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SwtLibby · 06-09-2011, 04:06 PM

Hi all,

This is my first post ever to any Thyroid forum and thought I'd introduce myself.

This last Feb I was diagnosed with Hashi's, however all my labs have been the normal ranges so I have not started any kind of medication treatment. I had a FNA on 2 nodules and the biopsy results came out benign. I was told that it can time for the disease to progress so I am supposed to have labs and ultrasounds done every 6 months until there are findings that warrant treatment, I guess. I am a fighter and have always maintained a positive attitude throughout all my illnesses (Type 2 Diabetes and Heart disease), but I am getting pretty worn down lately. I feel extremely weak at times, with a "sinking" feeling in my stomach/chest. I also get bad muscle cramps every night from the knees down to my toes that wake me up. I have bad joint pain/stiffness in 2 particular fingers (one in each hand) that had gone away for a bit but has started up again the last few weeks - its always worse in the morning. I have recently started getting hives every day unless I take allergy medication. My throat feels swollen sometimes and makes me nauseous. Thyroid issues do run in my family too. I could go on for a bit

but I thought I'd also post my thyroid ultrasounds and lab results so I'll stop there before I make it too long. If anyone has any comments or advice, I would appreciate it - thank you for allowing me to share my story with everyone!

I have another appointment coming up soon to check my labs again, since I've been feeling worse. It's kind of funny to hope that the labs are abnormal, so that I can start treatment and feel better! I'm sure I'm not the only one.

ULTRASOUNDS:

2/11/11:
FINDINGS: The right thyroid lobe measures 5.8 cm in length, 1.8
cm AP and 1.7 cm transverse and shows heterogeneous echotexture
with solid hypoechoic nodule posterior to the midportion
measuring 1.3 x 0.8 x 0.8 cm. This was less apparent on prior
exam, however, on retrospect appears to be essentially unchanged.
Isthmus is thickened at 5 mm.

Left thyroid lobe 5 cm in length, 1.9 cm AP and 2 cm transverse
and shows small hypoechoic solid nodule anteriorly at the margin
of the isthmus measuring 0.8 x 0.5 x 0.7 cm. This lesion was not
apparent on prior exam.

IMPRESSION:
1. Enlarged heterogeneous gland.
2. Nodules are present bilaterally as described above. Left
lobe nodule is apparently new from prior exam. Continued
followup is recommended as neoplasm cannot be excluded.
3. Right lobe nodule was less apparent on prior exam but may
have been present. Stability is difficult to assess. Continued
followup recommended.
3. Decrease in isthmic thickness seen since the prior exam.

8/12/10:
FINDINGS: Thyroid ultrasound demonstrates mild thyromegaly. The
right lobe measures 6.2 x 2 x 2 cm and the left lobe measures 5.5
x 2 x 2.1 cm in size. The thyroid gland is enlarged and somewhat
heterogeneous without evidence of discrete nodules. Correlate
clinically.

IMPRESSION:
Thyromegaly with heterogeneity. No definite discrete nodules.
Correlate clinically and follow up.

THYROID LAB TESTS:
2/4/11 Free T4: 1.25 Range: 0.8 - 1.80 ng/dL
2/4/11 TSH: 1.49 Range: 0.34 - 4.82 uIU/mL
10/5/10 Free T3: 3.21 Range: 2.3-4.2 pg/mL
10/5/10 Free T4: 0.77 Range: 0.6-1.61 ng/dL
10/5/10 TSH: 2.08 Range: 0.40-4.50 mIU/L
10/5/10 Thyroglobulin AutoAb <20 Range: <20 IU/mL
10/5/10 Thyroid Perox AutoAb: 28 Range: <35 IU/mL
7/9/10 TSH: 1.36 Range: 0.34 - 4.82 uIU/mL
7/9/10 Free T3: 3.19 Range: 2.3 - 4.2 pg/mL
5/26/10 Antithyroid Peroxidase Antibody: 27 Range: LESS THAN 35 Unit: IU/mL
11/16/09 TSH: 1.67 Range: 0.34 - 4.82 uIU/mL
1/6/09: TSH: 3.53 Range: 0.34 - 4.82 uIU/mL
1/6/09: Free T4: 1.26 Range: 0.6 - 1.61 ng/dL

Terri880 · 06-09-2011, 06:42 PM

Quote:

Originally Posted by SwtLibby

Hi all,

This is my first post ever to any Thyroid forum and thought I'd introduce myself.

