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nainai 06-30-2012 10:44 AM

I don't know how to figure the lab results out.
My Tsh, 3rd generation came back to be .59 and the reference range is .50-4.30 according to the sheet my doctor's office printed out for me. My T4, Free was .9 with the ranges of .8 - 1.8. I also had an ultra sound a few weeks ago that indicated my right lobe of the thyroid is enlarged measuring 5.4 X 1.4 X 1.7 cm. There were some ill-defined hypoechoic densities in the right lobe of the thyroid that may represent small adenomas. The largest measures 1.3 X .8 cm.

The left lobe of the thyroid is enlarged as well measuring 5 cm X 1.5 X 1.7 cm with at least one small hypoechoic nodule in the left lobe.


1. Considerable enlargement of both lobes of the thyroid with several small nodles in the right lobe with the larges measuring 1.3 cm.
2. One small hupoechoic nodule also seen in the left lobe.

I requested that I see an endo. My family doctor has not commented on either the lab results or the ultra-sound. Lab test were completed on June 8th, and ultra-sound on 6/13 of 2012. I had been cleaning and found some old lab test and an mri from 2004 & 2009 that suggested I needed to keep an eye on my thyroid is the one of the reasons I had requested them to be ran again. I had felt so bad for so long (healthwise) that I have just gotten use to the fact that I have no energy, headaches, losing hair, brain fog-unable to concentrate, weight gain (workout 5 days per week since June 2011), constipation unless I use phyllium, sweat embarassingly like a pig.. Things like that for years. I just wonder if some of those symptoms have anything to do with my thyroid. I can post the labs and mri from 2004 & 2009 if it may be helpful.

Thanks for any help anyone can give.


ladybud 06-30-2012 11:01 AM

Re: I don't know how to figure the lab results out.
With an enlarged thyroid with nodules, it is likely you might have Hashimotos thyroiditis, an autoimmune disorder common in women that can start out with hypERthryoidism (overactive) and eventually turn to hypOthyroidism(underactive). I would request thyroid antibodies to be run on your blood as well as a free T3, to go with your TSH and T4. Previous test results would be helpful (please post labs normal ranges too) to see how things have changed. An endocrine referral would be appropriate after these tests are back. A simple goiter (enlarged gland) can be caused by iodine deficiency, so be sure your salt is iodized. There is a "goiter belt" geographically in the US where the soil is iodine deficient, and those people are particularly prone to goiters if they don't use iodized salt for basic prevention.

nainai 06-30-2012 11:47 AM

Re: I don't know how to figure the lab results out.
In 2004 the TSI was 89% Baseline with the range of <=125. The Thyroid Peroxidase Antibodies was <2 iu/ml and the range was N <2. The Thyroglobulin Antiobodies was <2 iu/ml and the range was N <2. The FNA of the Right lobe of the thyroid gland in 2004 showed 1.43 cm slightly inhomogeneous nodule in the mid portion of the right lobe with the aspirate bloody. The cytology later showed 7cc of slihtly hazy brown fluid. Two smears and cell block show a mixture of blood, macrophages, lymphocytes and occasional neutrophills. No malignant epithelial eliments are identified.

I had an mri done in 2009 due to migraine headaches and problems with my neck. 1.2 cm cystic focus in right lobe showed up and a recommendation for further examination requested, but never pursued.

Does this seem like I have just a goiter due to iodine problems?

nainai 06-30-2012 11:50 AM

Re: I don't know how to figure the lab results out.
Also, regarding the results of the current tsh, 3rd generation and the t4, free test, when my doctor's office called to give me the results, they told me they were within the normal limits and not to be concerned.

bee01 06-30-2012 01:42 PM

Re: I don't know how to figure the lab results out.
Nainai- though your TSH is low and might lead some to believe your levels were close to hyper, your Free T4 shows that you are hypothyroid.

It's very difficult to understand why the TSH sometimes does not correspond with low thyroid hormones. Sometimes, levels like yours indicate a problem with the hypothalamic-pituitary axis. In other words, your hypothalamus is not sensing the low hormones and stimulating the pituitary, or the pituitary is not picking up on cues from the hypothamalus to produce more TSH.

I don't know if it's common to have a problem with the HPT axis as well as the thyroid (evidenced by the MRI), perhaps someone else can share some light here.

I am unfamiliar with TSI tests but if I had to venture a guess (probably not a good idea), I would say that the TSI antibodies are suppressing the TSH and causing hypothyroidism? Hopefully one of the veterans will chime in here and add to the discussion.

nainai 06-30-2012 04:32 PM

Re: I don't know how to figure the lab results out.
Thanks so much for the replies ladies. I really appreciate your help with this.

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