Thyroid Disorders Community
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Avatar universal

TSH level 306 . Free T4 0.33 .

Can someone help me understand my situation/health condition ? I would appreciate any information on it , the specifics  , or dangers . Thanks in advance . I have a multinodular goiter in my Thyroid gland . I had an ultrasound done July of 2014 and went to the ER June of 2015 . I have the records , reports , an x ray on a disk , and the ultrasound images on a disk . My TSH level is 306 and Free T4 is 0.33 .Thyroid - Hypothyroidism - Depression - Anxiety - Had two children - Smoke cigarettes . Almost every day is a bad day . My throat feels like I am being strangled . The pain used to be consist on the sides of my neck , but has spread to my upper neck , right below my jaw . I find myself yawning for air . My moods are mostly sad , depressed , indifferent , or angry  . I am happy sometimes . I have headaches almost all the time , and I become sensitive to light and sound . The pain is really hard to ease  . I don't socialize much . I don't like being around people anymore because I find it harder to interact with everything going on . I am confused at times , and my memory worsens .
25 Responses
Avatar universal
Your Free T4 level is about the worst i can even remember here on the Forum.  That is an indication of you being severely hypothyroid.  You really need treatment, as you can become very severely ill.  

Why are you not being treated with thyroid medication?  You need to see a good thyroid doctor.  Do you have health insurance?
What do you mean severely ill ? And I posted the reports/records
Avatar universal
Any tests for TPO antibodies done ? Vitamin B12 levels?
No . I kind of wish they would have ran more tests than they did  .
Avatar universal
Can you post the ultrasound report? Have you had tests for TPO antibodies done?
I posted the ultrasound report , and no to the TPO antibodies test .
Avatar universal
Clinical data: Hypothyroidism
Technique: Real-time grayscale imaging of the thyroid was performed. Images supplemented with color Doppler technique.
Prior Studies: No prior studies supplemented.
Findings: The right lobe of the thyroid measures 4.6x1.6x1.6cm and demonstrates a hypoechoic nodule measuring 1.2x0.7cm. The isthmus measures 0.5cm and is unremarkable.
Impression: Heterogenous echogenicity and multiple nodal suggestive of multinodular goiter or thyroiditis. Hypoechoic nodule 1.1cm x 0.6 cm x 0.9cm midportion of the right lobe of the thyroid. 1.2 cm x 1cm hypoechoic nodule midportion of the right lobe of thyroid.
Reccommendation: Fine-needle aspiration and cytology.



Procedure                                Units        Ref Range
TSH                    306.000 H     ulU/mL      0.300-4.00
T4 Free                     0.33 L     ng/dL         0.80-1.80

Thyroid Interp : In adults these values could reflect: Hypothyroidism, Possible Pituitary Failure

I no longer have health insurance . When I had the ultrasound done I was maybe 12 weeks pregnant and was covered by pregnancy Medicaid . I was scheduled for an aspiration , but my insurance canceled the day before the appointment . Now it is a struggle to figure out how to seek further medical attention . I was/am not sure how bad it could be to go any longer without treatment or medication . I do however , plan on going to the ER again at some point if the symptoms or unbearable and I seem to be reaching that breaking point .  Thank you once again . This truly is taking a toll on me . I am lacking so much energy and find it hard to make it through the day , but somehow motivate myself to fulfill my stay at home motherly duties .
649848 tn?1534633700
With a TSH that high and a Free T4 as low as yours, you're very hypothyroid and without treatment, you will become very ill, if you aren't already.  

If you continue without thyroid hormone replacement, you could go into, what's called, myxedema coma, which is a life-threatening condition caused by untreated hypothyroidism and requires immediate medical assistance.  

I urge you to go to the ER and seek treatment very soon.
I will probably head back to an ER soon . This time I might go to a better one than last . I don't know how much longer I can go l am so ready to get back to normal , whatever that is .
649848 tn?1534633700
The recommendation on your ultrasound is for a fine needle aspiration, which is a biopsy of the nodule on your right lobe... The purpose would be to rule out thyroid cancer.

