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Old 09-26-2007, 07:46 AM   #1
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Question What questions should I ask my doctor?

Hi,
I am new to this site ,but not to the boards. I also have back problems and found some good advice there. Now, I am hoping for some help here. I was diagnosed with hypothyroidism after the birth of my child 5 years ago. At the same time I had an ultrasound and it showed a few nodules. I had them checked every year, no changes. This summer I started feeling that something is not right there and an ultrasound report last week said:
The thyroid is diffusely homogeneous in echogenicity. The previously noted nodule in the right thyroid lobe has significantly increased in size. It has very irregular margins and is highly vascular. It is now approx. 2.2 x 1.0 x0.9 cm.
This nodularity is noted throughout the right and left lobes
.
Another thing is that I have calcium problems for about a year( to much of it) and they could not find what was the problem.
Please advise me what to ask the specialist I am about to see on friday.
Thank you very much.
Alex

Last edited by ala3; 09-26-2007 at 07:47 AM.

 
Old 09-26-2007, 07:59 AM   #2
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Re: What questions should I ask my doctor?

What about your blood work? Are they testing these routinely as well?
TSH, FT3, FT4, T3 Uptake, and antibodies(TPOAb, TGAb)?

What are your numbers and result ranges? It may just be a groiter and medication is no longer able to keep it suppressed.. they may want an uptake scan and biopsy to determine the type of growth. If they haven't done the tests listed above.. you need to have them done.

Sincerely,
MG
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Old 09-26-2007, 08:11 AM   #3
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Re: What questions should I ask my doctor?

Hi MG,
I am taking synthroid and my thyroid bloodwork as of last week is normal. My last test for antibodies was done last summer and no problems. They were done because of my hypercalcemia. I am sure he's going to order some more bloodwork now. Do you know if I should expect the biopsy done right away in his office or is it a test done in a hospital or outpatient settings. Thank you so much for all the advice. I am a little nervous. I feel this thing in my neck and it really boders me.
Alex

 
Old 09-26-2007, 08:37 AM   #4
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Re: What questions should I ask my doctor?

Biopsies and surgeries are done by a surgeon. In many cases an ENT.

I wouldn't expect a same day biopsy. How normal was normal and is your MD just looking at your TSH? You want to gun for optimal in all your results.

At your stage my other was scheduled for an uptake scan and a biopsy.. the biopsy was had questionable cells with abnormal growth rate.. so a partial thyroidectomy of the dead abnormal half was scheduled. The negative antibodies is another plus.. AI's are such a pain.

Good luck on your appointment.
Sincerely,
MG
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Old 09-26-2007, 09:03 AM   #5
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Re: What questions should I ask my doctor?

Do get a COPY of all your lab reports.

You want to make sure your hormone levels are optimal, NOT just in "normal range". There can be a huge difference between "nornal range" and OPTIMAL (but your doctor might not think so). So you need to check behind him. Synthroid patients can easily get a low FREE T3. (even when their tsh and free T4 levels are optimal).

I bet your magnesium is way low (the high calcium level could account for some of that; a high calcium level would increase the need for magnesium). Low magnesium could be contributing to some or all of your back pain! My calcium was way too high and my magnesium was way to low. I had neck back pain that WENT AWAY after I supplemented with magnesium!

The thyroid produces a hormone called CALCITONIN, it helps the bones absorb calcium form the blood.

Good luck with the thyroid biopsy. Remember, if it is thyroid cancer, it is one of the most successfully treated types of cancer. Best wishes and let us know what happens. Most of us have been there & we care.
: )
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Old 09-26-2007, 09:15 AM   #6
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Re: What questions should I ask my doctor?

Thank you MG and GCC,

I found my last results:09/11/07

TSH 4.55
T4 1.3
Calcium 10.7
Magnesium not tested. I see that the TSH is flagged as high.
What do you think?
Thanks.
Alex

 
Old 09-26-2007, 09:55 AM   #7
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Re: What questions should I ask my doctor?

You are hypothyroid by the TSH alone. I think you need to be checking your T3 as well. And the FT3 and FT4 tests are the most accurate because they are least likely effected by medications and other factors.. and the percentage of error in the tests are lower as well.

Is that T4 or FT4 that is 1.3? My T4 range is 4.5-12.5. My free T4 of FT4 range is normally .45-1.25.. If that is your T4 as in Total T4 you are way too LOW! This would mean you T3 is most likely low as well unless you are over converting your T4.

I need the ranges on the calcium.. I am not sure what that tells me, because depending on the test it could be in the hundreds or teens.

You need thyroid medication.. and some additional tests runs so that you can get your T3 and T4 at optimal levels.

Sincerely,
MG
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Old 09-28-2007, 11:05 AM   #8
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Re: What questions should I ask my doctor?

Hi,
Thanks to all that replied. I went to the endocrinologist today. He said that a year ago my nodule was 7mm now it is 2.2 cm. He said ,he was glad I felt it because normally they do not recommend follow up ultrasounds for small nodules.He could not feel the lump because it's deep inside, so he did not do a biopsy. He said that I need one with an ultrasound. My refferal will go out hopefully by Monday afternoon. So I am back to the waiting game.
He did not order any blood tests, he wants to wait for a biopsy. When I asked him what he thinks of it , he just said that it worries him that it is so highly vascular. So , I am nervous, but I guess many of you went through the same process.
Thanks.
Alex

 
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