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    Old 04-19-2013, 12:09 PM   #1
    arabesque01
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    More help reading test results

    I am waiting for an appointment with an endocrinologist and getting frustrated with the lack of a response from my regular doctor. I have a very strong family history of thyroid problems with my mother, grandmother, and 3 of 3 aunts who all are hypo.

    After having recent thyroid-related symptoms increase, I requested a full thyroid panel. TSH tested in range at 0.97 (range 0.34-5.6), T4, total was 11.8 (range 5.0-12.2), T3, and total was 156 (range 87-178). Thyroglubulin AB was 24.3 (range 0-4.1) and TPO AB was 222.5 (range 0-5.6). Obviously the antibody levels are outside of range, but what about the other levels? I know that they are within normal, but they don't seem that far from the border either? Is it normal for TSH to be on the low side and T3 and T4 to be higher? I'm not sure I understand the relationship between them.

    I also went in for an ultrasound because my neck has felt sore/tight around my thyroid. The results are really confusing me, and I still have 2 weeks until my appointment. They are as follows:

    The right lobe of the thyroid measures 4.7 x 1.8 x 1.4 cm and the left lobe of the thyroid measures 4.7 x 1.8 x 1.3 cm. The isthmus measures 0.4 cm in maximal AP diameter. The thyroid parenchyma is diffusely heterogeneous with multiple nodules seen.

    The nodules they report are as follow:
    0.4 x 0.7 x 0.1 cm hypoechoic nodule in the upper right thyroid
    0.2 x 0.4 x 0.2 cm cystic nodule in the mid right thyroid
    0.3 x 0.5 x 0.2 cm cystic nodule in the upper left thyroid
    0.4 x 0.5 x 0.3 cm isoechoic complex nodule in the upper left thyroid
    0.3 x 0.2 x 0.1 cm hypoechoic nodule in the mid left thyroid
    0.5 x 0.9 x 0.4 cm isoechoic solid nodule in the mid left thyroid
    0.3 x 0.4 x 0.2 cm cystic nodule in the lower left thyroid
    0.8 x 1.1 x 0.6 cm complex solid nodule in the lower left thyroid

    There are no additional thyroid nodules or masses. There are no perithyroid masses or fluid collections.

    Doppler evaluation demonstrates minimal vascularity to the dominant solid nodule on the left with otherwise symmetric and normal vascularity to the thyroid gland.

    Impression: Enlarged heterogeneous multinodular thyroid. Ultrasound-guided fine needle aspiration of the dominant nodule on the left is recommended.

    What does heterogeneous mean here? Is my thyroid size normal? What about the nodules? There do seem to be a lot of them, but they also seem really small? If that's the case, can they really be what's causing my throat to feel swollen? The report recommended a biopsy of one of the nodules on the left, but is it big enough to biopsy, or does size matter? Does any of this look like it could be Hashi's?

    And by any chance could any of the GI problems (bacteria overgrowth in my small intestine), recurring skin rashes, or eye problems (recurring styes including one that has been there for almost 2 years and my eyes have been so dry and irritated that I can barely wear my contacts for longer than a couple of hours) be related to any of this? I would appreciate any help. I want to make sure I am prepared for my appointment and able to ask the questions I need since it is pretty hard to get into see the endocrinologist at my doctor's office.

     
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    Old 04-19-2013, 09:14 PM   #2
    FinnMaid
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    Re: More help reading test results

    Quote:
    Originally Posted by arabesque01 View Post
    TSH tested in range at 0.97 (range 0.34-5.6), T4, total was 11.8 (range 5.0-12.2), T3, and total was 156 (range 87-178). Thyroglubulin AB was 24.3 (range 0-4.1) and TPO AB was 222.5 (range 0-5.6). Obviously the antibody levels are outside of range, but what about the other levels? I know that they are within normal, but they don't seem that far from the border either? Is it normal for TSH to be on the low side and T3 and T4 to be higher?
    You really should get free thyroid levels checked (FT4 and FT3) tested to get a better picture. Total Ts easily gives inaccurate results with women especially on birth control (estrogen raises those total amounts). FreeTs would tell you how much of thyroid hormones is actually available for use. Usually TSH rises when freeTs drop with hypoT but sometimes this doesn't happen (one's pituitary gland may be a bit slow to react or there may be some other factors that affect the result), that's why one needs to pay attention to those freeTs too. If your TSH is on the lower side you would expect to see your FreeTs on the high side (and that would make hyperT symptoms more likely). What type of symptoms are you having?

    I'm not an expert on ultrasound results but I believe heterogenous texture means damage done to your thyroid by Hashimoto's thyroiditis (and you have high TPOAb too which also is a sign of Hashi's)

    Last edited by FinnMaid; 04-19-2013 at 09:21 PM.

     
    Old 04-19-2013, 09:36 PM   #3
    ladybud
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    Re: More help reading test results

    Your thyroid gland is enlarged with numerous nodules, so that would give you an abnormal sensation in that area. The antibody levels being high are consistent with Hashimoto's thyroiditis. The nodules, enlargement and discomfort all fit with Hashi's, which causes inflammation of the gland and eventual destuction of it. Your TSH and T3, T4 are inverse, so if TSH is low, T3 & T4 would be high. Yours are normal but borderline high in the normal range. Some people do experience a hyperthyroid phase with Hashi's early on, then develop hypothyroidism later. The solid nodule is big enough for a needle biopsy. It is reassuring that that nodule has low vascularity, making benign a more likely scenario than malignant. Hope this helps until your app't with endo.

     
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