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Old 01-03-2013, 01:37 PM   #1
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Hyperthyroid Symptoms, normal TSH (0.41) & 3cm nodule - worried!

Hi all, I'm new to this board and to thyroid problems but wondered if someone could help as I have been having a lot of problems and do not seem to be getting much help!

I became very unwell 6 months ago (7 months after giving birth to my first child). I became extremely fatigued, my legs began to ache daily and I began to experience what I now know to be classic Hyperthyroid symptoms: shakiness, tremor, high blood pressure (157/99), high pulse rate. Whilst shopping the pharmacist actually thought I was having a panic attack. Some days I felt like I was having adrenaline rushes that lasted all day. The next day I wouldn't be able to move, even preparing food for my baby became a huge task. Around this time I also noticed the appearance of a Goiter and despite months of sleep deprivation with a new baby, the shakiness/anxiety etc was interrupting my sleep further.

On seeing my GP all my bloods came back normal, inc my Thyroid results:
TSH 0.41 (normal range 0.10-4.00)
FT4 14.6 (normal range 10.0-22.0)
TPA 51 (normal range 0-60)

I understand 0.41 used to be classified as Hyperthyroid?

I requested further investigation into the Goiter and a scan confirmed my Thyroid was enlarged and had multiple nodules, with 2 dominant nodules: one on the right over 2.0cm and one on the left at 3.0cm.

After 5 months of problems and GP visits I am finally under an Endo, however, the Endo refused to take any further blood tests (inc FT3 which I have never had checked) and says that as my TSH is hovering around the 0.4-0.5 range he is happy that this is my body's natural level. No further investigation needed.

The next step he has ordered is FNA on the 3cm nodule - but not for another 3 months. Thyroid cancer worries me slightly given the size of the nodule, my age (28) and the fact that my hormones are normal. The scan also states 'no significant lymphoderma'... which suggests there is 'some' impact on my lymph nodes (just not significant!). Does anyone have any ideas?

 
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Old 01-03-2013, 01:57 PM   #2
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Re: Hyperthyroid Symptoms, normal TSH (0.41) & 3cm nodule - worried!

Any MD can order a Ft3 test. Including a nurse practitioner in one of the on the spot clinics. It is the rare endocrinologist that actually treats a thyroid patient. Most are diabetes specialists and lost with only a day at best instruction on thyroid issues under their belt.

Your FT4 levels are 38.3% of normal. This is trending hypothyroid in range. I suspect you are over converting your t4 to t3, but with out an adrenal profile and ft3 test you can not be sure. This endo is obviously not one that is willing to actually study your thyroid adrenal health with the care and concern it deserves. I strongly recommend you get your general practitioner or OB to run the tests. They might also be able to refer you to a more knowledgable MD Known for treating thyroid and other issues.

I am sorry that you are having to suffer through this but we will help where we can. It is not in your head and you are not imagining it. Something is up with your thyroid..

Sincerely,
MG
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Old 01-03-2013, 02:06 PM   #3
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Re: Hyperthyroid Symptoms, normal TSH (0.41) & 3cm nodule - worried!

If I had to hazard a guess. I would strongly suspect Hashimoto's thyroiditis. It is suspected if medical research polling is to be believed that 12.7% of the population has it according to some of the more recent random blood tests of around 18000 patient groups. These people tested positive for the TPOAb and TgAb indicators. Of the pool of unsuspecting hypothyroid to be patients, 80% of those are female. And pregnancy is the most common activator of this condition followed by menopause.

Now I am not an md by any means. But I have Hashimotos and I have Graves' disease. There are also six other members if my family with thyroid AIs. The nodule and hypot t4 with hyperT TSH is what is giving me the... Huh welcome to the hashi's dysfunctional family feeling. You really need to go shopping for that perfect md for you. He or she can be as hard to find as the perfect accessory unfortunately.

Good luck!
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Last edited by mkgbrook; 01-03-2013 at 02:07 PM.

 
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Old 01-03-2013, 02:13 PM   #4
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Re: Hyperthyroid Symptoms, normal TSH (0.41) & 3cm nodule - worried!

A quick background check on my endo suggests he is a Diabete's specialist. You were right there!

I'm so confused with everything. Do any of my symptoms sound like anything specific? I must say the anxiety / tremor type symptoms have eased somewhat but the tiredness and achiness is a daily issue.

Hypothyroidism does run in my Father's side.

