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  • newbie... feedback on my lab results

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    Old 05-11-2013, 08:08 PM   #1
    thrifty82
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    newbie... feedback on my lab results

    Hello,
    This is my first post!

    A little back story...
    About a 1-2 months ago I noticed a large lump on my neck. I also began experiencing severe fatigue and just felt terrible in general (neck pain, headaches, foggy memory/focus, shooting pain in legs/feet&wrists/arms, weight gain). Also, thyroid issues run in my family.

    I went to my primary care doctor and she could see the lump in my neck before even touching it. After she felt it, she said it was easily 3cm. The next day I went for blood work and ultrasound. I am now waiting to here from the endo for an appointment (it has been almost 2 weeks!).

    The only thing they told me about the ultrasound is that it showed a single large nodule on my thyroid.

    I have a copy of my lab results, but nobody has told me anything yet. I have to wait for the endo.

    If anyone has any thoughts, insight, knowledge to share...I would appreciate it very much.

    I had a CBC, TSH, CMP, urine test
    Here are my numbers that were out of range: (none were severely out of range so does it even mean anything?
    RDW 15.8 (11.5-15.5)
    SEG 71 (45-65)
    TSH 3.94 (.36-3.74)
    Osmolality, calc 276 (278-305)
    SGOT 14 (15-37)

    Thanks

     
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    Old 05-13-2013, 08:44 AM   #2
    midwest1
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    Re: newbie... feedback on my lab results

    Only one of those test results has to do with thyroid... TSH. It's higher than the average healthy person's, which means you're extremely likely to be hypothyroid. You need to have your actual thyroid hormones - free T4 and free T3 - measured. TSH is a pituitary hormone and only an indirect indicator of your thyroid status.

    The nodule is a separate issue that has nothing to do with blood hormone levels. It will have to be evaluated for possible malignancy, but try hard not to worry excessively about this. The odds of cancer are low. And even if it happens to be cancer, the cure rate is high.

    Wait times for endo consultations can be long, due to the shortage of MDs in that speciality. But do keep checking on them to be sure you haven't gotten lost in a crack somewhere. It does happen.

    Let us know what happens next.
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    Old 05-13-2013, 11:28 AM   #3
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    Re: newbie... feedback on my lab results

    I agree that TSH is high, and with additional labs, you should likely be put on treatment. With a large nodule, tests specifically for that will be done, and should include anti-thyroid antibodies for autoimmune thyroid disease, Hashimoto's. Your fatigue will improve once treatment has begun. The others are mostly borderline. The osmolality reflects state of hydration, and you may be overhydrated. Are you drinking tons of fluids? If so, just back off a little and let thirst be your guide.

     
    Old 05-13-2013, 09:26 PM   #4
    thrifty82
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    Re: newbie... feedback on my lab results

    Thanks for the feedback! I am anxious for any news. I was starting to think the doctor forgot about me, so I called the dr office on Fri. They didn't forget...the specialist has not had time to look at my file yet...so I am still waiting. I figured they will have to do more blood tests....yuck! It it normal to have days when I feel "okay," and then other days I do not have any energy at all?? The past few days my neck has not bothered me.....no choking feeling...but I still feel and see the lump in my neck. Is this normal?

    Here's to hoping I hear from the Endo. tomorrow!!!
    Thanks again for your responses!

     
    Old 05-14-2013, 01:44 AM   #5
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    Re: newbie... feedback on my lab results

    If it is Hashimoto's, there is inflammation in the gland, which can fluctuate in severity. Inflammation produces certain chemical byproducts called cytokines that cause fatigue. So yes, varying energy levels are normal, and on the days you feel more ntired, you can try taking an antiinflammatory like OTC naproxen. That can help plus can relieve the choking sensation somewhat when the gland is more swollen.

     
    Old 05-29-2013, 12:36 PM   #6
    thrifty82
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    Re: newbie... feedback on my lab results

    I'm still waiting
    My appointment with the endo for biopsy is next week.
    I finally have a copy of my ultra sound report from last month (they will do another
    with the biopsy).

