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TSH level 306 . Free T4 0.33 ?


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Old 12-17-2015, 09:53 PM   #1
slam0911
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Question TSH level 306 . Free T4 0.33 ?

EXAM : ULTRASOUND OF THE THYROID


Clinical data : Hypothyroidism.

Technique : Real-time grayscale imaging of the thyroid was performed. Images
supplemented with color Doppler technique.

Prior studies : No prior studies submitted.

Findings : The right lobe of the thyroid measures 4.6 x 1.6 x 1.6 cm and
demonstrates a hypoechoic nodule measuring 1.1 x 0.6 x 0.9 cm.
The left lobe of the thyroid measures 3.2 x 1.7 x 1.6 cm and demonstrates a
hypoechoic nodule measuring 1.2 x 0.7 cm.
The isthmus measures 0.5 cm and is unremarkable.

IMPRESSION : Heterogenous echogenicity and multiple nodal suggestive of
multinodular goiter or thyroiditis.
Hypoechoic nodule 1.1 cm x 0.6 cm x 0.9 cm midportion of the right lobe
of thyroid.
1.2 cm x 1 cm hypoechoic nodule midportion of right lobe of thyroid.

Recommendation : Fine-needle aspiration and cytology.
Follow up as clinically indicated.


CHEMISTRY

ENDOCRINOLOGY

Procedure Units Ref Range
TSH 306.000 H ulU/mL 0.300-4.00
T4 Free 0.33 L ng/dL 0.80-1.80

Thyroid Interp : In adults these values could reflect: Hypothyroidism, Possible Pituitary Failure






Can someone help me understand my situation/health condition ? I would appreciate any information on it , the specifics , or dangers . Thanks in advance . I have a multinodular goiter in my Thyroid gland . I had an ultrasound done July of 2014 and went to the ER June of 2015 . I have the records , reports , an x ray on a disk , and the ultrasound images on a disk . My TSH level is 306 and Free T4 is 0.33 .Thyroid - Hypothyroidism - Depression - Anxiety - Had two children - Smoke cigarettes . Almost every day is a bad day . My throat feels like I am being strangled . The pain used to consist only on the sides of my neck , but has spread to my upper neck , right below my jaw . It is harder to breathe and swallow . I find myself yawning for air . When I turn my neck or lay down in a certain position I feel a compression or the feeling of a knot in my throat . My moods are mostly sad , depressed , indifferent , or angry . I am happy sometimes . I am lacking so much energy and struggle to make it through the day . I am very sluggish and tired all the time , but somehow motivated to fulfill my stay at home motherly duties . I have headaches every day , and I become sensitive to light and sound . The pain is really hard to ease . I don't socialize much . I don't like being around people anymore because I find it harder to interact with everything going on . I am confused at times , and my memory worsens more and more each day .

I no longer have health insurance . When I had the ultrasound done I was maybe 12 weeks pregnant and was covered by pregnancy Medicaid . I was scheduled for an aspiration , but my insurance canceled the day before the appointment . Now it is a struggle to figure out how to seek further medical attention . I was/am not sure how bad it could be to go any longer without treatment or medication . I do however , plan on going to the ER again at some point if the symptoms become unbearable and I seem to be reaching that breaking point . So far , I have just been hanging by a thread . Thank you once again . This truly is taking a toll on me .

Last edited by slam0911; 12-19-2015 at 07:24 AM.

 
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Old 12-18-2015, 08:47 AM   #2
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Re: TSH level 306 . Free T4 0.33 ?

Yikes!!!!! Your June labs indicate you are SEVERELY hypothyroid. It is no wonder you feel as bad as you do. Were you put on any thyroid medication at that time?

It is imperative you get the situation under control. Worry about the biopsy and how to pay for it later but you absolutely ABSOLUTELY cannot continue without correcting this with thyroid replacement meds if your labs remain as abnormal as yours. Your condition may be life threatening. It's possible your june labs reflected a temporary condition so you need to have your labs rechecked but considering your continued symptoms it is likely you need replacement meds and you need them yesterday.

The synthetic form of medication and one that is usually Rx'd is one of the cheaper ones as far as drugs go.

For testing is there a women's health clinic you could go to? You will need followup and continued monitoring. The ER is definitely NOT the place to seek treatment for this.

Please see someone ASAP. I don't want to scare you but your life may be in danger.

 
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Old 12-18-2015, 09:40 AM   #3
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Re: TSH level 306 . Free T4 0.33 ?

Slam, I hope you come back soon. I hope you are on some kind of replacement med. If not, I cannot overstate how serious your condition may be. Your body was barely producing any amount of thyroid hormone at all judging from your june labs. Please make sure your condition is monitored and if you are not being treated please don't hesitate to seek treatment ASAP. If you need more convincing, do some reading on myxedema coma. Trying to save money now may end up costing you a very expensive stay in ICU or worse.