 
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Old 01-03-2013, 02:14 PM   #5
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Re: Hyperthyroid Symptoms, normal TSH (0.41) & 3cm nodule - worried!

Also what does over converting T4 to T3 mean?

 
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Old 01-03-2013, 02:19 PM   #6
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Re: Hyperthyroid Symptoms, normal TSH (0.41) & 3cm nodule - worried!

Quote:
Originally Posted by mkgbrook View Post
If I had to hazard a guess. I would strongly suspect Hashimoto's thyroiditis. It is suspected if medical research polling is to be believed that 12.7% of the population has it according to some of the more recent random blood tests of around 18000 patient groups. These people tested positive for the TPOAb and TgAb indicators. Of the pool of unsuspecting hypothyroid to be patients, 80% of those are female. And pregnancy is the most common activator of this condition followed by menopause.

Now I am not an md by any means. But I have Hashimotos and I have Graves' disease. There are also six other members if my family with thyroid AIs. The nodule and hypot t4 with hyperT TSH is what is giving me the... Huh welcome to the hashi's dysfunctional family feeling. You really need to go shopping for that perfect md for you. He or she can be as hard to find as the perfect accessory unfortunately.

Good luck!
Ooh this is useful - I'll have a look into Hashi's a little more. What are your main symptoms from this & Graves? Thank you so much

 
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Old 01-03-2013, 06:38 PM   #7
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Re: Hyperthyroid Symptoms, normal TSH (0.41) & 3cm nodule - worried!

Not many symptoms now. My thyroid is dead or nearly so. I still have thousands of antibodies running about looking for trouble.

Initially I would go from hypoT to hyperT in the same day. Mornings I would run temps of 99 by night I would be at 97. Hot flashes to chills. Weight gain, hair loss, dry skin, brittle nails, zombie brain, hormone induced visually impaired migraines, and more. I made an excel spread sheet and listed hyperT or graves symptoms and hypot symptoms.

It was this list and some symptoms unique to me that help me and my md track down my insulin resistance, reactive hypoglycemia, Pcos, hypoadrenalism, in addition to the graves and Hashimotos.

Sometimes Hashimotos results in hashitoxicosis early on. This can be mistaken for graves or hyperT. There is tons of information in my earlier posts. Especially the thyroid care and concern series. Look up threads by me and read away!

I was lucky and my body and blood tests provided all the proof I needed to back up my symptoms. The hardest thing for me was finding a md willing to check the boxes and run the blood work. To get the thyroid antibody tests I had to pull out my black belt card and order the md to write the order and prove me wrong. I was right. Tpoabs maxed out in the 10,000 range. TSIs only got up into the 400s. I had TGAbs as well. No TRAbs. But the TSIs. TPOAb and TGAb are the antibodies associated with Hashimotos and TSI and TRAb are the antibodies associated with Graves. I strongly recommend anyone with thyroid issues to test for antibodies. WHY? Autoimmune thyroid diseases are genetically dominant. If you have it your children are at higher risk.. Your parents.. Siblings.. Aunts... You get the picture.

I was glad I could help.

MG
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Old 01-04-2013, 02:04 AM   #8
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Re: Hyperthyroid Symptoms, normal TSH (0.41) & 3cm nodule - worried!

This is all really useful info, thank you. Both my Grandparents and my Aunt are Hypo so I'm guessing I've genetically inherited some form of thyroid problem, whatever that may turn out to be!

Here's hoping I get somewhere with the investigations - I'm fed up of feeling exhausted after the most simple tasks. I don't know how I'm going to cope returning to work :/

 
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Old 01-04-2013, 02:18 AM   #9
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Re: Hyperthyroid Symptoms, normal TSH (0.41) & 3cm nodule - worried!

This is all really useful info, thank you. Both my Grandparents and my Aunt are Hypo so I'm guessing I've genetically inherited some form of thyroid problem, whatever that may turn out to be!

Here's hoping I get somewhere with the investigations - I'm fed up of feeling exhausted after the most simple tasks. I don't know how I'm going to cope returning to work :/

 
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Old 01-04-2013, 08:55 AM   #10
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Re: Hyperthyroid Symptoms, normal TSH (0.41) & 3cm nodule - worried!

Press for your GPs and aunt to have the antibody tests run in addition to getting your own. When you come in packing a family tree of dysfunction and the autoimmune hammer it does aide in proactive treatment and management of your condition.

I truly wish you the best of luck!
MG
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