Thyroid Problems

[vmc678]

I am a 44 year old female.  I recently started having issues with dizziness, hair loss, weight gain, and extreme fatigue.  I went to a chiropractor and he was doing an MRI for my neck and an abnormality showed up on my thyroid.  It said  Incidental note is made of a 1.4
cm left thyroid nodule.
IMPRESSION: Unremarkable MRI of the cervical spine. Incidental note is made
of a 1.4 cm left thyroid nodule, and correlation with thyroid sonography if
not already performed.
So, I went to an endocrinologist and this is all the results that were found:
Component Your Value Standard Range Flag
T4, Free 0.85 ng/dL
0.76 - 1.46 ng/dL
TSH 1.890 u[iU]/mL
0.358 - 3.740 u[iU]/mL

This what my what thyroid periodase AB said:

Component                                  Your Value   Standard Range         Flag                                                            
Thyroid Peroxidase Antibodies 18.2 IU/mL 0.0 - 9.0 IU/mL            H

This is from my ultrasound:
There is a solid nodule in the left lobe of thyroid
gland measuring 18 x 14 x 14 mm. Ultrasound-guided FNA is
recommended.

NOTE: Permanent recorded sonographic images were taken.

Narrative
CLINICAL DATA: Left neck swelling

COMPARISON: None

TECHNIQUE: Multiple sonographic images of the thyroid gland were
obtained.

FINDINGS:

The isthmus measures 2.1 mm. Unremarkable isthmus.

The right thyroid lobe measures 4.7 x 1.1 x 1.0 cm. There is a
small partially cystic hypoechoic nodule in the deep right lobe
measuring 6 x 3 x 5 mm.

The left thyroid lobe measures 3.8 x 1.6 x 1.7 cm. There is a
homogeneous mildly hypoechoic solid nodule in the left lobe
measuring 18 x 14 x 14 mm. There is internal flow within this
nodule.

There is a lymph node in the left side of the neck measuring 12 x
5 x 11 mm which has a benign-appearing fatty hila.


I am getting my biopsy done this coming Wednesday.  She diagnosed me with Hoshimoto's disease and then said since my levels were normal, I'm fine.  I am a little confused as to why I am having symptoms of thyroid disease or at least I think I am.  If someone can please either reconfirm what she says or give me other opinions, I'd appreciate it. What is wrong with me?

[gimel]

There hasn't been nearly enough testing to conclude that you are fine.  TSH is useful as a diagnostic only when it is at extreme levels indicating the likliood of hypothyroidism (or hyperthyroidism at the other extreme).  In addition to Free T4, you should make sure they always test for the biologically active thyroid hormone which largely regulates metabolism throughout your body.  That is Free T3.  In addition there are three other tests that are very important for you:  Vitamin D should be at least 50 ng/ml, B12 in the upper part of its range, and ferritin should be at least 100.   Even more important than lab tests, are symptoms.  Following is a list of symptoms typical of hypothyroidism.  Which others do you have beside the ones you mentioned?

Fatigue
Increased sensitivity to cold
Constipation (have to use laxative)
Dry skin  (have to use skin creme)
Weight gain  (difficulty losing weight)
Puffy face
Hoarseness
Muscle weakness
Elevated blood cholesterol level
Muscle aches, tenderness and stiffness
Pain, stiffness or swelling in your joints
Heavier than normal or irregular menstrual periods
Thinning hair
Slowed heart rate
Depression
Impaired memory