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    Old 02-15-2006, 09:10 AM   #1
    van7771
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    Thyroid Problems?

    Karen:

    I recived the results for the CT of the Abdomen and the Ultrasound of my Thyroid, it says the following:

    CT of Abdomen came back normal, nothing is wrong everything looks normal which is a good thing.

    Ultrasound came back with the following:
    Right lobe of the gland measures 5.3 x 2.0 x 1.5 cm in diameter. I the lower pole of the right lobe again identified is an approximately 1 x1 x1 nodule. this is unchanged. No other nodules are identified. The isthmus is normal in thickness.
    I checked back when l had the left side removed and found that the size of the left gland was 2 x3 x4 cm in diameter with the nodule measuring 1.5 x 1.4 x 1.2 cm in diameter. So my thyroid that was taken out was smaller with a larger nodule. The current right lobe is larger with a smaller nodule.
    It makes me wonder if the lobe l currently have is inflamed, because l constantly have irritation in my throat and the lobe is larger than the last one. Do you still have your pathology reports, is this common to have two lobs different in size, maybe l am just being to picky about nothing. Anyway l should have labs today or tomorrow so l will let you know. I have also scheduled an appointment this friday with another endo/surg to discuss taking the remaining thyroid out.

    Thanks:

    VAN

     
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    Old 02-15-2006, 01:47 PM   #2
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    Re: Thyroid Problems?

    Van7771:

    Have you done biopsy for thyroid nodule? Why did you remove left side off and keep right side? Was this decided by your surgeon or other doctors? What is the result of your lab work? I have the same problem and want to learn more from this forum. I hope you will do well in your coming doctor vistings.

     
    Old 02-15-2006, 06:10 PM   #3
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    Re: Thyroid Problems?

    Van,

    Here is a copy of my last ultra sound..............

    The right lobe measures 1.5 x 4.7 x 2.2 cm and it hetero geneous without a dominant mass. The left lobe measures 3.2 x 4.6 x 3.2 cm and contains a heterogeneous mass which measures 2.4 x 3 x 2.5 cm. The mass is hypervascular. A smaller, hyperechoic nodule is seen in the left isthmus measuring 1.5 x 1.9 x 1.2 cm.

    I always did the biopsies and skipped the uptake scans.

    That is what that says. I have all of my info and would be glad to post anything you would like to read.

    Glad you got another appt!

    Karen

     
    Old 02-15-2006, 08:42 PM   #4
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    Re: Thyroid Problems?

    Karen:

    So your right lobe didnt have any nodules from what l see here, the whole left lobe was nodules from what l can see, the nodules were very large.
    What do these two words mean, hypervascular and hyperechoic.
    I aslo got a call back from the labroatory that drew my blood last week and they messed half the labs up so l have to go back and get my blood drawn again. I am not to happy about that.
    Did you ever have issues with your throat, having food get caught in your throat and always having an irritated throat. I cant even yell because my throat bothers me so much. I think it all has to do with my thyroid and lymphnodes.

    THANKS:

    VAN

     
    Old 02-15-2006, 08:44 PM   #5
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    Re: Thyroid Problems?

    Traveller:

    If you go into my profile and look at threads and posts l have posted all my results, if you can find it let me know and l will repost them.

    VAN

     
    Old 02-16-2006, 07:08 AM   #6
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    Re: Thyroid Problems?

    Van......

    You are right,my right lobe was pretty much normal but like I said my surgeon said he never leaves in any thyroid tissue when you have follicular cells.

    The nodule in the left lobe had gotten very large by the time I had this ultrasound. The word hypervascular means it has an extreme amount of blood flow in it.......not a solid cyst but an actual "tumor" as in something that grown in the tissue and turns vascular.

    Hyperechoic is a term used in sonography..........there is hypoechoic and hyperechoic. the hyperechoic means the sound waves really bounce off the nodules..........it was very defined on the ultrasound.

    Remember when my surgeon got in there it had actually grown down under my collar bone and all in and around my neck muscles and vocal chords. The ultrasound does NOT paint an exact picture of how bad things are. There are several on the board who have had alot of invasion that was never picked up on the ultrasound.