When you seek treatment for your hypothyroidism, you should take the ultrasound report with you and try to get that biopsy done.
Ok , I will do so . I hope something works out .
649848 tn?1534633700
Are you still here?  Have you gone for any kind of treatment yet?  Please let us know how you're doing...
I will attempt seeking treatment once again next week . It isn't easy . I will keep you in the loop . Lord knows its hard for me to understand all of this on my own . I am confused often .
Avatar universal
Thanks to all the responses !!
Avatar universal
Danggit !! I didn't post the ultrasound report correctly . I had to copy from scratch because I lost my disk and couldn't pull it up , there was something missing about the left lobe . so here it is , copied from the disk .

Clinical data : Hypothyroidism.
Technique : Real-time grayscale imaging of the thyroid was performed. Images
supplemented with color Doppler technique.
Prior studies : No prior studies submitted.
Findings : The right lobe of the thyroid measures 4.6 x 1.6 x 1.6 cm and
demonstrates a hypoechoic nodule measuring 1.1 x 0.6 x 0.9 cm.
The left lobe of the thyroid measures 3.2 x 1.7 x 1.6 cm and demonstrates a
hypoechoic nodule measuring 1.2 x 0.7 cm.
The isthmus measures 0.5 cm and is unremarkable.
IMPRESSION : Heterogenous echogenicity and multiple nodal suggestive of
multinodular goiter or thyroiditis.
Hypoechoic nodule 1.1 cm x 0.6 cm x 0.9 cm midportion of the right lobe
of thyroid.
1.2 cm x 1 cm hypoechoic nodule midportion of right lobe of thyroid.
Recommendation : Fine-needle aspiration and cytology.
Follow up as clinically indicated.
649848 tn?1534633700
Your confusion is most likely caused by being very hypo...

Most likely your TSH has gone even higher and your FT4 is even lower than it was, previously... Please seek treatment as soon as possible...
I will schedule an appointment for my little sister tomorrow . Hopefully he will have something to tell me .
15695260 tn?1549593113
Hi there,

You've been given excellent, heart felt advice.  Please follow Barb's suggestion to seek immediate medical attention to address this health crisis.  We wish you the very best and will help in any way we can.  
Thank you . I appreciate the support !!!
Thank you for your update below slam0911.

We are glad you were able to see your doctor, and he's able to help.  

Feel Better Soon!

MH Community Mgr
Thank you . Because of this site I was able to be motivated by others to take a step in bettering my health .
Avatar universal
I have noticed another symptom I have been experiencing . Sometimes my heart starts racing and I feels like its about to jump out of my chest . (I am not sure of anyway to describe it .) I can feel it pounding , and it is hard to breathe , like some kind of force is weighing in on my chest . I can't move very quickly of course , so it isn't due to excessive work out or movement . I just didn't know if there was an explanation to this . I can't talk to / complain about my issues or complications to my friends or family . I feel more comfortable reaching out here . I have appreciated everyone's input and concern . It sure isn't something I am used to . So thank you , once again . I appreciate the support and advice .
649848 tn?1534633700
Everything you are describing are symptoms of severe hypothyroidism... this is a very serious condition you have and it MUST be treated IMMEDIATELY.  Without replacement thyroid hormones, you run the risk of going into a life threatening coma...

Do you have someone who can help you?  Seeking help or telling someone about your condition is not complaining - it's saving your life.
649848 tn?1534633700
Well, I posted a comment and it didn't show up, so am hoping it will, when I post this one
649848 tn?1534633700
Ah, thank goodness, my previous post appeared...
Avatar universal
Thanks Barb , I appreciate that . I saw the doctor today as I said I would . He started me on levothyroxine 125 mcg . So hopefully , that will do a lot of help . Today is my first day taking it . Looking forward to things possibly getting better . All he said was that my thyroid gland basically isn't working at all .
649848 tn?1534633700
Oh thank you for letting me know...I've been so worried about you.  I'm so glad you finally went to the doctor...it will take at least 4-6 weeks for the levo to reach full potential in your blood, so you won't feel good right away, but it will get better.

