Discussions that mention noritate

Thyroid Disorders board


MG-Still kicking around here with no surgery yet. Last week Fri. I had a biopsy--or I should say biopsies of the 3cm neck mass. Both the ENT that I consulted and the endo did not feel it was necessary because now they say the mass has to be removed and the rt. lobe at the least. Then see path. while I am on table. Well, I am waiting for my second opinion which won't be for nearly a month. But, after talking with the local thyroid cancer support group-they said where is your biopsy--you should have the biopsy. So, I called the endo and said I want a biopsy scheduled and it was done last Fri. Tomorrow I should know something more. The biopsy was not fun--he told me he would do 6 needles--well I didn't know that meant he would take 120 samples. I was so poked and prodded, the pain was really hard on me. But, the doc and the lab cytologist who put the specimens on the slides said the samples looked good. Meaning-adequate-I sure hope so.
Anyway, I will let you know how that goes. When I got up from the table and went to the bathroom, my face was beet red with like measles. I have had facial flushing and the derm has said rosacea --just use noritate cream and avoid triggers like hot drinks, alcohol, spicy food etc . But, my biggest trigger is fight/flight reaction and boy did the biopsy trigger my worst ever flare. There really is no med effective to prevent this kind of rosacea flare from what I have read. My pre biopsy xanax did nada. Soo...pursuant to reading I see the beta blockers esp. propranolol is useful in some people. Not used all the time but before the "event" which is likely to be a trigger. From what I recall you were scripted propranolol.
Do you take this everyday , or just for superstressed times--also what dosage and frequency?
Now the interesting thing that I read is that propranolol supresses conversion of t4 to t3 and my t3 is already much lower than t4. But....as this is only for occasional use--what difference could it really make AND it seems I will likely have a different thyroid situation quite soon.
So....question of the day for me
What do you know about propranolol screwing up the t4 to t3 conversion... If so, this is not a good thing ,right?
I hope this post finds you as it is buried at the end of this loooong thread.
MG-Still kicking around here with no surgery yet. Last week Fri. I had a biopsy--or I should say biopsies of the 3cm neck mass. Both the ENT that I consulted and the endo did not feel it was necessary because now they say the mass has to be removed and the rt. lobe at the least. Then see path. while I am on table. Well, I am waiting for my second opinion which won't be for nearly a month. But, after talking with the local thyroid cancer support group-they said where is your biopsy--you should have the biopsy. So, I called the endo and said I want a biopsy scheduled and it was done last Fri. Tomorrow I should know something more. The biopsy was not fun--he told me he would do 6 needles--well I didn't know that meant he would take 120 samples. I was so poked and prodded, the pain was really hard on me. But, the doc and the lab cytologist who put the specimens on the slides said the samples looked good. Meaning-adequate-I sure hope so.

Ugh! I am not envious of your proceedure. But I do think that you should get the bugger out. Just for the piece of mind and lack of bothr in the future.

Anyway, I will let you know how that goes. When I got up from the table and went to the bathroom, my face was beet red with like measles. I have had facial flushing and the derm has said rosacea --just use noritate cream and avoid triggers like hot drinks, alcohol, spicy food etc . But, my biggest trigger is fight/flight reaction and boy did the biopsy trigger my worst ever flare. There really is no med effective to prevent this kind of rosacea flare from what I have read.
I have Rosecea and my Dermatologist has me using Elidel and Metrogel. These are prescription creams/gels that you can apply 1 to 2 times daily. I also have been given progesterone for really bad flares. You can treat it.. it just isn't a permanant fix by any means. I use Elidel in the morning and at night and Metrogel in the evening after my shower. They have helped me immensely. Are you seeing a Dermatologist?

My pre biopsy xanax did nada. Soo...pursuant to reading I see the beta blockers esp. propranolol is useful in some people. Not used all the time but before the "event" which is likely to be a trigger. From what I recall you were scripted propranolol.
I was on inderal.. and it didn't do much for me. However i am now on the short acting beta-blocker pindolol. It is a kin to propranolol. I take it twice a day and it helps immensely. I only take 5 mg tablets. So it only takes 10 mg total each day to take the edge off of my flares. All in all my beta-blockers have only helped me. Mine I can go off of and go on half doses if my BP drops and HR drops. All in all it is easy for me to come off the pindolol. Some other beta-blockers have longer half-lives.

Do you take this everyday , or just for superstressed times--also what dosage and frequency?

It depends on your heart issue. If you have chronic high BP and HR then they would probably want you on a daily dose. If your issue is periodic.. a short acting lower dose on something like pindolol may be all you need.