    That is disgusting that the lab messed up your labs. I have had that myself and you wonder how they can do that???? It also makes you wonder if they are competent enough to even do the lab tests when they mess up the blood!

    Sorry you have to get them done again. That means more waiting.

    Karen

     
    Old 02-16-2006, 10:16 AM   #7
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    Re: Thyroid Problems?

    Karen:

    So do they know which nodule was causing all the problems, was it the actual tumor or the smaller nodule.
    Also l have been reading alot of threads about people after there TT and being hypo and having a tough time getting there synthroid/levoxyl right. This is something l would be concerned about when l get my TT. Do you have any insight on if this is somehting l need to worry about?

    VAN

     
    Old 02-17-2006, 12:52 PM   #8
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    Re: Thyroid Problems?

    Karen:

    Where do l start, l dont know what to do, so l go to one of the best Endo's in the valley, this guy is sapposed to be the best. I take the book of labs that l have and we talk about whats happened for about 1 hour. He looks me over and then says well l know your problem isnt edocrine related, your Thyroid isnt causing your symptoms and l definetly dont think your Thyroid needs to come out. So l asked him about the EBV and the fact that l have follicular cells and he says that there is no relation, he daid normal thyroids have hurthe cells, he said that if l had say hashimotos l would have antibodies in my blood or in my Thyroid that was taken out. He said my biopsy would test positive and because if didnt and l dont have blood work that shows antibodies there is no evidence l have Thryoid problems. He said my labs are completely normal and that he thinks my problem is psychological. He gave me the name of a Shrink and said l sould take SSRI's.
    I dont know what to do, who do l belive and how do l get better.
    Karen you mentioed your Endo knew you had Thyroid problems even when your labs were normal and l talked to him about that, he said if your labs are normal you wouldnt have hypo or hyper symptoms. He said how can you be hyper or hypo with normal labs.
    I asked him about the reactions to the Thyroid Meds and he said your body makes the exact same meds so why would it react if your body makes the same stuff. He said l reacted to the meds because it was in my head, he said it was like a placebo affect.
    Well l really didnt need to hear all this, l dont know what to do.
    I know l am not crazy and l know that something is wrong l just dont know where to get help and how to feel normal again.
    Karen if you have any advice l could really use it.

    Here are the labs l got back today:

    TSH: 2.30 (.40-5.0)
    FREE T3 3.6 (2.3-4.2)
    Anti Thyroid Antibodies
    Thyroglobulin Auto Anti: <20 (0-40.0)
    Thyroid Peroxidase Auto Ab: <10 (0-35)

    Thyroglobulin (Reflexive)
    Thyroglobulin Auto Anti: <20 (0-40.0)
    Thyroglobulin: 7.7 (2.0-60.0)

    Prolactin: 19.1 (1.6-18.8)
    Insulin: 5 (6-27)
    HDL: 38 >39

    VAN

    Last edited by van7771; 02-17-2006 at 04:09 PM.

     
    Old 02-17-2006, 05:45 PM   #9
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    Re: Thyroid Problems?

    Van, my gosh, I hate when a person is sick and a dr says time for the psychiatrist!!! I had that happen to me for years and it is very frustrating and you start thinking you are loosing all credibility with your dr, don't you? I used to go home and wonder if perhaps I was crazy and this is what it felt like when a person was starting a nervous breakdown.

    My largest nodule is the one that was causing the problems. I had been sick though for a long while before it got that big. Also, I had no antibodies for the longest time and hashi's was diagnosed through the biopsy.

    Ok, alot of people do not have antibodies for a good while and in fact about 10% NEVER develop them.. The fact that you have some at all is indicative of hashi's. Mine were always 3 with a range of less than 2 or 10 with the range of 0-20. Then, after about 2 years they went haywire. You also would not have had antibodies "in" your thyroid. Your thyroid would have had lymphocytes in it with hashi's, not antibodies, so what I want to know is did they check for lymphocytes? Do you have a copy of your surgery path report?

    SSRI's also can cause goiter so any dr who would suggest that you start them while you already have thyroid nodules is NOT very well versed in thyroid issues! Anti-d's are linked to thyroid problems. We have had several threads on here about those of us who took ssri's and had thyroid issues. I being one of them.

