Results: slow thyroid, low D, Hashimotos, and 1 thyroid nodule and 2 possible parathyroid adenoma's

Hi, recently I posted that my TSH was up to 8.4 and I was going to follow up with GP. He ran more blood tests (mid day) and this time the TSH was 5.25 high range of 5.01. My Vitamin D was 26.8 range 30 -100 IU/ml, TPO 234 High, T3 free was 3 range 2.0-4.4 PG/ML, T4 free .9 range .8-1.5 ng/dL. My thyroid uptake scan after taking Iodine-123, 6 hr uptake is below at 4.8 % normal range 5-19% and 24 hr uptake is below at 8.3% with normal range 12- 33%. Is this enough for treatment? On another note, Ultrasound showed Hashimotos on both lobes and also three nodules 2 of which they think are parathyroid adenomas. I was diagnosed Hyperparathyroid just last year and had one parathyroid removed they didn't mention these others then and I'm a bit confused because I always thought it took years for them to form and I think I read that 3-4 adenoma's are rare, so if two more are bad then that leaves possibly one normal one and is it most likely bad too? Anyone ever had this to happen to them. I did ask the Radiologist if they looked cancerous and he said he didn't think so, not sure where to go from here. Im scheduled next week for a parathyroid scan (sestamibi). Any suggestions?

15 Replies

  • Hi Jean43

    I cannot answer your question as I am hypothyroid but in the meantime till a member responds this is a previous post which might be helpful.

  • Thanks Shaws, for the link, I'll give that a look. I understand the parathyroid issue is something that not many have experience with, but what do you think as far as treatment for the thyroid goes based on what I've shared. Do you think I need thyroid meds? Also, what do they usually do with thyroid nodules if anything. I know that if the 2 are parathyroids they'll want to remove them, but I don't know what they normally do with thyroid nodules.

  • This is a link re thyroid antibodies. If you have antibodies you have an autoimunne thyroid disease called Hashimoto's so they must have tested your antibodies to give you that diagnosis. Some doctors don't prescribe for antibodies but Dr Toft of the British Thyroid Associations says re antibodies:-

    "But if it persists then antibodies to thyroid peroxidase should be measured. If these are positive – indicative of underlying autoimmune thyroid disease – the patient should be considered to have the mildest form of hypothyroidism.

    In the absence of symptoms some would simply recommend annual thyroid function tests until serum TSH is over 10mU/l or symptoms such as tiredness and weight gain develop. But a more pragmatic approach is to recognise that the thyroid failure is likely to become worse and try to nip things in the bud rather than risk loss to follow-up.

    Treatment should be started with levothyroxine in a dose sufficient to restore serum TSH to the lower part of its reference range. Levothyroxine in a dose of 75-100µg daily will usually be enough."

    This is an excerpt re Thyroid Nodules and if you have Hashimotos you should be on levothyroxine to try to prevent antibodies attacking your thyroid gland although you will become hypothyroid eventually.

    Thyroid nodules are classified cold, warm, or hot, depending on whether they produce thyroid hormones or not. Cold nodules don’t produce thyroid hormones. Warm nodules act as normal thyroid cells. Hot nodules overproduce thyroid hormones.

    Most thyroid nodules are not serious and don’t cause any symptoms. It’s possible for you to have a thyroid nodule without knowing it. Unless it becomes large enough to press against your windpipe and hamper your breathing, you may have no symptoms. Your doctor may be able to feel it during a physical exam.

    According to the American Thyroid Association, about 90 percent of all thyroid nodules are benign—in other words, noncancerous (ATA, 2012).

    What Causes Thyroid Nodules?

    The majority of thyroid nodules are an overgrowth of normal thyroid tissue. What causes the overgrowth of tissue is not known.

    Nodules are often found in people who have Hashimoto’s disease, an autoimmune disease that leads to hypothyroidism. Individuals who have thyroiditis (chronic inflammation of the thyroid) are also prone to developing thyroid nodules. If you have a diet low in iodine, you may develop thyroid nodules. This isn’t as common in the United States as it is in other countries because of the wide use of iodized salt and iodine-containing multivitamins.

  • Hi Shaws,

    I did test positive for antibodies TPO at 234. I know I've had them since at least 2012. I do remember the report stating that the nodules were neither hot nor cold, so I'm assuming then they are warm. It's good to know that they are usually benign. That eases my mind some. Thank you!

