions about this surgery. She stated to my primary doc she would not do a biopsy because she said I was too vascular and asked him to refer me to a surgeon. The first time I met with her she also stated I had hyperthyroid and constant thyroditis. She said some people keep getting that and it never goes away and if my rai was normal basing on 2008 test I could take meds or get a TT. She said think what you want to do.
The surgeon did say the mass is not a nodule. He said it appears my thyroid is just enlarged. Can that be cancer?
My symptoms at .3 tsh last year were pain in thyroid area and swollen feeling in throat, hand tremors, high heart rate resting. shaking insomnia and losing weight, and skin changes. It was real smooth. The tapazole helped out tremendously . My symptoms went away and I gained weight again.
Now 11/26/10 The thyroid again started feeling swollen and hurt. I started getting a few of my hyper symptoms back. They come and go .
Today my thyroid still hurts but I am exhausted the last 2 weeks. I need at least 12 hrs of sleep a night. I sometimes sleep 14. I feel out of it. I thought maybe I am going hypo so stopped my 5mg tapazole for 4 days and had all the bad symptoms of hyper again. I started having hand tremors, sweating fast heart rate etc.. So started back on it since I hate those symptoms and now ultrasound show thyroiditis and my thyroid is swollen on the right side pushing on my trachea.
Its weird because my symptoms all along have correlated with my tsh when its low I have hyper symptoms when its 1 or better I feel normal. My T3 usually stays around the middle .
I also had a TGAB a couple years ago and it was normal. I can ask to get tests repeated.
Friday I made an appt to see my new endo again to ask questions about this surgery. She stated to my primary doc she would not do a biopsy because she said I was too vascular and asked him to refer me to a surgeon. The first time I met with her she also stated I had hyperthyroid and constant thyroditis. She said some people keep getting that and it never goes away and if my rai was normal basing on 2008 test I could take meds or get a TT. She said think what you want to do.
The surgeon did say the mass is not a nodule. He said it appears my thyroid is just enlarged. Can that be cancer?
My symptoms at .3 tsh last year were pain in thyroid area and swollen feeling in throat, hand tremors, high heart rate resting. shaking insomnia and losing weight, and skin changes. It was real smooth. The tapazole helped out tremendously . My symptoms went away and I gained weight again.
Now 11/26/10 The thyroid again started feeling swollen and hurt. I started getting a few of my hyper symptoms back. They come and go .
Today my thyroid still hurts but I am exhausted the last 2 weeks. I need at least 12 hrs of sleep a night. I sometimes sleep 14. I feel out of it. I thought maybe I am going hypo so stopped my 5mg tapazole for 4 days and had all the bad symptoms of hyper again. I started having hand tremors, sweating fast heart rate etc.. So started back on it since I hate those symptoms and now ultrasound show thyroiditis and my thyroid is swollen on the right side pushing on my trachea.
Its weird because my symptoms all along have correlated with my tsh when its low I have hyper symptoms when its 1 or better I feel normal. My T3 usually stays around the middle .
COMMUNITY LEADER
Just because you had a TPOab test "a long time ago" and it was negative, doesn't mean it wouldn't show positive now, as things can change quickly. In order to diagnose Hashimoto's, you would also need to get a TGab, since some people have the TPOab, some have TGab and some have both. Being hypo is not required to have Hashi's. Some people do have both Hashi's and Graves and can swing back and forth for a long time.
Hyperthyroid and Graves are not the same thing, as a person can be hyperthyroid without having Graves, or can have Graves without being hyper. Some people who have Hashimoto's can swing back and forth between hyper and hypo for a long time before finally becoming totally hypo. Some people can have Graves or Hashimoto's and not have symptoms for many years, or even at all.
In my opinion, none of your labs really indicate hyper, except the TSH at 0.3, which is really not hyper, just on the bottom end of the scale, besides, redheadaussie is right - TSH is a pituitary hormone, so not always indicative of thyroid function. On the other hand, your FT4 from 11/10 does indicate that you might be a tad hypo, since your levels are at the very bottom of the range. Yes, triiodothyronine Free Serum is T3, specifically, FREE T3. Your FT3 is just at mid range, according to both results you posted. Symptoms tend to correlate best with FT3 levels, as opposed to FT4 or TSH.
The presence of a "mass" would be a concern, but I think I'd want a biopsy, before opting for TT. Maybe you need a different endo.......
I think the most important thing is what, if any, symptoms do you have?
Hyperthyroid and Graves are not the same thing, as a person can be hyperthyroid without having Graves, or can have Graves without being hyper. Some people who have Hashimoto's can swing back and forth between hyper and hypo for a long time before finally becoming totally hypo. Some people can have Graves or Hashimoto's and not have symptoms for many years, or even at all.