    Now, as far as your labs, your tsh is elevated!! Most feel best with a tsh of around 1, and I read in some of my literature that men more commonly than women need their tsh supressed. He is totally off base there. Your free t3 could also come up some. Perhaps you need your free t3 at the top of the range, I know I do. Mine has to be around 4.1 to feel my best. You dr is also using antiquated ranges. The tsh cap is now 2.5 even by the AACE!
    Finally I see he does NOT bother to run a free t4 test and that is the real indicator of how you might be feeling. Again, I need my free t4 at the top of the range as well. My tsh is only .75 ( at least at my last test) and that is fine.

    I think you are still caught in the same trap as you were, you just don't have a dr who knows the right info about thyroid. I know once I got in with the right one, as soon as she saw I had nodules on my thyroid it was all together different then. It didn't matter what my labs showed because she knew I was dealing with something and she was rigth. It did take another year and a half for my antibodies to show up but she was right all along.......................

    Now, as far as the hurthle cells I have read over each of my books and they all state that any hurthle cell detection in a biopsy is reason for a TT. Hurthle cells as well as follicular cells CANNOT be determined benign or malignant 100% until the thyroid tissue and nodules are out and under a different kind of biopsy, not the FNA which is all that can be done with the thyroid in place.

    This guy really mislead you. Actually on my biopsy it specifically says *IMPORTANT* NO hurthle cells detected...............suspected follicular adenoma.......suggestion: repeat biopsies or removal for definitive diagnosis.

    Notice I had no hurthle cells??? He told you the wrong information. Any surgeon knows that follicular and hurthle cells come out, if they don't know that then they do not have their ducks in a row!

    Van, be tough, do not let some dr push you into psychiatric care with meds that will aggrevate your thyroid!!

    Love and prayers to you Van, I sure have been there!
    Karen

     
    Old 02-17-2006, 07:39 PM   #10
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    Re: Thyroid Problems?

    Karen:
    I believe you and thanks for your reply, once l left the doctors office l felt like l wanted to die. I yelled at this doctor today, l told him l am sick of getting the run around, l told him that l had been to 4 different endo's in the area and each one of them said something different and l was sick of all the different answers. I asked him who to believe him or all the other doctors, l said how can all of you be experts but yet you all have different answers and none of them are the same. I straight up said who should l believe you or all your other endo friends. When l left the office he wasnt to happy with me because l layed into him for about 15 minutes. I really am sick of the run around, l payed this guy $400.00 for what? I wish l really could find a doctor who knows what there talking about, l get so many different opinions. I know for a fact that my problem wont be fixed with anti-depres, these guys just dont get it.
    As far as my pathology report goes, the doctor today was saying that because my biopsy from the O.R. didnt show anitiboies l therefore dont have hasi's.
    I told him l had talked with several people who had normal Thyroid levels and no antibodies and they had their Thyroid taken out and that solved their problems and his responce was. Then there biopsy from the O.R would have shown Hashis and your didnt so you dont have Hashi's or any other Thyroid problem. He said the only time a Thyroid should be taken out is if the nodule is cancerous or the nodule gets so large it cant be contolled. Thats the only time a Thyroid should ever be taken out. He said there are thousands of people with nodules and they are just fine, he said nodules are very common, and almost never cause problems. He also layed into me about the Thyroid leves, saying that if your Thyroid levels are normal they wont cause hypo/hyper problems.
    So l guess thats my question are my labs normal, could they be causing hypo/hyper problems. And if they are normal how could that make me feel so bad.
    I found a free T4 lab that was taken in October of 2005:
    T4 Free 1.2 (.8-1.6)
    Free T3 3.6 (2.3-4.2)
    TSH 1.94 (.40-5.0)
    And then l took the Cytomel and my TSH jumped up to 3.5.

    Karen can you tell me where you found the info on Hurthle Cells and if you know where l can find info on reacting adversly to Thyroid Meds?

