RAIU

[chelsun]

Could you help me understand my scan results?  
324 uCi of I-123 capusle form was administered, 6 hr RAIU 22%, 24 hr RAIU 42%
Images demonstrate thyroid asymmetry, left lobe larger than right.  There is a large photopenic region within the upper pole of the left lobe compatible with a cold nodule.  

IMPRESSION
Cold nodule in the upper pole of the left thyroid lobe.  Differential diagnosis includes colloid cyst, nonfunctioning adenoma or malignancy.

nonspecific generalized increased uptake within the mid and lower portions of the left thyroid lobe.  A hyperfunctioning adenoma in this region is not exluded

TSH 0.075

I appreciate any assistances you could provide

Michelle

[898]

Elevated RAIU + low tsh with normal T3 and T4 indicates subclinical hyperthyroidism;
the medical treatment for this condition is to reduce heart rate that can be caused by low TSH. Manny patients with Grave's have elevated T3 level [but this method is less reliable then positive TSI antibodies]
In addition to Grave's disease, the uptake % similar to yours can also be in case if toxic nodule[s] are present [but ultrasound did not mention any additional to the complex cyst].

[chelsun]

Thanks again,

Do you really think the hyperthyroidsim could be Graves?

TSH 0.075
RAIU 6- hour 22.5%, 24 hour - 42%

All other test including antibodies are normal?  

[898]

complex nodule in this case can be result of either internal bleeding into thyroid [liquid blood + dried blood] or cystic degeneration of smaller nodule.
The biopsy under the ultrasound is a good choice to get sample from solid portion of this nodule

[chelsun]

Went today to the new Doc, he did an ultrasound.  And there is only one growth which is cold and complex (solid and liquid combine)  He believes the hyperthyroidism is caused by Graves, but I'm not sure how he came up with this since my TSH counts are low, but all other factors T3, T4, antibodies are normal.  

He gave me two options

1. Start meds for the Graves and have the nodule biopsied
2. Surgery to remove and probably be on meds for the rest of my life.

He did do additional bloodwork, but I'm not sure these are my only options?

Michelle

[chelsun]

Thank you for your comments.  All these thyroid issues gets very confusing.  Currently I'm trying to get an appt. w/ a new endo, didn't care for the first one.  But the 2nd one can't see me until the 14th.  which then I'll need to probably schedule the ultrasound.  Lab results suggested that as well.  

The waiting is hard, especially when my symptoms are bad.  Diarrhea, racing heart, hand tremors, always hungry and i've lost 25lbs in 3 months.  UGH!  

Thanks again

[898]

the uptake is elevated [higher then 30%]
No uptake in the area of left lobe  which can be a cold nodule.
the ultrasound should be done to determine its size type blood flow if present
to see if it is solid, cyst or complex
another possible HOT nodule in  the same
lobe with increased uptake supected of adenoma.
[especially if it is palpable or visible]
again the ultrasound study is HIGHLY recommended prior to proceeding!!

[stella5349]

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