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Nervous wreck...

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Old 09-13-2008, 10:50 AM   #1
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TraumaJunkieVA HB User
Unhappy Nervous wreck...

Hi Everyone!

I was told that I had an enlarged thyroid in May after going to the ER for something completely unrelated. I did not have insurance at the time and just continued to monitor it myself until my new insurance became active (I did not want to have it labeled preexisting if I did need treatment). In the last couple of months my thyroid has about doubled in size of what it was before... I have gained almost 30lbs, am cold most of the time, my hair is coming out by what feels like handfuls (enough to clog the drain during my daily shower and I shed horribly), have no energy, and just feel like crap. I had contributed a lot of it to just starting a new job (with a long commute) and the stressful transition it has been. I had an appt yesterday with my new family doc for my thyroid though to finally get it checked. My mother was diagnosed with thyroid cancer about 2 years ago so I have been very paranoid for the last couple of months. It has gotten to the point that it is hard to swallow and if I do anything to exert myself I have some difficulty breathing (which is not good when I work in the ER)... the doc ordered labs and an ultrasound. I went over to the hosp and had my labs done... and was able to go back yesterday evening and pull my results from the computer... my ultrasound is scheduled for next week.

My results:
TSH - 2.01
T4, total - 8.92
T4, free - 0.93
Sed Rate - 11

I spoke with one of the surgeons I work with earlier this week. He basically told me that if my labs came back normal it would depend on the ultrasound results but given a family hx of thyroid cancer and the breathing and swallowing difficulty I would likley have to my thyroid remained.

I guess I am just looking for more support than anything... and any other advice anyone can share with me.


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Old 09-13-2008, 12:23 PM   #2
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Re: Nervous wreck...

Hi there! I just read your story. I am so sorry you feel like crap. I don't know too much about the numbers of your tests but I kind of thought 1.0 to 5.0 was a normal range for the TSH. Mine have been falling in the middle of that for the last two test in the past year. However right now I feel like CRAP!! My hair is also falling out onto everything. Long strands on my clothes, in the hairbrush, in the car ...etc.. That freaks me out. I am so tired! I started a new full time job a month ago too. I can barely stay awake at work. I try so hard not to nod off. It is taking forever to get over this ear infection and fluid in my ears is just not clearing up and I am dizzy. I just REALLY feel like my thyroid is way out of whack again. I got tested yesterday and have to wait several days for the results. I just feel in my heart and body that I will have to up my dose again. ugh!! I just hate this.

So just know you aren't alone. I have stuff to do this weekend and I just want to lay on the sofa and nap. This makes me depressed. Let me know what they decide to do with you. Try not to think you have thyroid cancer. Hang in there!

Old 09-13-2008, 02:29 PM   #3
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Re: Nervous wreck...

We need to know the lab's reference ranges for the tests in order to compare your result to where it falls within the range. Ranges vary; there is no one standard.

What I can tell you is that if your gland is diffusely enlarged all over - think 'swollen' - there is very little possibility you have thyroid cancer. If you have nodules - lumps and bumps that protrude from the thyroid gland's surface - there is a slightly higher chance you do, but it's still a very small chance. Don't worry until it's time to worry. And it isn't yet.

Sure... A surgeon would tell you you need surgery without knowing as much as one second fact about thyroid disease... LOL. Don't worry about that yet, either. So-called "normal" labs are often meaningless.

Your TSH is on the high side of normal. A healthy person without thyroid disease has TSH of about 1, no more than 2. But... your free T4 is at the bottom of the typical lab range [Let us know that range if you have it.], which means that the high-ish TSH is an attempt by your pituitary to get your thyroid gland to make more hormone than it is now. This call to work overtime can enlarge the gland and cause the choking feelings you've been having.

The ultrasound will show if you have any large nodules that need to be biopsied. You also must have thyroid antibodies checked. For hypothyroidism, these would be anti-TPO and anti-Tg tests. If present, these antibodies would explain the reason for the hypothyroidism and swelling.

Also very helpful would be a free T3 test to go along with the free T4.

If you don't have any troublesome nodules, and if you are hypothyroid (as I feel you are), the gland swelling might subside once you've taken thyroid replacement for several months.

A very useful book to explain all this in a way that's probably clearer than mine -- Thyroid for Dummies by Dr. Alan Rubin.

Let us know how the tests come out!

Last edited by midwest1; 09-13-2008 at 02:29 PM.

Old 09-13-2008, 06:13 PM   #4
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Re: Nervous wreck...

Thanks for the info and support!!!

I do have the full results in front of me. I will put my values again with the reference ranges for easier comparison.

TSH 2.01 (0.35-6.20mcgiu/ml)
T4, total - 8.92 (4.5012.0mcg/dl)
T4, free - 0.93 (0.71-1.85mg/dl)
Sed rate nonautomate 11 (0-20mm/hr)

The surgeon actually suffers from hypothyroid so I trust that he may know a little more than just any surgeon out there... and he did say that it would all be pending the ultrasound results, etc. His biggest fear is just the all around size of it right now and the fact that it does play into my breathing pattern... and if we cant get it reduced by other means in a timely manner, etc. Like I said it has at least doubled in 4 mos if not more. It does seem to be somewhat uniform but there is one side of it that is noticeably larger than the other. I just keep telling myself that I wont know anything until probably Tues afternoon/wednesday about the ultrasound (and that is just by me going in and pulling the results from the computer at work)... and most likely wont hear from the doctor about his interpretation of it all until some time closer to the end of next week.

Old 09-14-2008, 12:07 PM   #5
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Re: Nervous wreck...

Yeah... It's as I thought. Your free T4 level is only 19% of the range. A euthyroid person would be expected to have a level at least 50% of the range, usually even higher than that. Your gland has likely enlarged in an effort to keep up with your body's demand for hormone.

You will find that most MDs would tell you all your levels are "normal" and let it go at that. But there are some really smart ones around who know that they aren't "optimal", which is vastly different from "normal". Don't be put off by one who tells you that you don't have thyroid issues.

That surgeon may be your best hope of getting the right treatment. Don't lose contact with him. A doctor with his/her own case of thyroid disease can be your best friend.

Try your darnedest to get the antibody tests I mentioned. If you're told your levels are "normal", don't let it go at that. Seek as many opinions as it takes to get a prescription for thyroid hormone.
Good luck!

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