Aa
Ultrasound & Thyroid Scan
Dr. Lupo,
Thank you for your response and assistance. I greatly appreciate it. I am scheduled for another recheck for the TSH in May. I will also ask for a retest for the T4. However, my T3 level was never tested. When I requested, my Dr. said something to the effect that the T3 doesn't matter. I did receive a call from the Dr.'s office today telling me that my second set of antibodies test shows I have Hoshimoto's Disease and I have another appointment on Friday to discuss options with my Dr. I'm still wondering if a ultrasound shows no nodule's is there a need for a thyroid scan? and if it's dangerous to the thyroid to have the iodine or radiation medicine injected? Hoping you can respond before I go to the Dr.'s on Friday. Thank You for taking the time and reviewing and answering my postings.
Thank you for your response and assistance. I greatly appreciate it. I am scheduled for another recheck for the TSH in May. I will also ask for a retest for the T4. However, my T3 level was never tested. When I requested, my Dr. said something to the effect that the T3 doesn't matter. I did receive a call from the Dr.'s office today telling me that my second set of antibodies test shows I have Hoshimoto's Disease and I have another appointment on Friday to discuss options with my Dr. I'm still wondering if a ultrasound shows no nodule's is there a need for a thyroid scan? and if it's dangerous to the thyroid to have the iodine or radiation medicine injected? Hoping you can respond before I go to the Dr.'s on Friday. Thank You for taking the time and reviewing and answering my postings.
Hi there! sorry I've been go for a long time. I've been busy going for test and being depressed. I misspoke above when I stated that I don't have Hashi's. I was informed by my PCP that I do have Hashi's due to my antibodies being 599, they should not be higher than 34. That's how he made his diagnoses. In any matter, he explained that because my TSH, Free T-4 ect. are at normal ranges now, that they'll keep going higher and higher using a chart to explain to me. At that time is when he'll put me on medicine after it goes off the chart. Well, needless to say I'm now having problems with high liver enzymes. I've done alot of research after my ultrasound on my liver, kidney, aorta and pancreas results showed normal, and read that my high liver enzymes could be due to having Hashi's. I also read that even though my tsh, Free T-4 ect. level's are normal I should be taking something because of my Anti-Microsomal is very high. Therefore, I requested to see a Endocrinologist in which I have an appt. with in Oct. I just wanted to thank you for all your assistance in teaching me about this disease and update you on what's been going on. :)
In plain terms ideally the thyroid tissue should look similar to the fine grained sand and it called homogeneous; however aging and inflammatory processes in the past are changing uniformity of the tissue so it may look like coarse grained sand. In addition the wave frequency shift in the ultrasound machine during the exam may enhance appearance of such grains. In some cases the frequency shift caused mysterious appearance of the nodule in one patient, lot of worries and absence of nodule on following scan in 4 weeks on the different high resolution machine. Also the image is read and measured by technician who can be subjective. The most worrysome finding is a well defined calcified nodule in absolutely normal “fine grained” thyroid of the young person of male gender. About 50% of the woman aged 50 are having some degree of thyroid heterogeneity (not detectable if there will be no ultrasound). In theory a nodule may form from heterogeneous thyroid as well as from the perfectly uniform thyroid tissue.
Neck self exam can be helpful to detect such changes.
The multinodular goiter looks like this:
www.youtube.com/watch?v=yFa2mReaR2M
Neck self exam can be helpful to detect such changes.
The multinodular goiter looks like this:
www.youtube.com/watch?v=yFa2mReaR2M
Sorry, I responded above to your posting and was in a hurry. However, I did mean to ask you what you mean by coarse-grained but not necessary alot of nodule's? I must've misunderstood what I've read. My understanding from my posting above on the results of my ultrasound, meant no nodules when the radiologist stated normal and did advise for other imaging to be done. Please help me understand what the results meant? Thanks Again
:) yes quite excited in knowing I don't have another disease. However, not to happy about the stress that've been dealing with because of another misdiagnosis. I'm also saddened saddened at the same time, to know that a doctor that I've trusted for so long and he knows my history of all the other misdiagnosis, drug allergies and he whenever I've needed a antibiotic, he'd say to his nurse, Gee she's limited and to prescribe me one when not needed, ridiculous. I'm not a quiet patient and expressed with him how I feel about what the idiot dr. did to my maxillary cavities. I remember telling him the prognosis about the negligent I can still remember his reply, oh no don't tell me that. I guess a lesson learned sometimes is a good thing, because I sure won't be a guinea pig anymore. I want to thank you for sharing your knowledge, advice, opinion's about the thyroid. I will still come to here to stay in touch and learn more about the thyroid.
I see you are excited :)
It is almost impossible to diagnose a person with small multinodular goiter by palpation (unless are nodules 2 cm and larger); the heterogonous echotexture means it is coarse-grained but not necessary meaning there are lot of nodules are there.
It is almost impossible to diagnose a person with small multinodular goiter by palpation (unless are nodules 2 cm and larger); the heterogonous echotexture means it is coarse-grained but not necessary meaning there are lot of nodules are there.
