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Old 03-30-2009, 11:18 PM   #1
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Enlarged thyroid with a thickend Isthmus

I am a bit confused on the measurements and if they are way out of the normal range. I had an ultrasound done 2 years ago, blood work came back normal, but have been miserable with fatigue, signifigant weight gain, lump in neck that is causing pressure on my trachea. I am having trouble breathing. I cant lie down at night, it feels like someone is choking me, and I have a hard time swallowing. It's so awful. What do I do?

Here are my ultrasound findings:
Right Lobe 4.5 x 1.2 x 2.4cm
Left Lobe 5.0 x 1.1 x 1.6cm
Thickened Isthmus is 4mm AP diameter

Impression: Thyromegaly with a thickened Isthmus. This is probably due to goiter. There is no evidence of distinct thyroid nodule or mass, however.

 
Old 03-31-2009, 07:42 AM   #2
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Re: Enlarged thyroid with a thickend Isthmus

Usually the measurements of normal thyroids are no more than 4-4.8 x 1.0-1.8 x 0.8-1.6cm. Yours seem to be on the higher side of normal. Not huge.

Since you have symptoms of hypothyroidism, and your gland seems larger than what would be normal for you, your gland is likely working overtime to keep up with your needs. That overworking is what causes it to enlarge.

What to do? Find a doctor who will test your TSH, free T4, free T3 and thyroid antibodies - both TPO and Tg. If you've had any of these tests already, you can post your results here w lab ranges if you care to; we can help you determine if they look ok.

 
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Old 03-31-2009, 07:35 PM   #3
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Re: Enlarged thyroid with a thickend Isthmus

Thank you so much for your quick reply. I went to the doctor today with the 2 year old ultrasound, and his reply was that he didn't find anything wrong with it, even though I have lots of symptoms. He seems to think the pressure I feel in my neck is from weight gain. Keep in mind, I am 5' 3" and 160lbs, so I am not terribly overweight, and certainly not in my neck region. I was so upset and discouraged. He gave me a prescription of 7.5mg of Mobic and said that should help the inflammation. However, I did request he write me a prescription for bloodwork as you stated. I will be going tomorrow for that and awaiting the results. I will post as soon as I get the results. Thank you kindly for your response. I'll be in touch. Take care.

 
Old 04-02-2009, 10:57 AM   #4
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Re: Enlarged thyroid with a thickend Isthmus

I just got my lab results in and the doctor said they are normal. He only tested TSH and it was 3.37. Is this normal according to current standards. From what I have read recently, the American Association of Clinical Endocrinologists have lowered the scale for TSH levels to .3 to 3.04 down from the highest level of 5.0. Is this true? Are doctors just not aware of this and letting people suffer. I would be curious to know and what I should do. thank you so much for your time

 
Old 04-02-2009, 10:59 AM   #5
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Re: Enlarged thyroid with a thickend Isthmus

I would say find a new dr for sure!!! Your TSH is on the high side for sure. Why are dr's soooo hard to deal with anymore?! Sheesh

 
Old 04-02-2009, 11:02 AM   #6
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Re: Enlarged thyroid with a thickend Isthmus

I'm telling you! I can't believe that so many people could be suffering and just need a simple pill to help regulate their thyroid levels. It's so ridiculous! Why is there so much controversy as to what is high and what is not?? Do they just not have the information? Or do they create their own scales to base this on?

 
Old 04-02-2009, 02:22 PM   #7
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Re: Enlarged thyroid with a thickend Isthmus

Quote:
Originally Posted by hburkett1 View Post
I'm telling you! I can't believe that so many people could be suffering and just need a simple pill to help regulate their thyroid levels. It's so ridiculous! Why is there so much controversy as to what is high and what is not?? Do they just not have the information? Or do they create their own scales to base this on?
You're asking the same questions we've all be asking forever. There are no simple answers as to why the folly continues. It's a big can of worms that seemingly no one wants to untangle.

Medical knowledge moves slower than glaciers, in all things, not just thyroid. The cause and cure for stomach ulcers was quashed for a full 10 years after the discovery. I feel sure the truth might never have been accepted except that ulcers cause fatal bleeding. (Guess there remains a teeny-weeny bit of ethos in the profession which won't allow people to swiftly bleed to death.) HypoT doesn't as swiftly kill people. That happens in dribs and drabs. Hence, we continue suffer at the hands of MDs who have chosen not to learn anything new or different about the subject since they sat in Endocrinology 101.

It isn't that lab results lie. MDs are just too ignorant to understand how to interpret them correctly, or even to order the best tests. "Ranges" are exactly that and no more - an entire range of levels within which your particular "normal" level sits. There is no reason to think that any level within that range will be normal or adequate for you as a person, because you have one level that's right for you. It's very much like shoe sizing. There is a women's standard size range of 7-10. Trying to make do with a size 8 if your foot measures 10 is sure to cause trouble. MDs continue to mistakenly believe that any level within that range is right for everyone. Wrongo, buckos.

Big Pharma is to blame, too. The development of a different designer drug for every symptom known to man eliminates the drive to find the cause of the symptoms and fix that. Plus, this method of ~ahem~ "treatment" is a lot more profitable, to boot! Given as how hypoT tends to cause up to a dozen or more symptoms, why would the profit-driven MD want to get at the root of the myriad symptoms and fix it correctly? The Cash Cow patient takes the brunt once again.

I know, I know... I sound bitter. But I was once the patient of such an MD, so I think I'm entitled to a little bitterness. After I did my research and figured out that low thyroid might be causing my problems, my then-GP actually refused me the TSH test I requested. But I demanded one, and the result came back at 4.83. He told me that was not hypothyroid, even though that lab range stopped at 5.0. He said he never treats until it reaches 6. That's how stupid and arbitrary these people can be. You betcher boots I was gloating when I saw him again after I took myself to an endo, got my diagnosis, and had started treatment. It usually takes a great deal of persistence to get diagnosed and treated.

Have you heard Oprah Winfrey's story? She had seen a total of four doctors for her symptoms. She began, on her own, to suspect her thyroid. Finally, she asked the fourth doctor, "Could it be my thyroid?" He said that it couldn't be... Her thyroid tests would have ruled that out. She asked, "When? When was my thyroid tested?" - because she was sure it hadn't been tested. He thumbed through her hefty medical file, and guess what? There were no thyroid tests! If such a big-name, powerful celebrity has the same trouble as the rest of us, what confidence should we have in the people charged to care for us?

Well... You probably don't want to hear my rant. I'll just say here that you're right about the American Association of Clinical Endos "new" guideline for TSH - that the upper limit should be 3. But you won't find many GPs who've heard about it, even though the statement was issued in 2002. Glaciers move faster...

Be as persistent as I had to be! I'm well now because I advocated for myself.

 
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