    Results:
    Right lobe 2.1x2.5x5.8cm
    Findings: 1.9x2.8x3.4cm mildly complex but mostly solid nodule
    Of somewhat inhomogeneous echotexture. No other discrete nodules.
    No abnormal calcifications identified.

    Left lobe 1.4x1.7x4.8cm
    Findings: some inhomogenity of echotexture noted.
    No discrete nodules or mass. No abnormal calcifications.

    What does this mean?

     
    Old 05-29-2013, 12:38 PM   #7
    thrifty82
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    Re: newbie... feedback on my lab results

    I'm still waiting
    My appointment with the endo for biopsy is next week.
    I finally have a copy of my ultra sound report from last month (they will do another
    with the biopsy).

    Results:
    Right lobe 2.1x2.5x5.8cm
    Findings: 1.9x2.8x3.4cm mildly complex but mostly solid nodule
    Of somewhat inhomogeneous echotexture. No other discrete nodules.
    No abnormal calcifications identified.

    Left lobe 1.4x1.7x4.8cm
    Findings: some inhomogenity of echotexture noted.
    No discrete nodules or mass. No abnormal calcifications.

    What does this mean?

     
    Old 05-29-2013, 08:06 PM   #8
    thrifty82
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    Re: newbie... feedback on my lab results

    (sorry for the double post)

     
    Old 05-30-2013, 02:30 PM   #9
    gloom
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    Re: newbie... feedback on my lab results

    I think the English translation is. One mostly solid nodule, with some fluid filled spaces. Typical stuff. You need an FNA biopsy to look at the cells making up the nodule.

    The right side of your thyroid that only notable thing is the "inhomogenity of echotexture" Means that the thyroid tissue doesn't look as smooth like it should. That could be suspicious for autoimmune disease.

    The biopsy is usually not much to worry about. They use a very fine needle to snag some cells to look at. Usually doesn't hurt. Most of the time it's not cancer. And most (99% or more) thyroid cancer responds to treatment and the treatment isn't very nasty.

    Blood tests you'll probably have are TSH (again) T4 and T3, the last two are actual thyroid hormones. And thyroid antibody tests to look for autoimmune disease.

    It's possible you have beginnings of autoimmune disease (Hashimoto's). Also possible especially if the nodule has recently hemorrhaged internally (common) that your thyroid might be a bit unhappy and not producing enough hormones for a bit. One thing to remember some people may have higher range TSH values and that's normal for them.

    Good luck, I know waiting is annoying, but pretty typical for endocrinology.

     
    Old 06-02-2013, 09:39 PM   #10
    thrifty82
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    Re: newbie... feedback on my lab results

    Thanks for the info

     
    Old 06-13-2013, 05:06 PM   #11
    thrifty82
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    Re: newbie... feedback on my lab results

    Ok...just an update.

    I had the biopsy and it came back inconclusive. I am still awaiting for the results of my antibody test, but he suspects an autoimmune disease too. My endo had recommended a total thyroidectomy. I meet with the endo surg. next week.

    I had another ultrasound and here are the results:

    FINDINGS:
    The right lobe measures 5.3x3.1x2.3 cm and the left lobe measures
    4.9x1.6x1.1 cm. The isthmus measures 4 mm in thickness. There is a
    large predominantly solid echogenic nodule replacing most of the
    right thyroid lobe that has a peripheral hypoechoic and hyperemic
    halo measuring 3.8x2.3x2.9 cm. The background thyroid parenchyma is
    slightly hypoechoic and heterogeneous. No additional discrete thyroid
    nodules are present. A small rounded right level VI lymph node
    measures approximately 5 mm. Additional benign-appearing cervical
    lymph nodes are noted bilaterally.

    IMPRESSION:
    1. Large predominantly solid echogenic nodule replacing most of the
    right thyroid lobe measures 3.8 x 2.3 x 2.9 cm. Further evaluation
    with ultrasound-guided fine-needle aspiration is recommended.
    2. Sonographic findings compatible with mild underlying chronic
    autoimmune thyroiditis


    I would appreciate thoughts, suggestions ect....
    Thank you everybody for your feedback.

     
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