Update on all lab test that were competed:
TSH-0.236
FREE T-4-1.0 IS SHOWING THE RANGE SHOULD BE BTW 0.350-4.940
ANTI-MICROSOMAL-599 IU/ML-I CALLED THE LAB TO A TRANSLATE FOR A NORMAL RANGE. NORMAL RANGE IS BTW 1-1000 IN WHICH MINE RESULTS WOULD BE CONSIDERED NORMAL, EVEN THOUGH MY DOCTOR WROTE HIGH ON MY CHART.
Thyroglobulin Ab- <20/IU ML-NORMAL ACCORDING TO LAB AND MY CHART.
ULTRASOUND RESULTS NORMAL THEREFORE, NO RECOMMENDATION BY RADIOLOGIST FOR FURTHER SCANS.
MY CONCLUSION EVEN THOUGH I'M NOT A DR. IS THAT I DON'T HAVE A THYROID ISSUE ACCORDING TO ALL MY LAB'S AS OF NOW. HOWEVER, NO FREE T3 TEST HAS BEEN RAN YET, BUT WAITING FOR A CALL BACK FROM MY PCP TO ORDER THAT TEST IN COMBINATION TO THE TSH RETESTING IN MAY. THEREFORE, I BELIEVE THAT YOUR BLOOD TEST, IMAGING TEST IS THE REAL DIAGNOSIS FOR YOUR HEALTH.
SO, YOU'RE PROBABLY WONDERING HOW I KNOW WHAT MY CHART IS SAYING. WELL, THANKFULLY MY DOCTOR IS UP TO DATE WITH TECHNOLOGY AND I TOTALLY HAD FORGOTTEN TILL LAST NIGHT, PROBABLY FROM STRESS LEARNING THAT I COULD POSSIBLY HAVE HASHIMOTO'S DISEASE OR ANY OTHER ADDED DISEASE TO ALL MY OTHER HEALTH ISSUE'S. ANYHOW, HE NOW HAS A PORTAL AVAILABLE FROM THEIR WEBSITE FOR PATIENTS USE. THEREFORE, I WENT INTO THAT AND RESEARCHED AND THAT'S WHERE I SEEN HE WROTE ON HIGH NEXT TO THE ANTI-MICROSOMAL RESULT. SO, I TOOK IT UPON MYSELF TO DO FURTHER RESEARCH IN CONTACTING THE LAB. SO AGAIN THE ONLY LEVEL I CAN FIND THAT IS LOW IS MY TSH AND THAT'S UP FROM MY TESTING IN DECEMBER 2011, IN WHICH AT THAT TIME IT WAS 0.141. NOT SURE AS TO WHY AFTER YRS. OF TESTING THE TSH AND NEVER WAS LOW OR HIGH, THE LEVELS ARE NOT FLUXUATING. HOWEVER, I AM A TYPE 2 DIABETIC AND TAKE METFORMIN, FROM THE RESEARCH I'VE DONE METFORMIN CAN HAVE A PLAY IN YOUR TSH LEVELS AND NOT HAVING A THYROID CONDITION.
I ALSO FOUND THAT WHEN I WAS TREATING WITH ANOTHER DR. YRS. AGO IN THE SAME MEDICAL CENTER, HE'S A NOTE THAT HE DETECTED A GOITER THAT WAS NON TOXIC MULTINODULAR. WELL, IT'S FUNNY HOW NO GOITER SHOWED UP IN MY ULTRASOUND PREVIOUSLY DONE. ALSO, THIS IS MY FIRST ULTRASOUND DONE ON MY THYROID EVER, THEREFORE I'D LIKE TO KNOW HOW THIS OTHER DOCTOR WAS ABLE TO MAKE A DIAGNOSIS NOW TOXIC WHEN HE NEVER EVEN RAN A TEST. FOR THE RECORD THIS IS THE FIRST I'VE EVEN HAD KNOWLEDGE OF HIS STATEMENT. ALSO, I HAVE JUST WAS DIAGNOISED OF HAVING A SEBECEOUS CYST ON MY LEFT BREAST, WELL IT POPPED SO WHEN I WAS IN THE DR.'S OFFICE TO REVIEW LAB TEST IN RELATION TO MY THYROID TEST, THE DR. SWABBED THE POPPED CYST TO CHECK FOR A STAPH INFECTION. I GET A CALL THE OTHER DAY TELLING ME IT WAS POSITIVE FOR A STAPH INFECTION AND HE PUT ME ON ANTIBIOTIC. WELL, MAYBE HE'S GONNA KNOW SOON THAT IT WAS A BIG MISTAKE TO GIVE ME ACCESS TO MY FILE, BECAUSE ACCORDING TO HIS REPORT, IT STATES, "NO WBC, NO ORGANISM FOUND" AND I WILL INFORMING HIM ABOUT THE ISSUE. NOW HE KNOWS MY HISTORY OF BEING ALLERGIC TO 5 ANTIBIOTICS AND AMMUNED TO SEVERAL FROM TAKING SO MUCH AFTER THE ERROR DONE WITH MY SINUS SURGERY. MAKES YOU