I'm sure the doctor is right that your thyroid isn't working at all...

Did they do anymore tests?  If so, which ones?  Did you get a copy of the results?  If so, if you'll post them, with the reference ranges, we can help guide you along the process.

Whatever you do, please don't stop taking the levo and please don't stop seeing the doctor on a regular basis...
649848 tn?1534633700
We're glad we were able to help you.  Please feel free to ask any questions you might have about your condition, medication, labs, etc and we'll be glad to answer them.
Avatar universal
I really hate for you to be worried , but at the same time I feel thankful that someone is . They were not able to run any tests , as I do not have insurance . So unfortunately , I was able to receive any further information . I apologize for the delay in response . It has been a hectic last couple of days . I have become so drained and hardly able to function it feels like . Hopefully with help from the medication and hopefully getting some more rest this weekend , I will get back to usual . Usual for me feels like maybe 40-60% . Lately , u have been feeling maybe 10-20% . I have no idea why . But Monday I was wiped . I had to muster up the motivation to make a reply . As I am doing at this moment . I appreciate the kindness of y'all checking in on me . So I wanted to make a post before I went to bed . I am exhausted . Also , if anyone had any idea as to why I am feeling worse (since Monday) , I would appreciate any input or any advise . Also , I would like to state , If all goes well next week and I can get the time or energy I will go apply for Medicaid . Feel free to remind me . I have been all the more forgetful also . Bad enough for dad to mention something about it . Thank you once again . I wish everyone a Merry Christmas and a Happy New Year !!!
Avatar universal
Unable*** I have been feeling***
If anyone HAS***

these are my corrections to previous post ^^^
Avatar universal
Merry Christmas to you too, I hope you start feeling better now that you have some meds. Take care! Kel
649848 tn?1534633700
I'm not sure why you're so afraid of your family or of saying anything to them about this, but it's really necessary that you get the necessary testing and treatment for your hypothyroidism... Someone - your dad, at least, must care about you, if he reminded you to get medication on Monday...

I'm also not sure how you got medication without being tested, but I'm glad you're on med, anyway...

Most likely, the reason you're feeling a little worse is that it takes time for your body to readjust to having the hormones it had been doing without for so long.  It's not unusual to feel worse before feeling better, but do stay on the medication.  Another thing is that 125 mcg is quite possibly not a high enough dosage, since your TSH was so high and your FT4 so low, but that can only be determined by further testing.  It takes 4-6 weeks for the medication to reach full potential in your blood, so don't look for any great improvements immediately.  You should improve over time, though with levels like yours, it will take being on med, consistently, for weeks, if not months to get your body back to normal... Just stay on the med.

Thyroid medication is relatively inexpensive... many pharmacies fill a prescription for $4/month and almost everyone can afford that, even without insurance.

Do stay on your med and stay with us so we know how you're doing... Merry Christmas

Avatar universal
Do you feel stiffness in head, sensitivity to sound, tightness in eye muscles, nose tightness shortness of breath, palpitation. My tsh was 400 I was put on levothyroxine 150 after a month my tsh was 2. Symptoms mostly relieved. Used omega 3 & b complex that helped quickly.
Avatar universal
I feel like there has been some improvement since I have started taking the levothyroxine . My moods have brightened some . I have become more social . I am not as sluggish throughout the day and can actually stand longer than five minutes . My headaches have cleared up from daily to a occasionally . The pain/ tightenng in my throat isn't that frequent . Not much improvement on my memory . I struggle with it so much still . I do struggle with taking it everyday . So far I have gone three days straight without taking it . I am trying so hard to remember , and come up with ways to kep remembering . I am so thankful to everyone here who has motivated me to do something about this . It has paid off so far , and honestly I cannot wait to see what 3 months gets me . I will continue to stop by and keep posted . I a really hoping that things get better from here . God Bless You All !!!!!!!
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