This last Feb I was diagnosed with Hashi's, however all my labs have been the normal ranges so I have not started any kind of medication treatment. I had a FNA on 2 nodules and the biopsy results came out benign. I was told that it can time for the disease to progress so I am supposed to have labs and ultrasounds done every 6 months until there are findings that warrant treatment, I guess. I am a fighter and have always maintained a positive attitude throughout all my illnesses (Type 2 Diabetes and Heart disease), but I am getting pretty worn down lately. I feel extremely weak at times, with a "sinking" feeling in my stomach/chest. I also get bad muscle cramps every night from the knees down to my toes that wake me up. I have bad joint pain/stiffness in 2 particular fingers (one in each hand) that had gone away for a bit but has started up again the last few weeks - its always worse in the morning. I have recently started getting hives every day unless I take allergy medication. My throat feels swollen sometimes and makes me nauseous. Thyroid issues do run in my family too. I could go on for a bit

but I thought I'd also post my thyroid ultrasounds and lab results so I'll stop there before I make it too long. If anyone has any comments or advice, I would appreciate it - thank you for allowing me to share my story with everyone!

I have another appointment coming up soon to check my labs again, since I've been feeling worse. It's kind of funny to hope that the labs are abnormal, so that I can start treatment and feel better! I'm sure I'm not the only one.

ULTRASOUNDS:

2/11/11:
FINDINGS: The right thyroid lobe measures 5.8 cm in length, 1.8
cm AP and 1.7 cm transverse and shows heterogeneous echotexture
with solid hypoechoic nodule posterior to the midportion
measuring 1.3 x 0.8 x 0.8 cm. This was less apparent on prior
exam, however, on retrospect appears to be essentially unchanged.
Isthmus is thickened at 5 mm.

Left thyroid lobe 5 cm in length, 1.9 cm AP and 2 cm transverse
and shows small hypoechoic solid nodule anteriorly at the margin
of the isthmus measuring 0.8 x 0.5 x 0.7 cm. This lesion was not
apparent on prior exam.

IMPRESSION:
1. Enlarged heterogeneous gland.
2. Nodules are present bilaterally as described above. Left
lobe nodule is apparently new from prior exam. Continued
followup is recommended as neoplasm cannot be excluded.
3. Right lobe nodule was less apparent on prior exam but may
have been present. Stability is difficult to assess. Continued
followup recommended.
3. Decrease in isthmic thickness seen since the prior exam.

8/12/10:
FINDINGS: Thyroid ultrasound demonstrates mild thyromegaly. The
right lobe measures 6.2 x 2 x 2 cm and the left lobe measures 5.5
x 2 x 2.1 cm in size. The thyroid gland is enlarged and somewhat
heterogeneous without evidence of discrete nodules. Correlate
clinically.

IMPRESSION:
Thyromegaly with heterogeneity. No definite discrete nodules.
Correlate clinically and follow up.

THYROID LAB TESTS:
2/4/11 Free T4: 1.25 Range: 0.8 - 1.80 ng/dL
2/4/11 TSH: 1.49 Range: 0.34 - 4.82 uIU/mL
10/5/10 Free T3: 3.21 Range: 2.3-4.2 pg/mL
10/5/10 Free T4: 0.77 Range: 0.6-1.61 ng/dL
10/5/10 TSH: 2.08 Range: 0.40-4.50 mIU/L
10/5/10 Thyroglobulin AutoAb <20 Range: <20 IU/mL
10/5/10 Thyroid Perox AutoAb: 28 Range: <35 IU/mL
7/9/10 TSH: 1.36 Range: 0.34 - 4.82 uIU/mL
7/9/10 Free T3: 3.19 Range: 2.3 - 4.2 pg/mL
5/26/10 Antithyroid Peroxidase Antibody: 27 Range: LESS THAN 35 Unit: IU/mL
11/16/09 TSH: 1.67 Range: 0.34 - 4.82 uIU/mL
1/6/09: TSH: 3.53 Range: 0.34 - 4.82 uIU/mL
1/6/09: Free T4: 1.26 Range: 0.6 - 1.61 ng/dL

What am I missing? Are your Hashimoto's Antibodies elevated??? I don't see evidence of that. Either TPO or TG??