WONDER WHEN HE'S THE ONE THAT SAYS, I'M LIMITED TO ANTIBIOTICS WHY HE'D PUT ME ON ONE THAT I CAN TAKE AND WILL TREAT A STAPH INFECTION, KNOWING THAT MY CULTURE SHOWED NO STAPH. I HAVE TO PREVENT GETTING STREP THROAT, BECAUSE I'M ALLERGIC TO ALL ANTIBIOTIC'S THAT TREAT THAT BACTERIA. I'VE LEARNED THAT SOME BACTERIA'S ONLY CERTAIN ANTIBIOTIC'S WILL TREAT. I TAKE MY HEALTH SERIOUS ESPECIALLY AFTER BEING MISDIAGNOSED BY A ENT THAT PUT A SCOPE DOWN MY THROAT TO SEE WHAT WAS GOING ON WHEN I WAS HAVING A ALLERGIC REACTION TO A ALLERGY DRUG HE PRESCRIBED PREVIOUSLY. ANYHOW, HE INSISTED THAT I HAD A HIATEL HERNIA AND PUT ME ON PROTONIX. THIS IS THE SAME DR. THAT PERFORMED SINUS SURGERY TO REMOVE POLYP'S AND DECIDED HE WAS GONNA MAKE HOLES IN MY MAXILLARY CAVITIES, NICE HUH. I SUFFERED FOR 7 YRS. AND JUST WANTED TO DIE WITH CHRONIC SINUS INFECTIONS AND WAS ALWAYS LIKE EVERY OTHER MONTH ON STERIOD'S AND ANTIBIOTIC'S THAT I ENDED BECOMING AMMUNED TO. ANOTHER ENT FINALLY TOLD ME WHEN I ALMOST ENDED UP WITH MENINGITIS, THAT HE DIDN'T KNOW WHY THE DOCTOR THAT PERFORMED MY SINUS SURGERY WOULD PUT HOLES IN MY MAXILLARY CAVITIES, THAT NOW IS CAUSING BACTERIA TO JUST SIT IN THERE AND NO WAY. THANKFULLY, I WAS ABLE TO BE REFERRED TO ANOTHER SPECIALIST, IN WHICH HE COULDN'T DO RECONSTRUCTIVE SURGERY DUE THE HOLES ARE NOW THERE, HE WAS ABLE TO DO A PROCEDURE THAT'S TO LONG TO EXPLAIN BUT WAS ABLE TO BRING ME RELIEF. HE AND HIS NURSE TOLD ME THAT THEY FIX ALOT OF THAT ENT'S MISTAKES. ANYHOW, AFTER MY POOR EXPERIENCES WITH DR.'S MISDIAGNOSING ME AND THAT HORRIBLE IRREVERSIBLE SURGERY THAT WAS PERFORMED. I'M VERY CAUTIOUS NOW WHEN SEEING A SPECIALIST. I DO MY RESEARCH ON THEIR PROFILE, VERY EASY TO DO. JUST TYPE IN THE STATE YOU LIVE IN ADD MEDICAL BOARD AND IT HAS OPTIONS YOU CAN CLICK ON AND PROVIDES YOU TO EVERYTHING YOU WANT TO KNOW ABOUT THAT DR. SUCH AS EDUCATION, MALPRACTICE SUIT''S ECT. I NOW WISH I WOULD'VE KNOWN ABOUT THAT SITE BEFORE I WENT TO THE IDIOT THAT WAS NEGLIGENT IN MY CASE, BECAUSE I LOOKED HIM UP AND YOU'D BE SICK TO YOUR STOMACH WHEN YOU READ ALL OF HIS LAWSUIT'S EITHER SOLVED ALREADY OR PENDING, FINES ECT. HE'S NOW ON PROBATION AND CAN'T PRACTICE WITHOUT SUPERVISON FOR 3 YRS. OH AND WHEN I REQUESTED MY MEDICAL REPORTS TO TAKE FURTHER ACTION, THAT'S WHERE I SEEN HE NEVER NOTED THAT HE DIAGNOSED ME WITH A HIATEL HERNIA. HE STATED THAT I HAD TOLD HIM I WAS ON ZANTAC PREVIOUSLY FOR HEART BURN AND INDIGESTION PROBLEMS. IN ANY MANNER, THE PROBLEM WHEN I ENDED GOING INTO MY PCP BECAUSE THE THROAT WAS CLOSING DUE TO THE ALLERGY DROPS WAS A ALLERGIC REACTION IN WHICH HE GAVE ME A STERIOD SHOT AND PUT ME ON ANTIBIOTICS DUE TO THE THROAT CLOSING AND SOMETHING ABOUT WHEN THAT HAPPENS AND INFECTION COULD ARISE. I REALLY DON'T REMEMBER WHAT HE EXACTLY EXPLAINED BUT SOMETHING TO THAT EFFECT. NOW, I'M ON PROTONIX FOR THE REST OF MY LIFE, BECAUSE MY BODY IS USE TO HAVING LESS ACID IN IT AND IF I DON'T TAKE IT, WHATEVER I EAT WILL CAUSE HEARTBURN AND INDIGESTION.