Seriously, you need to have this taken care of now. If you aren't on thyroid meds, do not wait another day to see someone even if it means an ER visit. If the ER can't direct you to low cost follow-up, would your OB/GYN or a doctor you may have seen when you had insurance be willing to help and allow you to make payment arrangements until you can obtain insurance?

 
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Old 12-18-2015, 10:05 AM   #4
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Re: TSH level 306 . Free T4 0.33 ?

I have checked on the cost of the medicine . It was $40 , and that was the off brand price . I know that may not seem like much , but we are struggling financially . Recently lost our home and everything in it . Also , 3 of our tires need to be replaced . One popped on me already , and two more are getting there . We have an 11 month old little girl . I am sure you already know it goes . It just seems like every way I look at it , I can't catch a break . I can get a doctor to call the medicine in but without me able to afford a follow up and have my levels checked in the future how will they be able to assure the right dosage ? I was thinking about scheduling an appointment Monday , I have to take my sister , so I was thinking about showing him the labs while we are there . I am also trying to figure out a health insurance plan , but these things don't come easy to me . The myxedema coma , said to be rare . Is that just with the less abnormal levels ? Do my levels being highly abnormal make me more at risk ? What ever more information you are able to provide me with , I would greatly appreciate . I'd just like to know more about what is going on . So far no one has explained much to me .

Last edited by slam0911; 12-18-2015 at 10:11 AM.

 
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Old 12-18-2015, 10:33 AM   #5
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Re: TSH level 306 . Free T4 0.33 ?

Yes, myxedema coma is rare, but trust me you are well on your way if you don't take care of this ASAP. Your free T4 level is in the cellar. ALL of the body's processes depend on adequate amounts of thyroid hormone. The longer you let this go, the more likely you'll end up in trouble. Your symptoms already sound quite severe.

I just checked walmart's generic thyroid med (Levothyroxine) price and a month's supply costs $4. A 90 day supply costs $10. I'm assuming your're in the US because you don't have insurance. Considering what you say is going on in your life are you sure you don't qualify for medicaid?

If the best you can do is to show your sister's doctor your labs, do it. Again, I'll suggest a woman's health clinic for followup if you have access to one. They often have sliding scale fees based on ability to pay. Do you belong to a church? They may be able to help some or at least refer you to someplace that can. Or call the social services department of your local hospital to see what resources they may have available or know of.

Again, not trying to be an alarmist but please see someone ASAP. Your life is more important than tires and your family needs you.

 
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Old 12-18-2015, 11:32 AM   #6
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Re: TSH level 306 . Free T4 0.33 ?

Thank you so much for looking into that . I will see if he will call it in . I am going to apply for Medicaid next week I will look into other means of getting treatment , also . Hopefully all will fall into place . I would love to have a doctor explain things a little more . You know what I mean ? It's been so hard understanding the importance because nothing was stressed nor explained to me . I now am grasping an understanding of the situation . Though , I would still like more tests and/or to get to the underlying problem and solve it . I really hope it is something that can be resolved and not have to follow me further into my adult life . Thank you so much for responding !!!

Last edited by slam0911; 12-18-2015 at 11:37 AM.

 
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Old 12-18-2015, 11:51 AM   #7
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Re: TSH level 306 . Free T4 0.33 ?

Good luck and God bless, slam. I will keep you in my thoughts and prayers in hopes you get the treatment and answers you need.

Thyroid medication is often something that must be taken for the rest of your life, not always, but almost always. In the earlier stage of treatment you will likely need labs done in 4-8 weeks after starting medication and at similar intervals after every dose change. It can take a few months to find the right dose and start feeling better. Once the dose is determined, testing may only be done yearly or even less often if your symptoms are in control.

One very common symptom of hypothyroidism besides the extreme fatigue and emotional lability you're experiencing is mental confusion, so if things don't make a lot of sense right now, they will as your condition improves.

Wishing you a speedy return to good health!

Last edited by Harri3t; 12-18-2015 at 11:56 AM.

 
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Old 12-18-2015, 01:43 PM   #8
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Re: TSH level 306 . Free T4 0.33 ?

My wife had a TSH of 246 and the doctor had her get a thyroid x-ray which game back OK. Then they started her on levothyroxine first 25 mcg for a month, then 50 for a month and then 100 which made her normal again. Her symptoms were bad but yours are worse so no matter what you have to do go to the doctor. Borrow the money, sell belongings or put a lien on something. Your kids need a mother!!! It will take a while to get you back to normal but it needs to improve not get worse.

 
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Old 01-29-2016, 10:52 PM   #9
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Re: TSH level 306 . Free T4 0.33 ?

walmart cash price for levothyroxide $4

 
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