    Also here is word for word my biopsy report from the O.R. when my Thyroid was taken out on the Left Side, let me know what you think.
    The specimen is recieved fresh from the O.R. the specimen measures 4x3x2 cm. The specimen is serially sectioned to reveal a peripheral, well defined and circumscribed, tan, solid, diffusely hemorrhagic nodule which measures up to 1.5x1.4x1.2 cm. The nodule grossly abuts the surrounding capsule margin.
    Final Diagnosis: Thyroid, left: Follicular adenoma with extensive hurthle cell metaplasia.

    So thats word for word what my biopsy said, my nodule was different than yours, the nodule causing all your problems was vascular if l remember and mine wasnt, does that mean anything?
    I will not give up but today l sure wanted to, thanks again for all your continued help, if you could let me know where l can find that info l would appreciate it.

    VAN

     
    Old 02-17-2006, 08:31 PM   #11
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    Re: Thyroid Problems?

    Van,

    I cannot post web addresses here, but if you look online there is more than enough info on hurthle cell and follicular cell growth. There is info in black and white all over the net about the importance of hurthle cells and follicular cells. My dr;s all knew this, thank goodness. In fact when my surgeon saw that I had follicular cells he insited the thyroid come out that week. Both my endo and surgeon knew that. My surgeon even mentioned the improtance of the fact I had no hurthle cells. I think you need to put some time into researching this so you can print off material and take it with you. Make them argue against written info. I wish I could pass along all the info I have but alot of it I got off the net and you can get the same stuff.

    I tried to explain the labs before................your tsh is ELEVATED, meaning it shows you are HYPO. Also, your free t4 is only mid range and most need theirs in the upper third. How you get mid range is to add the lower number to the highest number in the range......then, divide by half. That is your mid range and you are going to want your numbers OVER mid range. Your free t4 might need to come up quite a bit..............

    Van................your dr is WRONG, your labs show hypo! Elevated tsh + low free t4 + low free t3 = hypo.

    Again, your biopsy would NOT have shown antibodies................it would have shown lymphocytes, NOT antibodies. Did they check for lymphocytes?

    My FNA showed lymphocytes infiltration, that is how I was diagnosed with hashis. At that time my antibodies were perfectly normal.

    I think you just need to keep doing the dr dance...............I went to more than 10 to get to the right ones..........I live in a VERY tiny town so keep looking..............there are way more dr's than there are GOOD dr';s, keep that in mind!

    Can you go to a bookstore this weekend and go to the health section and get all the books out on thyroid issues and go to the back of them and look up hurthle cell and follicular cell nodules? That would help you alot.

    Karen

     
    Old 02-17-2006, 10:06 PM   #12
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    Re: Thyroid Problems?

    Karen:

    Ya l will do that l also found on the healthboards a site where people post articles and websited and have started reading this information. I have a few books like:
    Thyroid Power and Hypothyroidism the Unsuspected Illness, l have read both of these books and l will go find more.
    I really would like to find articles that tell me why l reacted to Thyroid Meds the way l did. In all my reading everybody talks about how your just take Synthroid and that fixes the problem, but it didnt fix it for me. I know you had the same problem and l would like to find some articles that l can take to the Doctor and say here look at this your wrong and look at his article on Hurthle cells your wrong, just like you said.
    In looking through my FNA and Biopsy there is no mention of Lymphoctes, l would think this means there were none?
    I also went back through my blood work and looked for Lymphocytes and found the following, not sure if it has any meaning:

    June 2003
    Lymphocyte # 2.8 (.8-3.1)
    Lymphocyte % 28.9 (14.7-42.8)

    Nov 2004
    Lymphocyte # 2.0 (.8-3.1)
    Lymphocyte % 47.4 (14.7-42.8)
    Granulocyte % 43.8 (44.0-76.0)

    I have been tested several times after this and my Lymphoytes are in normal range?

    Karen l hope its okay that l continue to ask questions, l am trying my best to put this all together and the fact that your patient and willing to help really is a huge help. I really do thank God every night for people like you, your an answer to my prayers. I will see what l can find and let you know, once again thanks and God Bless.

    Thanks

    VAN

     
    Old 02-18-2006, 07:32 AM   #13
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    Re: Thyroid Problems?