SORRY ABOUT THE LONG POST, BUT GOT CARRIED AWAY AND A LITTLE UPSET TO KNOW THAT SOMETIMES DR.'S TREAT PATIENTS LIKE THEY'RE A COMPUTER, BROKEN TV, ECT. I THINK YOU KNOW WHAT I'M SAYING. I TEND TO TAKE A HUMAN LIFE TO BE A BIGGER THING THAN A BROKEN TV, ECT. AND TAKE IT VERY SERIOUS WHEN IT COMES TO A PERSON'S HEALTH. YOU CAN'T REPLACE A HUMAN.
TSH-0.236
FREE T-4-1.0 IS SHOWING THE RANGE SHOULD BE BTW 0.350-4.940
ANTI-MICROSOMAL-599 IU/ML-I CALLED THE LAB TO A TRANSLATE FOR A NORMAL RANGE. NORMAL RANGE IS BTW 1-1000 IN WHICH MINE RESULTS WOULD BE CONSIDERED NORMAL, EVEN THOUGH MY DOCTOR WROTE HIGH ON MY CHART.
Thyroglobulin Ab- <20/IU ML-NORMAL ACCORDING TO LAB AND MY CHART.
ULTRASOUND RESULTS NORMAL THEREFORE, NO RECOMMENDATION BY RADIOLOGIST FOR FURTHER SCANS.
MY CONCLUSION EVEN THOUGH I'M NOT A DR. IS THAT I DON'T HAVE A THYROID ISSUE ACCORDING TO ALL MY LAB'S AS OF NOW. HOWEVER, NO FREE T3 TEST HAS BEEN RAN YET, BUT WAITING FOR A CALL BACK FROM MY PCP TO ORDER THAT TEST IN COMBINATION TO THE TSH RETESTING IN MAY. THEREFORE, I BELIEVE THAT YOUR BLOOD TEST, IMAGING TEST IS THE REAL DIAGNOSIS FOR YOUR HEALTH.
SO, YOU'RE PROBABLY WONDERING HOW I KNOW WHAT MY CHART IS SAYING. WELL, THANKFULLY MY DOCTOR IS UP TO DATE WITH TECHNOLOGY AND I TOTALLY HAD FORGOTTEN TILL LAST NIGHT, PROBABLY FROM STRESS LEARNING THAT I COULD POSSIBLY HAVE HASHIMOTO'S DISEASE OR ANY OTHER ADDED DISEASE TO ALL MY OTHER HEALTH ISSUE'S. ANYHOW, HE NOW HAS A PORTAL AVAILABLE FROM THEIR WEBSITE FOR PATIENTS USE. THEREFORE, I WENT INTO THAT AND RESEARCHED AND THAT'S WHERE I SEEN HE WROTE ON HIGH NEXT TO THE ANTI-MICROSOMAL RESULT. SO, I TOOK IT UPON MYSELF TO DO FURTHER RESEARCH IN CONTACTING THE LAB. SO AGAIN THE ONLY LEVEL I CAN FIND THAT IS LOW IS MY TSH AND THAT'S UP FROM MY TESTING IN DECEMBER 2011, IN WHICH AT THAT TIME IT WAS 0.141. NOT SURE AS TO WHY AFTER YRS. OF TESTING THE TSH AND NEVER WAS LOW OR HIGH, THE LEVELS ARE NOT FLUXUATING. HOWEVER, I AM A TYPE 2 DIABETIC AND TAKE METFORMIN, FROM THE RESEARCH I'VE DONE METFORMIN CAN HAVE A PLAY IN YOUR TSH LEVELS AND NOT HAVING A THYROID CONDITION.