  • As for thyroid..your TSH, both, show hypothyroidism. Ft4 is low also. I don't know why they made you do an uptake scan. With Hashimotos, you are supposed to give thyroid treatment, which will slow or stop the attack on your thyroid. It can also shrink any nodules and take down or completely stop, swelling of the thyroid gland. You may need to find a new doctor as if this one hasn't started treatment, he really doesn't know what he is doing.

  • Hi faith63, thank-you for your response. I'm beginning to think so too, because I've been gaining weight like crazy and am just so tired all the time. The weight seems to be all going to the belly and feels so abnormal. It seems Dr's differ so much on when to treat, but with the fluctuating tsh levels wasn't sure if it would make it go the other way and make me hyper which I would hate those symptoms more, I think.

  • Some people, like me ordered our own tests..TSH is not nearly enough to tell what is happening...and then ordered our own meds. Meds should be t3 or contain t3, not the Levothyroxine they only prescribe, especially close minded in the UK.

  • Hi Jean,

    I don't understand these units for your "vit D" measurement. You wrote:

    "My Vitamin D was 26.8 range 30 -100 IU/ml". Please check - did it not say "ng/ml" ?

    In any case that range ( - if in ng/ml) may be TOO high FOR those suffering from certain types of inflammation causing conditions ( - said to be a Th1 type condition) according to some ( - quite convincing ?) authorities.

    More info easily found by a search of say "vitamin D inflammation Th1" etc.

    There are also Y'tube videos on this stuff, including one by Capt Tom Perez from 2008.

    Hope that helps - wonder if this may offer an alternative view of your health issues ?

  • Hi Epictetus,

    Yes, your right it was NG/ML. My C-RP was high too, and I figured it was probably related to the thyroid. Although, the Dr. checked for that marker after they found antibodies that are related to a liver autoimmune condition. Thanks for the info, and Im definitely interested in the inflammation connection.

  • High CRP can be an indication of inflammation, as can an elevated ESR, I understand.

    I'd suggest you become familiar with this body of medical opinion, before considering what to do, especially INCREASING "vit D" levels, including by supplementation, as many would be advised to by well-meaning practitioners, unfamiliar/UNAWARE with this viewpoint.

    A more recent paper can be found by searching "Fearless Parent Vitamin D November 2014 Meg Mangin" List of refs at end will lead to other more technical documents, if required.

    A "vit D" blood level of 27ng/ml converts to ~ 67.5nmol/L, which by some reference ranges is fine ( - 50-125nmol/L, seems a common UK ref range). I wonder if you've been taking "vit D" in any form ?

    Good luck with your investigations !

    BW !

  • Yes, I was taking vit D. At least, when I remembered to take it. My count last time was 19.1.

  • Hi Jean,

    (Was the 19.1ng/ml the previous reading ? In which case the 26.8ng/ml reading, more recently was an increase on that; is that what you're saying ? ).

    The most important thing is IF you have this "vit D" dysregulation issue they are talking about, even a reading of 20ng/ml (= 50nmol/L) would be considered UNHELPFULLY high by this group of experienced clinicians ( - which I feel is worth considering further) and contrasts with the opinions of others who don't seem to really acknowledge/understand this "vit D" dysregulation, being caused by the immune response.

    It is the blood levels of the activated "vit D", the 1,25(OH)2D as you will read/see, in the blood which appears to matter in how well we feel - and THAT is usually NOT measured, in part because it is so unstable. Look at what is being said about the ratios of the "storage" (calcidiol) to the activated (calcitriol), which is different in those people who have this "dysfunction" to those who don't.

    Take care !

  • This is interesting Epictetus.

    Do you think Vit D could be increased once the TH1 inflammation had decreased or is it an ongoing condition?


  • Hi Flower !

    Yes, its v. interesting - to me, what this group of people is saying is FASCINATING and pretty much opposite to the mainstream, although the immune system forming the activated "vit D" molecule appears to be fully established.

    You won't have to go far into this body of work to understand that when the underlying infection is resolved/substantially reduced, the immune response ( - which is activating the storage from of the "vit D") shuts down and so the observed "vit D" dysregulation no longer persists. Learn, learn, learn . . . . . if this applies to you, and you've not got anywhere with resolving long term ill-health issues, this I feel is one important area to carefully consider, especially if inflammation is suspected and confirmed.

    Start off with the Fearless Parent article and the Ytube videos, perhaps ? Will be pleased to read your considered comments, in due course.

    Good luck.

  • Yes, the 19.1 was the previous reading. I started supplementing but not very well, which is why it came up only to 26.8. Im going to have to do some more research on this, I guess, what your telling me does go against everything that I've been told or read recently, but I'm open minded and will definitely read up on it. If you have any other scientific studies that support that theory. I would love to read them.

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