Found out today my TSH is normal, but FNA diagnosed Hashimoto's. Can I have Hashi's with normal TSH? Please help!

[KJ5854]

Back on Dec 5th I had FNA on four nodules.  Report on first two nodules says, "Features are consistent with Hashimotot's Thyroiditis with probably coexistent nodule goiter."  Report on third nodule says, "Features are consistent with noduler goiter with possible coexistent Hashimoto's thyroiditis.  The fourth nodule says, "Features are consistent with nodular goiter, colloid rich with focal hyperplasia.  Hemosiderin containing histiocytes seen - suggest recent hemorrhage."

So, two say Hashimoto's, one says possible Hashimoto's and another says nothing at all about Hashi's.  One nodule has a focal atypia and the report says it likely represents a tiny focus of papilliary carcinoma of the thyroid.  Because of this, my doctor is doing surgery but he suggested I have my entire thyroid removed because of the Hashi's.

I got my lab work from GP today and my TSH in Oct '07 was 1.142.  Isn't that normal?  I'm not having alot of Hypo symptoms, except for some hair loss, dry skin and brittle nails.   Can you have Hashi's with no symptoms?  If I do have Hashi's but my TSH is normal I don't have to be on meds right?  Does Hashi's worsen over time?  Meaning, would my TSH levels eventually rise and would I eventually have symptoms?  

Can an FNA definitively diagnose Hashi's?  I haven't had any other bloodwork done to confirm this diagnosis.  Should I have that done before I decide to have my whole thyroid out?  I'm wondering if taking out my entire thyroid may be a little too much.  Maybe I should just remove the suspicious nodule and see if it's cancer.  Although, my doctor says because of the calcification of the nodule he's 80% sure it's cancer.  And, in that case the whole thyroid has to come out.

What would you guys do?  Please help, I need some advice!  Thanks, KJ

[melangel76]

Yes, you can have hashi with normal TSH.

Some research shows, and practitioners have found that preventative treatment with levothyroxine may be warranted in people with euthyroid Hashimoto's disease (normal TSH levels, but thyroid auto-antibodies that show evidence of autoimmune Hashimoto's disease). Such treatment can in some cases slow down elevation of antibodies, and help prevent autoimmune disease and hypothyroidism.

If you have thyroid symptoms, a "normal" TSH level, but haven't been tested for thyroid auto-antibodies, insist on testing.
http://thyroid.about.com/od/hypothyroidismhashimotos/a/preventative.htm

[melangel76]

Have a thyroid ANTIBODY blood test, this should tell you if Hashi is suspected.