I ALSO FOUND THAT WHEN I WAS TREATING WITH ANOTHER DR. YRS. AGO IN THE SAME MEDICAL CENTER, HE'S A NOTE THAT HE DETECTED A GOITER THAT WAS NON TOXIC MULTINODULAR. WELL, IT'S FUNNY HOW NO GOITER SHOWED UP IN MY ULTRASOUND PREVIOUSLY DONE. ALSO, THIS IS MY FIRST ULTRASOUND DONE ON MY THYROID EVER, THEREFORE I'D LIKE TO KNOW HOW THIS OTHER DOCTOR WAS ABLE TO MAKE A DIAGNOSIS NOW TOXIC WHEN HE NEVER EVEN RAN A TEST. FOR THE RECORD THIS IS THE FIRST I'VE EVEN HAD KNOWLEDGE OF HIS STATEMENT. ALSO, I HAVE JUST WAS DIAGNOISED OF HAVING A SEBECEOUS CYST ON MY LEFT BREAST, WELL IT POPPED SO WHEN I WAS IN THE DR.'S OFFICE TO REVIEW LAB TEST IN RELATION TO MY THYROID TEST, THE DR. SWABBED THE POPPED CYST TO CHECK FOR A STAPH INFECTION. I GET A CALL THE OTHER DAY TELLING ME IT WAS POSITIVE FOR A STAPH INFECTION AND HE PUT ME ON ANTIBIOTIC. WELL, MAYBE HE'S GONNA KNOW SOON THAT IT WAS A BIG MISTAKE TO GIVE ME ACCESS TO MY FILE, BECAUSE ACCORDING TO HIS REPORT, IT STATES, "NO WBC, NO ORGANISM FOUND" AND I WILL INFORMING HIM ABOUT THE ISSUE. NOW HE KNOWS MY HISTORY OF BEING ALLERGIC TO 5 ANTIBIOTICS AND AMMUNED TO SEVERAL FROM TAKING SO MUCH AFTER THE ERROR DONE WITH MY SINUS SURGERY. MAKES YOU WONDER WHEN HE'S THE ONE THAT SAYS, I'M LIMITED TO ANTIBIOTICS WHY HE'D PUT ME ON ONE THAT I CAN TAKE AND WILL TREAT A STAPH INFECTION, KNOWING THAT MY CULTURE SHOWED NO STAPH. I HAVE TO PREVENT GETTING STREP THROAT, BECAUSE I'M ALLERGIC TO ALL ANTIBIOTIC'S THAT TREAT THAT BACTERIA. I'VE LEARNED THAT SOME BACTERIA'S ONLY CERTAIN ANTIBIOTIC'S WILL TREAT. I TAKE MY HEALTH SERIOUS ESPECIALLY AFTER BEING MISDIAGNOSED BY A ENT THAT PUT A SCOPE DOWN MY THROAT TO SEE WHAT WAS GOING ON WHEN I WAS HAVING A ALLERGIC REACTION TO A ALLERGY DRUG HE PRESCRIBED PREVIOUSLY. ANYHOW, HE INSISTED THAT I HAD A HIATEL HERNIA AND PUT ME ON PROTONIX. THIS IS THE SAME DR. THAT PERFORMED SINUS SURGERY TO REMOVE POLYP'S AND DECIDED HE WAS GONNA MAKE HOLES IN MY MAXILLARY CAVITIES, NICE HUH. I SUFFERED FOR 7 YRS. AND JUST WANTED TO DIE WITH CHRONIC SINUS INFECTIONS AND WAS ALWAYS LIKE EVERY OTHER MONTH ON STERIOD'S AND ANTIBIOTIC'S THAT I ENDED BECOMING AMMUNED TO. ANOTHER ENT FINALLY TOLD ME WHEN I ALMOST ENDED UP WITH MENINGITIS, THAT HE DIDN'T KNOW WHY THE DOCTOR THAT PERFORMED MY SINUS SURGERY WOULD PUT HOLES IN MY MAXILLARY CAVITIES, THAT NOW IS CAUSING BACTERIA TO JUST SIT IN THERE AND NO WAY. THANKFULLY, I WAS ABLE TO BE REFERRED TO ANOTHER SPECIALIST, IN WHICH HE COULDN'T DO RECONSTRUCTIVE SURGERY DUE THE HOLES ARE NOW THERE, HE WAS ABLE TO DO A PROCEDURE THAT'S TO LONG TO EXPLAIN BUT WAS ABLE TO BRING ME RELIEF. HE AND HIS NURSE TOLD ME THAT THEY FIX ALOT OF THAT ENT'S MISTAKES. ANYHOW, AFTER MY POOR EXPERIENCES WITH DR.'S MISDIAGNOSING ME AND THAT HORRIBLE IRREVERSIBLE SURGERY THAT WAS PERFORMED. I'M VERY CAUTIOUS NOW WHEN SEEING A SPECIALIST. I DO MY RESEARCH ON THEIR PROFILE, VERY EASY TO DO. JUST TYPE IN THE STATE YOU LIVE IN ADD MEDICAL BOARD AND IT HAS OPTIONS YOU CAN CLICK ON AND PROVIDES YOU TO EVERYTHING YOU WANT TO KNOW ABOUT THAT DR. SUCH AS EDUCATION, MALPRACTICE SUIT''S ECT. I NOW WISH I WOULD'VE KNOWN ABOUT THAT SITE BEFORE I WENT TO THE IDIOT THAT WAS NEGLIGENT IN MY CASE, BECAUSE I LOOKED HIM UP AND YOU'D BE SICK TO YOUR STOMACH WHEN YOU READ ALL OF HIS LAWSUIT'S EITHER SOLVED ALREADY OR PENDING, FINES ECT. HE'S NOW ON PROBATION AND CAN'T PRACTICE WITHOUT SUPERVISON FOR 3 YRS. OH AND WHEN I REQUESTED MY MEDICAL REPORTS TO TAKE FURTHER ACTION, THAT'S WHERE I SEEN HE NEVER NOTED THAT HE DIAGNOSED ME WITH A HIATEL HERNIA. HE STATED THAT I HAD TOLD HIM I WAS ON ZANTAC PREVIOUSLY FOR HEART BURN AND INDIGESTION PROBLEMS. IN ANY MANNER, THE PROBLEM WHEN I ENDED GOING INTO MY PCP BECAUSE THE THROAT WAS CLOSING DUE TO THE ALLERGY DROPS WAS A ALLERGIC REACTION IN WHICH HE GAVE ME A STERIOD SHOT AND PUT ME ON ANTIBIOTICS DUE TO THE THROAT CLOSING AND SOMETHING ABOUT WHEN THAT HAPPENS AND INFECTION COULD ARISE. I REALLY DON'T REMEMBER WHAT HE EXACTLY EXPLAINED BUT SOMETHING TO THAT EFFECT. NOW, I'M ON PROTONIX FOR THE REST OF MY LIFE, BECAUSE MY BODY IS USE TO HAVING LESS ACID IN IT AND IF I DON'T TAKE IT, WHATEVER I EAT WILL CAUSE HEARTBURN AND INDIGESTION.