Now the interesting thing that I read is that propranolol supresses conversion of t4 to t3 and my t3 is already much lower than t4. But....as this is only for occasional use--what difference could it really make AND it seems I will likely have a different thyroid situation quite soon.
Dito on Access. You are talking MEGA doses of propranolol. 150 mg or more. The standard token dose of 10 - 20 mg a day wouldn't affect things.

MG
MG-
So glad to hear from you again. I hope you are doing well. Thank you for your response.
I did get my biopsy results and it reads:
Right neck nodule,fine needle aspiration cytology.
-Consistent with origin in thyroid, low probability of neoplasm. See comment.
Comment:Aspirate smears shows follicular cells, Hurthle cells and abundant lymphocytes.
Colloid is also identified. The findings are consistent with lymhpocytic/Hashimoto's thyroiditis. No malignant cells are seen.
AND the FNA U/S report---
The previously identified 3x1x1 cm solid lobular right neck mass like structure adjacent to or projecting from the right thyroid lobe is again identified without evidence of significant interval change. The adjacent right thyroid measures 2.5x1x.09cm with diffusely heterogeneous echotexture and approx. 4 small (3-8mm) echogenic solid nodules without evidence for significant interval change. The left thryoid measure 2.9x1x1cm and appears stable with diffusely heterogeneous echotexture but without discrete focal mass effect . No psammomatous calcifications are present.

And a ct scan shows-- along the more inferior aspect of the rt. thyroid gland and just lateral to the thyroid gland and between the rt. common carotid and rt. vertebral arteries ,a soft tissue nodule most suggestive of a lymph node that measures 0.7x1.3x0.9 cm.Other small lymph nodes are demonstrated along the bilateral anterior cervical chains are sub cent. in size.
And a sestamibi-showed very little functional thyroid tissue to take up the thyroid pertechnetate tracer.
My endo seems to have given up on putting the bits of info together. And, while the biopsy came back benign....I have my appt. with the thyroid cancer spec. at the univ. who has had another radiologist review all cts. from Mar. and June and the U/S's and the sestamibi. Also they are requesting the tissue slides to look at those again. So, I expect that at the end of this month if all goes as planned, someone will have looked over everything and then there will be a plan based on the info. This has really been a long drawn out process to say the least. But having heard stories from some thyroid cancer surviviors, I am glad that there was no rush with the first surgeon's plan to just remove the mass and rt. lobe and then see if malignancy shown then take left lobe too. Otherwise to leave the left lobe. I still think the whole thing should go. It is not like saving the left lobe is saving a viable functioning lobe--the sestamibi showed little functioning thyroid tissue.
OK----now about the effects all this is having on my face.
Yes, I am seeing a dermatologist and she scripted noritate which is like metrogel but in a cream--my skin is very dry. Sometimes I think the noritate is irritating and have to lay off of it for awhile. Maybe it helps a smidgen--
I do not have a bp prob. at all and my lipid profile is great. I do get white coat hypertension. So, if I took a beta blocker for the emotional triggered rosacea flare it would just be on the occassion of a med appt/diagnostic procedure.
If I understand you , you are not taking the beta blocker for bp and it is just for the rosacea flare--is that right??
So now you say the propranolol /inderal---(same drug I think) was useless--was that useless as it related to your bp or rosacea?
The pindolol being short acting and short lived in your system from the roasacea flaring viewpoint sounds just like what I need.
Could you just clarify it is for the rosacea and not the bp that you are using it for???
Thank you so much!!! And, do you think your thyroid is going to be with you for awhile yet??
MG-So glad to hear from you again. I hope you are doing well. Thank you for your response.
I am doing alright. My computer had mouse issues.. then keyboard issues.. then transformer issues. So my ability to get on and check things has been limited. I went to see Dr. Lahkani in Vanderbilt today. He seems knowledgable, but does not believe in the FT3. He will run it.. he just doesn't think it is stable enough to be a reliable measure. We agreed to disagree there. Mine have been stable and consistant over a couple of years.. ;)

I did get my biopsy results and it reads:
Right neck nodule,fine needle aspiration cytology.
-Consistent with origin in thyroid, low probability of neoplasm. See comment.
Comment:Aspirate smears shows follicular cells, Hurthle cells and abundant lymphocytes. Colloid is also identified. The findings are consistent with lymhpocytic/Hashimoto's thyroiditis. No malignant cells are seen.

Okay so they are saying the thing is chewed up and not cancerous given the samples collected. Well that is good news.

