Hashimoto's at 19, thyroid ultrasound showed only one lobe at 26

I was diagnosed with Hashimoto's at 19 and had a fairly rigorous thyroid examination at a specialist centre in France at the age of 26 (I was living there at the time). The copy of the letter to my then GP said:

"However, [the ultrasound] showed a thyroid reduced to only its right lobe. The total volume of the thyroid was 7.9 cm3, or half of a normal thyroid. It is generally of hypoechoic echogenicity, as can be seen in these thyroid deficiencies of autoimmune origin."

(Slightly stilted translation all my own work.)

Is it possible that I was actually born with only half a thyroid gland in the first place, if absolutely nothing could be seen of the left lobe? Or could the Hashimoto's have ravaged the left lobe so completely that nothing was left to see? If the former, then frankly it's amazing that I managed to make it to 19 without overt symptoms. If the latter, it would be interesting to see what an ultrasound would show now as the Hashimoto's has gone about its business merrily for another 12 years!

7 Replies

Hose, Hashimoto's atrophies the thyroid gland until it shrivels to a small nut of fibrous material so I think it has likely destroyed your left lobe. If you are on thyroid medication this will have slowed progression of the disease and may have delayed or stopped atrophy of your remaining lobe. Or, the right lobe has also been destroyed and your needs are being met by thyroid hormone replacement.

But would the atrophied left lobe, if indeed that is what has happened, show up on an ultrasound examination?

If it were there, but it appears that yours has gorn.

I think it's not necessarily surprising that you didn't have symptoms till you were 19. The output of the thyroid is more down to how hard it is being kicked by your pituitary than its actual size. What was left of your thyroid worked hard enough to keep your body going fine until you were 19. Some people have part of their thyroid surgically removed due to cancer or something else but what's left is enough for them not to need medication. Other people can't function on half a thyroid. As your antibodies chew away at the rest of your thyroid you will probably need increasing levels of medication until you are on a full replacement dose (if you aren't already).

Ha! I have no idea whether I'm on a full replacement dose yet or not. The bloody thing has a mind of its own and drives me up the wall with its fits and starts... There have been times when I've been stable for years and thought that was that, all done and dusted, only for things to break down again. Currently on 150mcg levo per day, have a feeling that I'll need at least 175mcg (a dose last seen when I was 11 stone and pregnant; now 8-ish stone and most definitely not having any more). Grumble grumble grumble

150mcg isn't all that high. Some people take 200 or 250mcg. The fits and starts are, I think, typical of hashi's - the antibodies attack in fits and starts and each time a bit more of your thyroid stops working so you need a higher dose. On the brighter side you are only 8ish stone. I should be 8ish stone but being hypo left me at 13 (although lets be honest, after having 4 kids getting down to 10 stone was always been an achievement for me). Down to 12 now and falling very gradually.

"Down to 12 now and falling very gradually"

Sounds like the shipping forecast! :)

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