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    Old 03-01-2009, 03:35 AM   #1
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    sndky HB User
    Question Low TSH and nodules

    Tomorrow I am going to the specialist with my blood test:
    TSH .05 (low)
    fT4 1.3 (normal)
    No symptoms

    I need help from the members of this board. I need to know what to expect. I have good insurance and often was sent to tests that were not needed.

    Here my questions:

    Is U/S always needed when TSH is low? Or people with high TSH also get U/S?

    Is low TSH always a sign of nodules? Or nodules can be found also if TSH is high?

    Could my TSH be low because I am fighting a cold?

    What normal fT4 with such low TSH means? That the problem somewhere else in my body?

    Please help me to understand.



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    Old 03-01-2009, 07:17 AM   #2
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    Re: Low TSH and nodules

    Unless you have palpable and /or visible swelling on the neck, the ultrasound is not the second step in your case.
    Low TSH with normal T4 is usually indicates subclinical hyperthyroidism.
    The next step can be the RAI scan --- low uptake indicates thyroiditis
    High uptake indicates possible Grave's disease
    High uptake in one spot indicates hot nodule [adenoma], which can be found by neck inspection.
    Additional bllod tests can be recommended
    thyroid antibodies
    ESR rate [to diagnose subacute thyroiditis which can be complication after respiratory infection]

    Old 03-01-2009, 08:16 AM   #3
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    sndky HB User
    Re: Low TSH and nodules

    Thank you very much for your quick response. It is very helpful to, at least, have an idea what to ask the doctor.

    I have only one other question. When my MD ordered full Thyroid panel the lab did only TSH and fT4. Why ther is no fT3 nor others?

    Thanks again,


    Old 03-01-2009, 09:51 AM   #4
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    Re: Low TSH and nodules

    Each lab/doctor has their own idea of what a "panel" consists of. It's an imprecise term that usually results in inadequate testing. Insist on that free T3 test.

    To answer a couple of your original questions:

    Having a cold doesn't affect TSH.

    TSH has nothing directly to do with nodules. Many people who have totally normal TSH and no thyroid disease have thyroid nodules which never cause them an iota of trouble.

    As I mentioned in another of your threads, low TSH combined with normal thyroid hormone levels (T4 and T3) can indicate a pituitary gland problem. But don't get too far ahead of yourself; wait and see what the thyroid tests show first.

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