I don't think I am the right one to help you with your blood tests, but I can try to give you some insight into your ultrasound. Small nodules, both sides, FNA indicates benignity. All good news. Thyroid is larger than it should be. It seems as if the radiologist thinks this should just continue to be followed. If it was me, I would do that I did it with far less reason to and it worked out fine. The nodule that is over 1 cm will probably have to be watched closer. But the fact that there are more than one is common with hashimoto's. We with that are more prone to get them.

If you have negative symptoms, you definitely need to find out what is going on and INSIST on treatment. Be persistent so you can feel better.

SwtLibby · 06-09-2011, 06:51 PM

@LuckyTerri - thanks for replying, I will dig into my past labs and try to find a TPO or TG result. My endo made it seem like she diagnosed me with Hashi's after the biopsy results, although she had her suspicions before that. If I find more info I will post it.

Terri880 · 06-09-2011, 07:05 PM

Good, cause I think those antithyroid peroxidase antibodies results are not them. But I'm not good with the blood test stuff. Is this the TPO test "10/5/10 Thyroid Perox AutoAb: 28 Range: <35 IU/mL "

I do think that some would say your most recent TSH is too high though. That could explain your symptoms.

midwest1 · 06-09-2011, 09:22 PM

Biopsy is the only 100% definitive way to diagnose Hashimoto's; but it's never done solely for that purpose. It's found only coincidentally during examination of nodule samples. Since you had a biopsy, that's the likely way the diagnosis was made.

This goes to prove that the lab tests for thyroperoxidase (TPO) and thyroglobulin (Tg) antibodies are only so accurate, and that "almost" positive results like yours can be highly suggestive of Hashi's even if it isn't otherwise medically necessary to do a biopsy.

You don't have to wait 6 months between checks. More enlightened endos are known to treat when antibodies and symptoms are present, no matter what the TSH looks like. You already know you have Hashi's, and you have symptoms. Ask that you be treated sooner rather than later. It just might help prevent any more nodule formation or growth.

SwtLibby · 06-10-2011, 12:55 AM

Thank you for the advice, I will definitely ask my endo about starting treatment sooner, especially since I've been feeling worse lately. I can't remember what it feels like to have energy and its been 2 years since I've felt "normal". I had a heart stent put in 2 summers ago (I had chest pains and they found my right coronary artery was blocked 95%) and since then, my health has had many twists and turns. I've also been Type 2 Diabetic since I was 18 and I still battle keeping my sugars under control. My cardiologist says my body is aging too fast

but I keep my hopes up that I'll feel better soon. The stories I read on this forum give me inspiration to keep truckin' along!

sammy64 · 06-10-2011, 05:35 AM

Welcome!

Sorry for the reason you're here but, glad you found us.

Midwest1 said everything I would have said.

Your thyroid hormone levels (FreeT4/T3) are below mid-range....most people feel better with levels in the upper half, if not the upper third of the range.

Good idea for you to pursue treatment with your doctor now.

Please keep us posted.

SwtLibby · 06-11-2011, 12:28 AM

I had some labwork done today (too many to list but here are a few):

Free T4: 1.25 Range 0.8-1.80 ng/dL
TSH: 1.19 Range 0.34-4.82 uIU/mL
ESR: 52 Range 0-20 mm/hr

Since the T4 and TSH are in the normal range, my PCP thinks it best to wait for my next endo appt which is in August. Before that appt I'll do more labwork again. My PCP also mentioned that my endo most likely will not give any treatment until my thyroid labs appear outside the normal range because she doesn't want me to go hyperthyroid...maybe I'll talk to my endo directly and see what she has to say.

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