    Van, YOU ask me as many questions as many times a day as you need too! That is what we are here for. I know it would be easier if we could post websites and personal info so we could contact each other but since we cannot we are going to have to just work that much harder together. I plan on spending today doing some research on your behalf. I will dig through my books and papers seeing what I can find, ok? I used to go to Barnes and Noble and get the huge cafe mocha from starbucks and sit in there for 3 or 4 hours reading their books. I found all kinds of useful info.

    Listen, I had the same trouble as you. I was told my biopsy was fine and that was that. I posted on this very board and a gal on here who had just had the same biopsy as me told me that my dr was wrong and I had to follow up with follicular cells. She even printed off my biopsy and took it to her dr for me and he told her to tell me it had to come out regardless of what dr's here were saying. This board started me on the rigth track, not dr's. I then had to find dr's here who knew it had to come out. So I was in the exact same boat as you are now. Dr's telling me one thing and me getting different advice here. I knew the advice here was the right advice though so I had to follow up on it. Once I got into the good dr's here though they confirmed what I had been told here all along. I know how hard it is Van to be told one thing by dr's and one thing here, but really, all my time here I have never seen anyone get the wrong advice! Usually once a person gets their advice here they feel they have their answer and only have to find a dr who knows the right way.

    Don't ever feel like you are asking too many questions...............I constantly check to see if you have posted..........I am here for you and am glad to help you get to the bottom of things..........

    Like I said, let me dig out all my papers and books and see what I can find for you. That is what I did.....................I took an article from Hopkins to a dr and showed him where it said "follicular cells in nodules should ALWAYS come out"................he was so flustered and I told him to please tell me how he expected me to think him right instead of Hopkins!!! He got so mad at me and that showed me he was wrong. hahaha

    Here for you always.
    Karen

     
    Old 02-18-2006, 11:19 PM   #14
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    Re: Thyroid Problems?

    Karen:

    Thanks for your help, whatever you can find that would be helpfull would be appreciated. Today l was thinking about what that Doctor said to me yesterday about how l had depression. Well l dont disagree with him l think l do have depression and alot of other mental crap, but l think its coming from the Thyroid.
    This doctor asked me if l had a girlfriend and l said well kind of its tough to have a relationship when everthing is second to getting better, he then asked me if l had sexual desires and l said well ya but not like l should, l asked him when you feel like crap do you have sexual desires and l think from those responces he though l was depressed.
    These doctors just dont understand, l wish they could feel this pain and maybe then they would understand.
    I just know that SSRI's are not the answer and l wish DR's could figure that out, he was so convincing for a while l actually thought about taking them, you second guess yourself. Anyway sorry for going off l just have been thinking alot about this lately and have been somewhat frustrated.
    Again Thanks Karen and l will look for your post with any info you may have found.

    Thanks:

    VAN

     
    Old 02-19-2006, 05:54 AM   #15
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    Re: Thyroid Problems?

    Van.............

    I finally found my "big box" of thyroid articles. I moved in January and hadn't come across that mess. I did find it in the garage today. I will read up on it today. I asked a friend of mine I saw today ( she had thyroid cancer) and told her about your situation. She said that ANY hurthle cells are like follicular cells..................they like to take out the whole gland. She too was surprised that they had left any part of your thyroid in considering what a troubled biopsy you had.

    Listen, of course you are depressed...........but not getting diagnosed properly and being left hanging healthwise MAKES a person depressed!!! I was too. In fact I was put on Celexa and it did nothing but make things 10 times worse for me! You do NOT have clinical depression though. You have a depression brought on by deep frustration with your unanswered health issues. Don't let them fool you. Of course you don't feel like having sex at the drop of a hat, who does when you are so bogged down with your health issues, unanswered questions and endless symptoms that are worrisome! Dr's love to put us in to the "depressioin" catagory because that gives them an answer to give us and they hope we will get off their back and get on some kind of medication. Anti-depressants are not meds to mess around with. If you do not need them they can mess you up. I had the awful time of having to withdraw from Celexa once I got my real answer, and it was like coming off heroin! I would never do it again. I should have never been treated with anti-depressants, I was not depressed in that sense.

    Give me some time to shift through all these papers and see what is what. I also have all my labs here if you want me to post them so you can see that my labs were perfect where at least yours show some hypo going on................

    Karen

     
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