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Old 03-22-2011, 12:34 PM   #16
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Re: New here and concerned

What I have to say is based upon almost 4 years of extensive research about the thyroid and thyroid disease....participating on several thyroid forums...and my own personal experience. Glad I can help.

Yes, T4 is thyroxine (that's where "levothyroxine" comes in - it's a T4 replacement med)

The T3 uptake is useless - it's a lame calculation.

The FreeT4 by dialysis is, by far, the best (and most expensive) test so you know your .9 value is VERY accurate....and horribly low

As you move forward, it would be best for you to get just these labs done:

FreeT4 (T4 or thyroxine, free, direct)
FreeT3 (tri-iodothyronine, free, serum)
and the doctor will insist on TSH (lol)

It's very important to get a FreeT3 level done. You see, T4 is our storage hormone and our bodies convert it to T3, the active hormone - the one we feel.

Sometimes, our bodies have difficulty converting - if we don't have enough T3, we will have hypo symptoms.

So, while most people can take levothyroxine (T4 med) and fare well, there are some of us that also need T3 (I'm one of them)

Not sure if I recommended this book to you but, I consider it to be one of the best out there. It's written by an endo who explains all about hypothyroidism and how levels in the normal range aren't necessarily your normal.

"What Your Doctor May Not Tell You About Hypothyroidism" by Dr. Ken Blanchard
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Old 03-22-2011, 12:36 PM   #17
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Re: New here and concerned

Quote:
Originally Posted by JillinPhoenix View Post
One other interesting piece of info are my labs from the recent past. Since T4 free is the only one of value, here is what that was:

Nov 2010: .84 (range .82 to 1.77)
April 2010: 2.0 (range 1.2 to 4.9)
and, of course, now: .9 (range .8 to 1.7)

Interesting!!
Interesting but sad for you - you have been hypo for while - this could have very well contributed to the development of the nodules you have.

Was the April 2010 lab done someplace different? That's a very odd result and lab range.

No matter what, your current labs and symptoms confirm hypothyroidism. Hope you can convince your doctor to start you on some levothyroxine.
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Last edited by cd37; 03-22-2011 at 12:37 PM.

 
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Old 03-22-2011, 12:43 PM   #18
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Re: New here and concerned

Yes it was done at a different lab. Of course, I might be reading it wrong. It says this exactly: "Free Thyroxine Index: 2.0 (1.2 to 4.9). Is that not the same as T4 Free? Being new to this, I'm not sure.

Quote:
Originally Posted by cd37 View Post
Interesting but sad for you - you have been hypo for while - this could have very well contributed to the development of the nodules you have.

Was the April 2010 lab done someplace different? That's a very odd result and lab range.

No matter what, your current labs and symptoms confirm hypothyroidism. Hope you can convince your doctor to start you on some levothyroxine.

 
Old 03-22-2011, 12:44 PM   #19
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Re: New here and concerned

I would like to clarify something.....in your very first post, you listed some measurements and, the way it read, it seemed as if you had a mass on the right lobe that was as big as an entire right lobe. Is that correct?

Did further investigation reveal a multi-nodular thyroid vs. a huge mass?

This is something you'd really want to clarify.
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Old 03-22-2011, 12:49 PM   #20
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Re: New here and concerned

Quote:
Originally Posted by JillinPhoenix View Post
Yes it was done at a different lab. Of course, I might be reading it wrong. It says this exactly: "Free Thyroxine Index: 2.0 (1.2 to 4.9). Is that not the same as T4 Free? Being new to this, I'm not sure.
Well, even though you had it done at a different lab, it is also a different test.

Free Thyroxine Index is another one of those useless calculations.

FreeT4 is FreeT4.....(T4 or thyroxine, free, direct)

Again, the dialysis measurement is top-notch but not really necessary....

Don't worry about the questions you ask - it's all part of the learning process.

I fought to have my FreeT3 tested by my first 3 endos and they never ran it. When my current thyroid doctor ran triodothyronine, free, serum - I didn't know what it was......it was FreeT3

Knowledge is definitely power when dealing with thyroid disease.
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Old 03-22-2011, 01:05 PM   #21
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Re: New here and concerned

I was trying to edit the report to simplify things, but here is the scoop verbatim. :-)

Findings: Today's study showed a 4.3 x 1.7 x 1.8 cm in dimension right thyroid lobe and a 3.9 x 1.5 x 1.5 cm in dimension left thyroid lobe. In the inferior midportion of the right thyroid lobe, there is a 2.6 x 1.5 cm relative hypoechoic heterogeneous mass that shows normal vascularity. Anterior to this mass, ther is a 0.6 cm hypoechoic nodule. Anterior and superior to this, there are 0.75, 0.24, and 0.22 cm hypoechoic nodules, and these are too small to characterize. In the left thyroid lobe, there is a 1 cm long hypoechoic oval nodule that shows no significant vascularity.

Impression:
1. A 2.6 cm hypoechoic mass seen in the posterior lateral aspect of the mid right thyroid lobe with no [evidence of hypervascularity]. Multiple hypoechoic goitrous nodules seen anterior to this mass with additional goitrous nodule seen in the upper pole of the right thyroid lobe. A 1 cm hypoechoic nodule seen in the upper pole of the left thyroid lobe.

2. The right thyroid lobe mass is not vascular and is essentially benign at this time.

So I probably messed up by editing it. Any additional insight now that I provided all the facts (my bad).

Thank you SO much, cd37. You are a doll!
Quote:
Originally Posted by cd37 View Post
I would like to clarify something.....in your very first post, you listed some measurements and, the way it read, it seemed as if you had a mass on the right lobe that was as big as an entire right lobe. Is that correct?

