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Old 05-06-2013, 12:41 PM   #1
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I think my Dr. is crazy. Lab results= +ANA! Now what!?

Recap....

In Feb I had blood drawn and my TSH was 1.9. Last month, found a lump, had ultrasound and biopsy. Which came back as Follicular Neoplasm on both lumps biopsied. (one was 1.3cm, the other was 1.1) Those are all the bigger they are. I have 5 other lumps and bumps but all mm size. So my thyroid is just lumpy and bumpy. ENT dr. says to wait 6 months and we'll recheck. Tells me he's "90% sure I have follicular adenoma". I've googled and been on here enough to know, nothing is certain until removal of the thyroid and pathology comes back on that.

Other "symptoms" I have...hair loss, weight gain, rashes (just on my shins)...

Fast forward to this weekend..

Went to my doctor. (Just regular doctor, not the ENT) Cause I've had a rash on my lower legs for TWO YEARS! It won't go away. dermatologist couldn't even figure it out. Even after a biopsy from my shin!! Many creams, antibiotics and steroid shots later...they finally do some more blood work. (this last saturday).

Now.....

My TSH is 2.5!!! (kind of a jump in just a few months??)
Free T-4 is 1.33 (.80-1.76 range)
Free T3 is 272 (230-420 range)
C-reactive protein (whatever that is)... 2.8 (.0-5.0 range)

ANA....4.98 (range on the paper says .0-1.0) So positive for something autoimmune the dr. said.

She thinks I have rheumatoid arthritis is what she's come up with!? WHAT!??

Can anyone tell me if my thyroid labs are whacky? I don't even know what to think anymore. I'm about ready to give up.

 
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Old 05-06-2013, 01:16 PM   #2
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Re: I think my Dr. is crazy. Lab results= +ANA! Now what!?

No don't give up! This can all be figured out and make sense. The lumps and bumps in thyroid gland may be a result of autoimmune thyroiditis, Hashimoto's. Have you had anti-TPO and anti-TG antibodies run? The ANA, since positive should have a titer and pattern identified, plus a few subsets of antibodies run. Follicular "neoplasm" is an odd pathology term, as thet usually say whether suspicious for cancer or benign looking. I would get a copy of the path report for yourself. Since you just had this blood work done Sat, the lab will still have your serum. I would call Dr. and ask to have anti-TPO, anti-TG (thyroid antibodies) and a ANA titer and pattern. If she'll do it, anti DS DNA and anti-SMith antibody would be helpful too. For the rash, A biopsy to rule out lupus must include immunofluorescent studies looking for immune complexes (a lupus "band) between the skin layers. An RA factor can be added on, and they can do all these tests without redrawing as long as there is enough serum. The lab just needs an add-on order from your Dr. You then should be seen by a rheumatologist, who can sort this out. I would be thinking possible lupus, over RA, given the 2 year rash, and possible Hashimoto's thyroiditis with hypothyroidism starting to develop. I hope your Dr will add those tests on, as many as possible. The titer and pattern and thyroid antibodies are the priorities if not enough serum left to do all.

 
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Old 05-06-2013, 02:09 PM   #3
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Re: I think my Dr. is crazy. Lab results= +ANA! Now what!?

Quote:
Originally Posted by ladybud View Post
No don't give up! This can all be figured out and make sense. The lumps and bumps in thyroid gland may be a result of autoimmune thyroiditis, Hashimoto's. Have you had anti-TPO and anti-TG antibodies run? The ANA, since positive should have a titer and pattern identified, plus a few subsets of antibodies run. Follicular "neoplasm" is an odd pathology term, as thet usually say whether suspicious for cancer or benign looking. I would get a copy of the path report for yourself. Since you just had this blood work done Sat, the lab will still have your serum. I would call Dr. and ask to have anti-TPO, anti-TG (thyroid antibodies) and a ANA titer and pattern. If she'll do it, anti DS DNA and anti-SMith antibody would be helpful too. For the rash, A biopsy to rule out lupus must include immunofluorescent studies looking for immune complexes (a lupus "band) between the skin layers. An RA factor can be added on, and they can do all these tests without redrawing as long as there is enough serum. The lab just needs an add-on order from your Dr. You then should be seen by a rheumatologist, who can sort this out. I would be thinking possible lupus, over RA, given the 2 year rash, and possible Hashimoto's thyroiditis with hypothyroidism starting to develop. I hope your Dr will add those tests on, as many as possible. The titer and pattern and thyroid antibodies are the priorities if not enough serum left to do all.
I have a copy of all the reports so far. Ultrasound, FNA and this latest lab from this weekend. And yep, that was the diagnosis on the FNA one nodule was "follicular neoplasm"...and the other was "suspicious of follicular neoplasm". That's about all it said. Oh, it did say something about microfollicular in both nodules, and "hurthle cell changes" in one of them. Thats about extensive as it got.

I doubt my dr. will run anymore blood tests. I had to beg for the ones I had them do this last weekend!!! OH......AND......one other test they ran this weekend..... a "Rheumatoid Factor, Qualitive"........NEGATIVE!!! (don't know what that counts for though?)

I'm leaning way more towards the Hashimotos/hypothyroid than anything. Lupus was a thought. Way more than Rheumatoid arthritis anyway! Something is definitely up though. All these lumps on my thyroid are NOT normal. And I'm thinking the thyroid problem could be the cause of the rash, hair loss, weight gain, night sweats, hot flashes.....etc.

 
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Old 05-06-2013, 02:40 PM   #4
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Re: I think my Dr. is crazy. Lab results= +ANA! Now what!?

It is up to you whether you want to live with the uncertainty and symptoms related to the thyroid for 6 months. One option is to get a second opinion from an endo as to whether the gland needs to come out to be sure there is no malignancy. You are right about there being no certainty on that until removal. The antibody results may shed additional light on it too. I think your symptoms are related except the rash. The RA factor is negative. An endo may more more willing to treat you medically, so I think it is a reasonable approach. Let us know how it goes.

 
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Old 05-06-2013, 02:59 PM   #5
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Re: I think my Dr. is crazy. Lab results= +ANA! Now what!?

I have a (2nd opinion) appt with a top-notch ENT/Oncology surgeon on the 22nd for my thyroid. I'm hoping he says to just get it out. I hate the not knowing what these thyroid lumps mean!!.

 
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Old 05-07-2013, 09:02 AM   #6
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Re: I think my Dr. is crazy. Lab results= +ANA! Now what!?

Just want to comment on your shin rash.
There's a condition that is associated with autoimmune thyroid disease called 'pretibial myxedema'. It's mostly associated with Graves' disease, but can also be seen with Hashimoto's thyroiditis.

Now... I'm not saying you definitely have PM, only that it's somewhat possible. You need to have specific thyroid antibody tests, not just the non-specific ANA. Demand TSI, and TrAB tests, which are related to Graves'/PM. Request anti-TPO and anti-Tg, which are related to Hashimoto's disease. It's less important to find out if you have Hashi's, especially if your gland will be removed anyway. But the Graves' antibodies could, at least in theory, be the cause of your shin rash.

Understand that thyroid function - the measurement of blood thyroid levels - and your nodules are two separate issues. Blood levels are responsible for most symptoms. Nodules are generally unrelated - except for "hot" nodules. At this point, the evaluation of the nodules is most important consideration.

Interview several ENT surgeons to find the best candidate to do your surgery. You want someone who does a ton of thyroid surgeries per year, which will decrease your odds of having complications.

Best of luck!
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