SORRY ABOUT THE LONG POST, BUT GOT CARRIED AWAY AND A LITTLE UPSET TO KNOW THAT SOMETIMES DR.'S TREAT PATIENTS LIKE THEY'RE A COMPUTER, BROKEN TV, ECT. I THINK YOU KNOW WHAT I'M SAYING. I TEND TO TAKE A HUMAN LIFE TO BE A BIGGER THING THAN A BROKEN TV, ECT. AND TAKE IT VERY SERIOUS WHEN IT COMES TO A PERSON'S HEALTH. YOU CAN'T REPLACE A HUMAN.
In my opinion no NUCLEAR scan is needed, but it is better ask for second professional opinion:)
Thyroid Peroxidase (TPO) Antibodies (TPOAb) / Antithyroid Peroxidase Antibodies
Thyroid Peroxidase (TPO) antibodies, are also known as Antithyroid Peroxidase Antibodies. (In the past, these antibodies were referred to as Antithyroid Microsomal Antibodies or Antimicrosomal Antibodies). These antibodies work against thyroid peroxidase, an enzyme that plays a part in the T4-to-T3 conversion and synthesis process. TPO antibodies can be evidence of tissue destruction, such as Hashimoto's disease, less commonly, in other forms of thyroiditis such as post-partum thyroiditis.
Source: http://thyroid.about.com/od/gettestedanddiagnosed/a/bloodtests.htm
And it is very likely that taking Metformin will lower the TSH levels (i have relartives in same situation), see the article
Thyrotropin Suppression by Metformin,
Published online before print October 11, 2005, doi: 10.1210/jc.2005-1210
The Journal of Clinical Endocrinology & Metabolism January 1, 2006 vol. 91 no. 1 225-227
http://jcem.endojournals.org/content/91/1/225.full
It is well known issue.
Please print this article and bring it to your doctor.
The Hashimoto’s disease progression takes two forms the thyroid either shrinks as it is eaten up and progressive hypothyroidism develops. Such form commonly occurs among older people, and it is fairly easy corrected with medicine, no cancers in this case are observed. On the younger individuals the goiter with nodules develops, the TSH is fluctuating badly or within the range, hypo symptoms are prevalent the antibodies are sky-high, and cancerous nodules are often found. This later form is very hard to manage.
Again I could be wrong but the cause of low TSH for you is most likely attributed to Metformin; just in case you may learn how to do thyroid self-exam to spot any grows yourself (although SUPRESSED TSH is actually preventing nodules from growth in many cases)
BEST!
Thyroid Peroxidase (TPO) antibodies, are also known as Antithyroid Peroxidase Antibodies. (In the past, these antibodies were referred to as Antithyroid Microsomal Antibodies or Antimicrosomal Antibodies). These antibodies work against thyroid peroxidase, an enzyme that plays a part in the T4-to-T3 conversion and synthesis process. TPO antibodies can be evidence of tissue destruction, such as Hashimoto's disease, less commonly, in other forms of thyroiditis such as post-partum thyroiditis.
Source: http://thyroid.about.com/od/gettestedanddiagnosed/a/bloodtests.htm
And it is very likely that taking Metformin will lower the TSH levels (i have relartives in same situation), see the article
Thyrotropin Suppression by Metformin,
Published online before print October 11, 2005, doi: 10.1210/jc.2005-1210
The Journal of Clinical Endocrinology & Metabolism January 1, 2006 vol. 91 no. 1 225-227
http://jcem.endojournals.org/content/91/1/225.full
It is well known issue.
Please print this article and bring it to your doctor.
The Hashimoto’s disease progression takes two forms the thyroid either shrinks as it is eaten up and progressive hypothyroidism develops. Such form commonly occurs among older people, and it is fairly easy corrected with medicine, no cancers in this case are observed. On the younger individuals the goiter with nodules develops, the TSH is fluctuating badly or within the range, hypo symptoms are prevalent the antibodies are sky-high, and cancerous nodules are often found. This later form is very hard to manage.
Again I could be wrong but the cause of low TSH for you is most likely attributed to Metformin; just in case you may learn how to do thyroid self-exam to spot any grows yourself (although SUPRESSED TSH is actually preventing nodules from growth in many cases)
BEST!
