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Diagnosis: Mulitnodular Thyroid, Hashimoto's and HYPERthyroid?? and Anemia...

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Old 10-29-2009, 06:18 AM   #1
Join Date: Oct 2009
Posts: 8
DLynnK HB User
Question Diagnosis: Mulitnodular Thyroid, Hashimoto's and HYPERthyroid?? and Anemia...

Hi everyone!

I'm confused.

Here is a clip from my intro post (for background info):
During childbearing years:
- goiter during first pregnancy, diagnosed with "thyroiditis" (goiter went away half way through pregnancy)
- gained large amount of weight in first pregnancy
- lost large amount of weight after pregnancies
- extremely heavy (unmanageable) menstrual periods
- depression
- mental fog
- sensitivity to cold
- multiple miscarriages

- feelings of pressure in neck
- goiter (or perhaps nodule) has developed over past 2 weeks (uncomfortable to have lump in my neck)
- exhausted
- muscle pain
- weight gain over past year
- very dry skin/hair
- extremely heavy menstrual periods
- mental fog
- diagnosed GAD (with panic tendencies)
- depression
- feel unwell (flu like) all of the time
- sensitivity to cold (feel frozen all of the time now, just can't get warm)
I saw my new (we just moved here) family doctor on Monday and he commented on how many nodules and how much swelling I had in my neck. He took my med history and sent me for blood and an u/s that day.

His office called me the following day and told me that he wanted to see me ASAP, so I booked an appt. for the next day.

I was given all of my results and he said that I have a multinodular thyroid.
I now have a thyroid scan booked for this coming monday.

He also said that I was HYPERthyroid (what!!??). I was so surprised since I have been having HYPO symptoms for years.

He said that I have Hashimoto's and that I must be in the hyper phase of it. He also said that one part of my thyroid could be hypo, while the other part is hyper.
He said that I will most likely be hyper for a while and then gradually go hypo. He is referring me to an endo for management.

He is also concerned about anemia since my red blood cells are small.

So, I went for more blood work (b12) and booked a full physical for the week following my scan to get my results and followup on the new blood work.

He did say that I was "a mess", but that he was going to get to the bottom of my thyroid issues and my anemia.

I asked for my test results, but they don't make much sense to me, yet. Any insight would be appreciated!!:

sTSH 0.27 (L) (0.35 - 5.00)
T4 FREE 16 (10 - 20)
FREE T3 4.3 (2.6 - 5.7)

RBC 5.07 (H) (3.6 - 5.01)
MCV 75 (L) (80 - 99.0)
MCH 25 (L) (27 - 32.0)

My questions are:

1. How could I have so many hypo symptoms and be hyper thyroid?

2. Could the hyper reading be due to a thyroid attack (the goiter/nodules flared up 2 weeks ago)?

3. Is anemia a symptom of thyroid issues?

4. The doctor mentioned cancer several times...I'm scared...should I be?

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Old 10-30-2009, 04:23 AM   #2
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Re: Diagnosis: Mulitnodular Thyroid, Hashimoto's and HYPERthyroid?? and Anemia...

Sounds like your doctor is very on top of thyroid issues, so I would see where it goes especially if you aren't feeling right.

I think the symptoms of hyper and hypo (I've been both in my life) overlap, both can give you fatigue, weight gain, etc, so you can't determine by symptoms alone.

In terms of the word "cancer" don't even worry about that, you likely have "mulitnodular goiter" which is a lumpy bumpy thyroid, primarily benign. If you had only one or two nodules, I'd be more watchful than if it's many, then if any are over 1cm (you need an ultrasound) they should have a needled biopsy, but I don't think you have to worry about that issue at all. There are no symptoms for it, so your doctor shouldn't have even mentioned that word without an ultrasound---sounds like your doctor is very excitable in terms of thyroids, but maybe that's a good thing because there are a lot of undertreated people on this board.

Old 10-30-2009, 08:39 AM   #3
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Location: AZ
Posts: 2,251
javelina HB Userjavelina HB Userjavelina HB User
Re: Diagnosis: Mulitnodular Thyroid, Hashimoto's and HYPERthyroid?? and Anemia...

With Hashi's the antibodies will attack the thyroid and the die-off will release excess hormones into the system and cause some hyper-like swings. Many doctors take that as a sign to not treat the patient but to just "watch" it and wait for the thyroid to finally die. I've heard this approach likened to just "watching" as a dog chews off your leg.

The alternate approach is to somewhat rapidly replace your thyroid hormones with a T3/T4 preparation, preferably natural desiccated thyroid hormones or synthetics and once full replacement happens (as evidenced by an elimination of hypo symptoms) the signalling will cease to the thyroid and it will become inactive. Once the thyroid is inactive the antibodies will not attack it and the goiter and nodules should resolve. This will also result in a very suppressed TSH because the thyroid is inactive but as long as your symptoms do not indicate hyperthyroid and your freel T labs are not too high that is ok.

Regarding anemia, it's very common with hypothyroidism. You need to test your ferritin levels, which I suspect are very low and suppliment your iron. You also should test vitamin D and B12 levels as they are usually deficient. It's also a good idea in your case to test your adrenal function with a saliva cortisol test as long-term hypothyroidism can cause adrenal fatigue and this needs to be addressed before replacing thyroid hormones.

Old 10-31-2009, 10:56 AM   #4
Join Date: Oct 2009
Posts: 8
DLynnK HB User
Re: Diagnosis: Mulitnodular Thyroid, Hashimoto's and HYPERthyroid?? and Anemia...

Thanks so much for the information!!

I am looking forward to the results of my thyroid scan next week and can't wait to talk to my doctor about not taking the "wait and see" approach.

The type of anemia they have found (high rbc count, but blood cells are very small in size) is abnormal.
They are currently looking into Thalassemia, but I have found some info online that suggests it could be a symptom of celiac. Something they haven't tested for yet.

I'm already starting to feel more empowered with the information I have gained here...and less scared.

Thanks so much!!!

Old 10-31-2009, 08:28 PM   #5
Join Date: Nov 2005
Location: Texas, USA
Posts: 456
hyperkim HB User
Re: Diagnosis: Mulitnodular Thyroid, Hashimoto's and HYPERthyroid?? and Anemia...

Hi, I am not very knowledgeable on hashi's....but usually the FT3 & FT4 levels do better in the mid to upper range ~ which is exactly where yours are. And your TSH is only slightly low. Mine at dx was .007 (normal was around .75 at the time.) Where is the hyperthyroid part??? Sounds like TSH treatment. Just some food for thought.

Also, I had a lot of hypoT symptoms while in hyperT lab range. I was later dx with adrenal fatigue which has alot of the same "slowed down" symptoms as hypoT ~ lower body temp, chilling bp & pulse, dry skinm dry hair, etc. Not saying you have that, just saying there may be other underlying things going on, or the body's natural defense to offset and try to keep things on an even keel.

Hope this helps some...

ps....if you were dx with hashi's what were your anitbody levels?
Hyperthyroidism 11/05
Confirmed Graves Dx 1/06
Adrenal fatigue Dx 8/06
Fibromyalgia Dx 1/08
Chronic Fatigue Syndrome Dx 1/08

Last edited by hyperkim; 10-31-2009 at 08:30 PM.

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