In my opinion, none of your labs really indicate hyper, except the TSH at 0.3, which is really not hyper, just on the bottom end of the scale, besides, redheadaussie is right - TSH is a pituitary hormone, so not always indicative of thyroid function. On the other hand, your FT4 from 11/10 does indicate that you might be a tad hypo, since your levels are at the very bottom of the range. Yes, triiodothyronine Free Serum is T3, specifically, FREE T3. Your FT3 is just at mid range, according to both results you posted. Symptoms tend to correlate best with FT3 levels, as opposed to FT4 or TSH.
The presence of a "mass" would be a concern, but I think I'd want a biopsy, before opting for TT. Maybe you need a different endo.......
I think the most important thing is what, if any, symptoms do you have?
Thyroid exercises and yog pranayam can help you. Start now and see how you feel in 3 weeks.
Hi bumping again I have not had much response. Can anyone please help me a little? I am scheduled for surgery in a few weeks but do not want to have it unless it is really necessary.
Just looked up here are my tsh tpo and tsi results from August 2009 right before I started the 5 mg tapazole. I had bad symptoms but they got better as soon as I started tapazole. My heart rate was real high with tremors, anxiety etc..
August 2009 before hyperthyroid med tapazole.
TSI a 101% Range ( 0-129)
TPO AB 5 Range ( 0-34)
tsh is .3 range ( .450 - 4.500)
T4 free direct , 1.43 ( .61- 1.76)
Triiodothyronine Free Serum ( I am guessing this is T3???) 3.2 Range ( 2.3 - 4.2)
August 2009 before hyperthyroid med tapazole.
TSI a 101% Range ( 0-129)
TPO AB 5 Range ( 0-34)
tsh is .3 range ( .450 - 4.500)
T4 free direct , 1.43 ( .61- 1.76)
Triiodothyronine Free Serum ( I am guessing this is T3???) 3.2 Range ( 2.3 - 4.2)
TY so much for trying to help me.
I have been on 5 mg of tapazole for hyperthyroid since sept 2009 I believe. It has helped a lot with my hyper symptoms. My levels have been around this range below while taking it I have never gone hypo. I just keep having ultrasounds that show thyroiditis and a swollen sore neck off an on for yrs.
I had TPO tested a long time ago and it was negative. My TSI was 101% with normal being less than 100% in 2009. So I guess slightly positive?
The last thyroid test I had was 11/26/10
tsh 1.3 .36- 3.74
free T3 3.4 2.3- 4.2
Thyroxine Free .89 .76-1.46
Do I have graves for sure and hashimotos? I thought you had to be hypo for hashi.
I have been on 5 mg of tapazole for hyperthyroid since sept 2009 I believe. It has helped a lot with my hyper symptoms. My levels have been around this range below while taking it I have never gone hypo. I just keep having ultrasounds that show thyroiditis and a swollen sore neck off an on for yrs.
I had TPO tested a long time ago and it was negative. My TSI was 101% with normal being less than 100% in 2009. So I guess slightly positive?
The last thyroid test I had was 11/26/10
tsh 1.3 .36- 3.74
free T3 3.4 2.3- 4.2
Thyroxine Free .89 .76-1.46
Do I have graves for sure and hashimotos? I thought you had to be hypo for hashi.
I can understand your confusion!
You say you had a low uptake in 2008, here it is 2011, and they haven't suggested another one? Having a TT is usually a last resort not a quick fix.
What medication are you taking? If you are taking thyroid replacement meds it is only going to make you worse if you do have Grave's.
Some people have thyroids which do come and go with a goitre and they usually have both Hashimoto's and Grave's at the same time. Did they test your for TPO antibodies as well as the TSI?
Are you able to post your thryoid test levels including ref ranges. You moved several times, and different labs use different ref ranges. Free T4 and Free T3 levels may be 'normal' but it is more important to see them rather than just the TSH. TSH is a pituitary gland hormone, not a thryoid one.
Cheers
You say you had a low uptake in 2008, here it is 2011, and they haven't suggested another one? Having a TT is usually a last resort not a quick fix.
What medication are you taking? If you are taking thyroid replacement meds it is only going to make you worse if you do have Grave's.
Some people have thyroids which do come and go with a goitre and they usually have both Hashimoto's and Grave's at the same time. Did they test your for TPO antibodies as well as the TSI?
Are you able to post your thryoid test levels including ref ranges. You moved several times, and different labs use different ref ranges. Free T4 and Free T3 levels may be 'normal' but it is more important to see them rather than just the TSH. TSH is a pituitary gland hormone, not a thryoid one.
Cheers
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