Once again thank you for responding to another one of my questions. I feel so stupid not being able even after reading articles in understanding the thyroid. I usually catch on fast, but must say the information about the thyroid is all gibberish to me. Anyhow, you've made me feel alot better, I'm understanding your teachings and really appreciate it. I am gonna take your advice and getting 3 testings of my my levels before I'll take medication. One of my concerns is thryoid cancer and I couldn't understand if I'd a ultrasound done and the results are normal and no recommendation to any other scan by the radiologist, and my PCP saying depending on what my results of my antibodies result showed, the next step would be a thyroid scan. I wanted confirmation as to is a ultrasound test accurate in diagnosing any nodule's or not. Well, his response was something to the effect, that if Hashimoto's Disease that could mean a secreting nodule. I have type 2 diabetes and do take metformin generic for Glucophage and have for yrs. What does TPO stand for?
Also, the people with insulin resistance or type 2 diabetes, have low levels of TPO antibodies in blood and who are taking Metformin ARE GOING to have low TSH levels (suppressed) as a side effect of this medicine
If let say the TSH swings between 5 and 0.1 this is going to be case of concern. Your TSH was low in December but it is getting higher now, so again another test may be needed some time ahead to follow the trend in your TSH levels. The hyperthyroidism during acute stage of thyroiditis is happening because the inflalmmation destroys the hormone storage cells in the thyroid and hormone (T4) leaks to the blood stream causing low TSH AND elevated T4. Still, I could be wrong, but I do not see any reasons for doing nuclear scan; many people with Hashimoto’s (even with nodules) are having normal uptake. Old rule say to repeat the tests at least 3 times to have valid results, then diagnostics are made.
So the nuclear scan recommended if the patient has Low TSH, high T4 and a goiter (either diffuse or nodular); in other cases it may not help much in diagnostics!
So the nuclear scan recommended if the patient has Low TSH, high T4 and a goiter (either diffuse or nodular); in other cases it may not help much in diagnostics!
I just realized that I"ve been spelling Hashimoto's disease wrong and wanted to make my correction.
Sorry, I pulled out my lab reports. My TSH in December 2011 was 0.141 and in March was 0.236. My Free T4 was 1.12 in Dec. and 1.00 in March.
Let me see if I'm starting to understand what you're explaining, because you're a big help and I can tell you're very knowledgeable. So it's normal for a person's TSH level to fluxuate? doesn't necessarily mean Hoshimoto's Disease? I had a low TSH result in Dec. of 1 and it went up to .236 in March. My T4 has been showing normal according that the lab that tested it (reason I say the lab that tested, is because I'm told all labs have different no.'s in results than other labs). I guess because of my TSH level being low in Dec. my doctor added a antibodies test in with my March's blood test. My results on that test was normal. He then sent me for a ultrasound, in which I posted the report above. Per the radiologist, that also was normal and no recommendation is on the report. The same day I had the ultrasound he did blood work do test what he called a second set of antibodies (I have no clue whatsoever he's talking about). Anyhow, I received a call yesterday from the nurse, she says you have Hoshimoto Thyroiditis and the dr. will discuss when you come in. I said come in, I don't have an appt. so she scheduled one for this Friday. Well, I know when I discussed my ultrasound result with him, that's when he mentioned that if the blood test from the second draw for the second set of anitbodies come back negative he's sending me for a thyroid scan. I said for what, the ultrasound was normal and I am assuming that meant no nodule's. I am gonna post my report results at the end of this posting. Anyhow, he was saying something about a thyroid scan to see a secreting nodule. I then again said I thought the ultrasound said no nodule's. Just doesn't make any sense to me. Now mind you, he's just my PCP in which he's a very thorough Dr. but had issue's in the past being misdiagnosed and now I'm on a pill that I have to take the rest of my life because of the error. Let me state he's not the dr. that misdiagnosed me. Also, I didn't go to him because of symptoms of a thyroid problem. I have type 2 diabetes, high cholesterol and take lipitor, therefore I have to have lab test every 3 mnths. and he runs everything. So, when I go Friday if he wants to start me on something (medicine) should I take it? or see a Endocrinologist first? or have him run the TSH, FT3 and FT4 again? as I mentioned above he didn't and hasn't ran at FT3 test. If I do have Hoshimoto's Disease and don't start on medicine in a certain length of time, will my thyroid get worse? What if he ran all those above test again and adds the FT3 to the order also, and the results are normal, could it be it was a fluke? I'm sorry for all the questions, but I'm really at awe about this thyroid disease and just don't want to take more med's if it's not necessary. So, thanks for all your's and everyone else's assistance in teaching me. Here's my results from my thyroid ultrasound: THE RIGHT LOBE MEASURES 4.1 X 1.5 X 1.5 CM. THE LEFT LOBE MEASURES 3.8 X 1.6 X 1.3 CM. HETEROGENEOUS THYROID PARENCHYMAL ECHOTEXTURE WITHOUT EVIDENCE OF A DISCRETE NODULE. I typed it in big letter's to stand out from my writing. Once again thank you very much for your assistance.
