Trying to make sense of test results..

[Chihuahua64]

I have been feeling very sick for the past 1 1/2 years or more. It started with fatigue that got worse and heavier over time. I also got heavier as I gained about 50 lbs! I also get body aches, brain fog, depression, weakness, that "run over by a truck" feeling, etc... Along with all that I was getting UTI's almost every month, but along with them, my other symptoms would be worse and my whole body just felt awful. I was put on a low dose antibiotic for 3 months that seemed to help the UTI's, but I have had 2 more since I stopped the meds..at least it's not every month now.

I used to work out up to 5 or 6 days a week, but stopped when the symptoms really got bad. The fatigue especially would sometimes bring me to tears it was so heavy. I have been to the doctor many times and always mentioned my thyroid because both of my sisters have thyroid issues. My younger sister has Hashimoto's, my older sister Graves, and my dad was also on throid meds.. I was also told about 5 years ago I had a thyroid nodule, but that it wasn't big enough to worry about. I have been really bad about getting regular ultrasounds.. Oh, every blood test I got previously, they only checked TSH, which was always in the normal range. The only thing my tests showed last year was that my vitamin D level was low, and they put me on 50,000 iu weekly.. that seemed to help somewhat for a while. I was diagnosed with Chronic Fatigue Syndrome, but I still felt it was thyroid related.

Ok, so, this past month, I got a few new symptoms. On the right side, in the middle of my throat I have had a kind of pain (or ache), and have heard a weird ticking sound when I go to bed at night. These symptoms haven't really been as bad the past week or so. Feeling around the area I felt a bump that hurt when I pressed on it. So, I go back to the doctor (different doc same office), and at my request he orders more detailed thyroid blood work, and an ultrasound, which I got done that day.

I am able to see my results online, and the doctor hasn't even called me yet.. so I am going a little nuts trying to make sense of it.. It seems like my T3 and T4 are just barely in the "normal" range.

My TSH was   2.58 uIU/mL 0.34 - 5.60 uIU/mL
Free T3  was   3.5 pg/mL 2.0 - 3.6 pg/mL
Free T4  was   0.87 ng/dL 0.61 - 1.76 ng/dL

My vitamin D level was higher than last year, but still under normal range at 29.6 ng/mL 30.0 - 100 ng/mL.

My ultrasound said:

The isthmus measures 3 mm in anteroposterior dimension.

The right lobe measures 4.9 x 1.6 cm x 1.4 cm. It contains several small colloid cysts, all measuring less than 3 mm in diameter.

The left lobe measures 5 cm x 1.3 cm x 1.5 cm. There is a sub-centimeters nodule in the lower pole of the left lobe, measuring 6 mm x 5 mm x 6 mm. (I think this is bigger than it was 4 or 5 years ago when I had my last ultrasound but I'm not sure)

The thyroid gland otherwise exhibits normal background echogenicity.

I would appreciate ANY opinions or advice!

[Chihuahua64]

Hmmm, I don't think I was tested for TPO antibodies.. it doesn't sound familiar, but my CRP level went from about 12 a year ago, up to 18, with 10 being the "normal high" if that means anything.

[Chihuahua64]

Hi, thanks for the response.. the doctor hasn't called me and it's been several weeks. I took the 50,000 iu of vitamin D for 3 months last fall, but since my last blood test I started taking over the counter, 5,000 iu's a day.. I up'ed that to 10,000 about a week ago. If I remember right, I think they did test my  B-12 and it was in the normal range.

[898_1]

Have you been tested for TPO antibodies? The image of your thyroid suggests some traces of past inflammatory process.

[goolarra]

Your FT4 is at 23% of range, which is low of the 50% target (which is based on where many of us had to be to find relief of symptoms).  However, your FT3 is at the very top of the range.  When FT4 lets low, the body sometimes kind of over-converts FT4 to FT3 to try to maintain stability.  

Vitamin D must be present in cells or thyroid hormone can't get into cells to do its work.  For that to happen properly, vitamin D should be in the 50-60 range.  So, what looks like a mild deficiency is actually much worse as it pertains to thyroid.  Are you consistently taking 50,000 IU of D?

Have you had B-12 tested?