AND the FNA U/S report---
The previously identified 3x1x1 cm solid lobular right neck mass like structure adjacent to or projecting from the right thyroid lobe is again identified without evidence of significant interval change. The adjacent right thyroid measures 2.5x1x.09cm with diffusely heterogeneous echotexture and approx. 4 small (3-8mm) echogenic solid nodules without evidence for significant interval change. The left thryoid measure 2.9x1x1cm and appears stable with diffusely heterogeneous echotexture but without discrete focal mass effect . No psammomatous calcifications are present.
This is a lot of doubel speak saying that while you have a wonky lymph node.. nothing is changing and thus it most likely is benign in nature. Malignant masses like to party and grow like crazy.. so say many MDs. I am not qualified to judge or make any other assumptions. I like facts though.. which require more in depth biopsy methods. ;)

And a ct scan shows-- along the more inferior aspect of the rt. thyroid gland and just lateral to the thyroid gland and between the rt. common carotid and rt. vertebral arteries ,a soft tissue nodule most suggestive of a lymph node that measures 0.7x1.3x0.9 cm.Other small lymph nodes are demonstrated along the bilateral anterior cervical chains are sub cent. in size. And a sestamibi-showed very little functional thyroid tissue to take up the thyroid pertechnetate tracer.

Okay translation. Your thyroid is about dead. Very little tissue is able to take in iodine and make T4. You thus should be mear completely dependent of T4 and T3 supplementation.

My endo seems to have given up on putting the bits of info together. And, while the biopsy came back benign....I have my appt. with the thyroid cancer spec. at the univ. who has had another radiologist review all cts. from Mar. and June and the U/S's and the sestamibi. Also they are requesting the tissue slides to look at those again. So, I expect that at the end of this month if all goes as planned, someone will have looked over everything and then there will be a plan based on the info. This has really been a long drawn out process to say the least. But having heard stories from some thyroid cancer surviviors, I am glad that there was no rush with the first surgeon's plan to just remove the mass and rt. lobe and then see if malignancy shown then take left lobe too. Otherwise to leave the left lobe. I still think the whole thing should go. It is not like saving the left lobe is saving a viable functioning lobe--the sestamibi showed little functioning thyroid tissue.

I support you there. I would be of the same opinion. Yank it all. However you have to go with what the MD is willing to do. It is not like we can perform surgery on ourselves.. thought it would be nice if they had one of those do it yourself thyroid fixer me bobs.

Yes, I am seeing a dermatologist and she scripted noritate which is like metrogel but in a cream--my skin is very dry. Sometimes I think the noritate is irritating and have to lay off of it for awhile. Maybe it helps a smidgen--

Have you been tested to make sure you are not allergic to the cream in the metrogel? You may need to go to a compounding pharmacy and get a specialized formulation to make sure something else isn't causing the issue.

I do not have a bp prob. at all and my lipid profile is great. I do get white coat hypertension. So, if I took a beta blocker for the emotional triggered rosacea flare it would just be on the occassion of a med appt/diagnostic procedure.
If I understand you , you are not taking the beta blocker for bp and it is just for the rosacea flare--is that right??

I am taking a beta-blocker for an orthostatic tachycardia issue. Basically if I am not laying down my heart rate goes crazy. So the beta-blocker is to keep my heart rate in normal limits while I am sitting and walking about during waking hours. Taking the longer acting beta-blockers depressed my heart rate and BP TOO much when I would lay down or sleep. My beta-blockers were not taken for rosecea.. only my elidel and metrogel are done for rosecea. My Aunt N gets rashes as a side effect of low Caritine production. Taking L-caritine helps control hers.

So now you say the propranolol /inderal---(same drug I think) was useless--was that useless as it related to your bp or rosacea?
I was given Inderal for migraines. It didn't help me there and while I felt no big difference while awake.. my sleep was disturbed greatly making it not effective for me.

The pindolol being short acting and short lived in your system from the roasacea flaring viewpoint sounds just like what I need. I do not know if this will help the rosecea. The pindolol being short lived helps me, by not depressing my HR and BP too much while I sleep. I think it might be one of the safer ones to try and see if it will help your rosecea. I would ask your MD's opinion on it.

And, do you think your thyroid is going to be with you for awhile yet??
ALAS, *sigh* My thyroid is a part of me still and no MDs are making any noise about allowing it to be removed. ;) If my mom or Aunt's had a historuy of medullary cancer.. well my Endo perked up on that one. But my mom's results are lost in the Gulf and my other Aunt just had papillary. SO.. not at added risk there. Right now he is all over my adrenals and pituitary gland. He did a bunch of genetic adrenal enzyme testing and more. So I am a guinea pig once more.

MG