Hi there! Thank you for informing me. However, I did end up posting my question to Dr. Lupo in the expert box when I realized that he might not monitor the patient forum. I'm seeing that you's are all very knowledgeable and happy that I joined. You's have help me release so much stress related to my thyroid issue.
Hashimoto’s thyroiditis or “arthritis of thyroid” is the chronic inflammation of the thyroid eventually leading to the hypothyroidism.
The TSH varies during the day; if it is on the low end of normal or slightly below normal as opposed to ‘undetectable’ and the T4 is normal most doctors will agree on the second blood test in few weeks. Many people after 45 may have low to moderate levels of TPO (Hashimoto’s) and TSI (Grave’s) antibodies without actually having the disease. Heterogeneous echotexture of the thyroid (also common with increased age) can be sign of past or present inflammation processes; however Grave’s disease manifests itself by exhibiting increased blood flow in the entire thyroid.
Therefore the best option is to repeat the blood test within few weeks to see if the readings persist or are getting worse.
The TSH varies during the day; if it is on the low end of normal or slightly below normal as opposed to ‘undetectable’ and the T4 is normal most doctors will agree on the second blood test in few weeks. Many people after 45 may have low to moderate levels of TPO (Hashimoto’s) and TSI (Grave’s) antibodies without actually having the disease. Heterogeneous echotexture of the thyroid (also common with increased age) can be sign of past or present inflammation processes; however Grave’s disease manifests itself by exhibiting increased blood flow in the entire thyroid.
Therefore the best option is to repeat the blood test within few weeks to see if the readings persist or are getting worse.
Hi there! Thank you for your assistance and response. I need all the knowledge I can get regarding testing that's necessary and about Hoshimoto's Disease. I'm so at lost about all this stuff that sounds foreign to me. I appreciate all that you can teach me. I've till Friday to decide on the thyroid scan and still don't understand the need for it, if my ultrasound is showing normal. I was told that if a thryoid scan was needed the radiologist would've recommended it. Wondering if maybe my PCP is just being thorough as usual. However, I heard it's not good to have that test, the iodine or radiation whatever is used could kill the thyroid. Well, gotta run to the dentist now, so I'll get back to you later today. Thanks for your assistance. Greatly appreciated.
Hi there! I'm new to this site, therefore I didn't know that if I posted my question to Dr. Lupo, that no one else would respond. I just wanted to make sure he would know I was asking him my question to get medical advise. Anyone feel free to respond to my posting's. I'm a dummy when it comes to the thyroid and appreciate all the knowledge I need to know. My Dr. that diagnosed me with Hoshimoto's Disease is my PCP, not a specialist and that's one reason that I'm specital. I have a dr. appointment on Friday and will definitely have him check my T3. I'm so confused and even with reading about the thyroid, it all sounds foreign to me right now. No one in my family nor friends have ever had a thyroid problem. Is F3 and FT3 the same? I'm not sure as to what exactly test need to be tested, please inform me by Friday. Also, I'm still puzzled as to why if my ultrasound report states normal, I assumed that meant no nodule's. Therefore, I'm also unsure as to why he said if my second set of antibodies result's came back showing Hoshimoto's Disease, that he would order a thyroid scan. I replied for what, the ultrasound shows no nodule's. He went on to say something about a nodule secreting he wanted to check for. I'm not up to unnecessary testing. Believe me, I've and an issue with misdiagnosis and testing in the past. That may be why I'm so specital about testing that doesn't make any sense and definitely will not take anymore med's unless it's confirmed that that's what I've. I'm not having any symptoms. My March results were, Ultrasound was normal, FT4 was normal, my first antibodies result was normal, TSH was low as stated above. However, I did look at my labwork results from December and it was even lower then it was a 1. Therefore, not sure if this could just be a fluke result. I'm so lost and a nervous wreck. Someone please advise me as to what test exactly I should be having done, in case he's correct in the diagnosis so I'm not leaving it left untreated for to long. Thank you for posting the link's above, I will definitely check them out when I get back from the dentist. Hopefully I'll understand them. Feel free to post to my posting's anytime.
The thyroid scan will not add much to the ultrasound. It may or may not show areas of decreased iodine uptake.
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You have posted in the patient forum and Dr Lupo does not monitor this forum. You will need to post in the expert forum, in order to get a response from him. Be aware that the expert forum only accepts, so many questions/day and the excess gets sent to the patient forum. You may have to post in the expert forum, repeatedly, in order to get your question to Dr Lupo.
We have some very knowledgeable members on this forum; if you'd like for them to answer your question, you may want to repost it, so it's not addressed to Dr Lupo.
We have some very knowledgeable members on this forum; if you'd like for them to answer your question, you may want to repost it, so it's not addressed to Dr Lupo.
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A good thyroid doctor will treat a hypo patient clinically by testing and adjusting free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels. Symptom relief should be all important, not just test results. You can get some good insight into clinical treatment from this letter written by a good thyroid doctor for patients that he sometimes consults with from a distance. The letter is then sent to the PCP of the patient to help guide treatment.
http://hormonerestoration.com/files/ThyroidPMD.pdf