Did further investigation reveal a multi-nodular thyroid vs. a huge mass?

This is something you'd really want to clarify.

 
Old 03-22-2011, 01:35 PM   #22
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Re: New here and concerned

OK...it does seem that, in your earliest post, you were actually providing measurements of each thyroid lobe.

That one mass - 2.6 x 1.5cm is on the large side - the rule-of-thumb with nodules is FNA (fine needle aspiration with biopsy) of anything 1.5cm or larger so, it's very good you will have that done.

Most cancerous nodules are solitary so, the fact that you have multiple nodules is a good sign.

You definitely want to follow up with your thyroid labs as a separate issue - you are hypothyroid and would clearly benefit from starting thyroid hormone replacement meds.

It can take easily 6-12 months to find the optimal dose so, the sooner you start, the sooner you can be on the path to wellness.

Again glad I can help - I'm here to pay forward all the great help I received from other thyroid forum members.
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Last edited by cd37; 03-22-2011 at 01:36 PM.

 
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Old 03-22-2011, 01:52 PM   #23
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Re: New here and concerned

I just reserved that book you recommended at B&N up the street. Thank you for that!

And that's what the ENT said too-- having more than one is an indicator of benign nodules usually and no vascularity. So... the FNA is just to be as sure as we can be with him saying that the benefits of surgery would not outweigh the risk as this point.

I see the endo doc on Monday the 28th. I will push for the additional blood test and meds. If she won't then I'll go back to the ENT and my primary care doc if needed. I can be pushy, but in a nice way, if I need to be.

Quote:
Originally Posted by cd37 View Post
OK...it does seem that, in your earliest post, you were actually providing measurements of each thyroid lobe.

That one mass - 2.6 x 1.5cm is on the large side - the rule-of-thumb with nodules is FNA (fine needle aspiration with biopsy) of anything 1.5cm or larger so, it's very good you will have that done.

Most cancerous nodules are solitary so, the fact that you have multiple nodules is a good sign.

You definitely want to follow up with your thyroid labs as a separate issue - you are hypothyroid and would clearly benefit from starting thyroid hormone replacement meds.

It can take easily 6-12 months to find the optimal dose so, the sooner you start, the sooner you can be on the path to wellness.

Again glad I can help - I'm here to pay forward all the great help I received from other thyroid forum members.

 
Old 03-22-2011, 01:57 PM   #24
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Re: New here and concerned

Quote:
Originally Posted by JillinPhoenix View Post
I just reserved that book you recommended at B&N up the street. Thank you for that!

And that's what the ENT said too-- having more than one is an indicator of benign nodules usually and no vascularity. So... the FNA is just to be as sure as we can be with him saying that the benefits of surgery would not outweigh the risk as this point.

I see the endo doc on Monday the 28th. I will push for the additional blood test and meds. If she won't then I'll go back to the ENT and my primary care doc if needed. I can be pushy, but in a nice way, if I need to be.
My pleasure - we're all in this together.

This is all good news as far as your professionals are concerned.

You really don't need additional blood work now since your labs are recent enough and you should start on a T4 med. After you've been on the dose for 6 wks., you would get labs and that's when you'd need the FreeT4 AND FreeT3 moving forward.

Pushy in a nice way will get you places
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Old 03-22-2011, 04:52 PM   #25
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Re: New here and concerned

I have started reading Dr. Blanchard's book. Very informative!

I have a question about soy. I am doing a low carb, low-ish fat diet as these are the only kind that I've ever had any success with. Sugar is a drug to me so I'm better off not having any. However, I still have my sweet tooth. So I eat an Atkin's bars as my snack to stave off that craving and it's working well. But, of course, they contain soy nuggets in many cases (soy protein isolate).

Blanchard's book says to eat soy in moderation. (I don't eat any other soy based products like soy milk, tofu, edaname.) Do we have a range of how much soy is considered "moderate" in a day? Here's the thing. I am eating SO healthy with my meals.... but you gotta live a little too, LOL. :-)

 
Old 03-22-2011, 06:17 PM   #26
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Re: New here and concerned

I eat Fiber One bars for the same reasons you do - I haven't had a problem. I do believe our consumption would be considered "moderate" - I think it's when you get into measurements of cups that things might become problematic.
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Old 03-22-2011, 06:24 PM   #27
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Re: New here and concerned

You are the Bee's Knees!! Thanks for the quick reply.

And this book is great. I'm making a list of questions for the Endo doc next week.

 
Old 03-22-2011, 06:32 PM   #28
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Re: New here and concerned

I just happened to be checking my email and noted a new post on your thread - couldn't resist

I'm glad you like the book - I thought it was great....and really gave me hope since it is written by an endo and should carry some weight when quoting to a doctor .

I know I've referenced certain things from it when speaking with my doctor - basically telling her I've read a few books written by endos and "it's my understanding....." as she nods in agreement.

It almost seems like we sometimes need to remind doctors what they learned in medical school or what they should have read in medical journals - lol.

Whatever it takes - right?

Please be sure to let us know how things go with the endo on Monday.
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Old 03-22-2011, 06:39 PM   #29
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Re: New here and concerned

Yeah you gotta ride that fine line between not sounding like we know more than they do and still sharing information (and is *our own* health we are talking about here).

Thanks again and I'll definitely keep you posted. :-)

 
Old 03-24-2011, 06:57 AM   #30
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Re: New here and concerned

I'm a newbie on here but not new to the headaches associated with thyroid disease - and I'm not talking about just having the disease....it's more what we go through in trying to get the proper care.

Hope you'll keep us posted!

Last edited by sammy64; 03-24-2011 at 07:04 AM.

 
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