Am I better off without seeing a doctor?

[AliHy]

Hello

I have a lump on my thyroid which the ENT consultant said was a multi-nodular goitre. I said I didn't want an operation as it wasn't affecting my voice or breathing. When I asked if it was associated with my lowering TSH levels he said he didn't know and that I would have to ask my GP. I have had a couple of blood tests when it was found that my TSH was lowish (0.33 in July 2015 and down to 0.11 in September 2015). My TF4 for the same period went from 15.5 to 17.4 which I gather is considered normal but is obviously going up slightly. Since seeing the ENT consultant for results of the biopsy and scan at the end of January nobody has been in touch. I had naively assumed that the GP would get back in touch when the results came through but I don't think that that is going to happen.

I'm now feeling very much better after several months of acid reflux, which an endoscopy showed was not caused by anything serious. Omeprozole and other ant-acids made me feel really ill and I started to get burning mouth syndrome. Following advice on this website I started taking the occasional betain capsule, using lemon juice or cider vinegar, cutting out grain and taking Vitamin B12. The burning mouth has gone and I have only had one episode of reflux in a couple of months, so is a great relief. The doctors have all said that the three things aren't connected but I gather from this website that they can be.

Over the last year I have also lost about one and a half stone in weight which has been great but if I lose any more I will be underweight. At the moment though it has settled and I am feeling really well. This may be associated with cutting out grains, white sugar and rarely drinking alcohol. However, I have had more frequent bowel movements in the last two years and frequently pass small, pebble like floating stools (although I do not feel constipated). An investigation of this 2 years ago showed nothing serious although I was told I had a contracted gall bladder. Nobody has been able to explain why as I don't seem to have gallstones.

What I am curious about is whether all these things are connected and if so, what I should do about it? This website seems to imply that they can be, but I haven't been able to put it all together. I would suspect that I am in danger of becoming hyperthyroid but if so, would this cause the acid reflux (which I thought was caused by a slower metabolism associated with being hypo). Also - should I go back to the doctor and demand more blood tests or just leave it? Having changed my diet I am feeling really well. I don't want to be put on any medications unnecessarily which may have side effects. After my experience with Omeprozole I'd prefer to stay off them if I can.

Be grateful for any advice

Thank you

[Heloise]

Hi Ali, I have to commend you on the changes you have made and the improvements that followed on your own. It's great. Some experts feel hypothyroid is still the core condition even with hyper symptoms. There is a paragraph about nodules in this article:

stopthethyroidmadness.com/t...

Lecithin helps with a fatty meal if you have a sluggish gall bladder.

Without knowing your FT3 level in spite of a good TSH and Free T4, it's hard to tell if you are optimal with your thyroid output. It's important in so many ways. This short video explains how it affects serotonin when you have low FT3.

youtube.com/watch?v=nZ_CP7l...(Not working as expected?)

[AliHy]

Many thanks Heloise - I found the information really useful. The video about serotonin and thyroid really makes sense as I haven't been having any energy dips since giving up sugar, and also have been feeling much more buoyant.

[Clutter]

AliHy, Did your ENT indicate whether you should have follow up checks on the multi nodular goitre as you've declined surgery for now? TSH 0.11 and FT4 17.4 are euthyroid so you don't currently need thyroid or anti-thyroid medication. Your weight loss is probably due to your dietary changes. If you are becoming underweight you may need to eat more to maintain weight.

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I am not a medical professional and this information is not intended to be a substitute for medical guidance from your own doctor. Please check with your personal physician before applying any of these suggestions.

[AliHy]

The ENT consultant wasn't helpful at all. He just asked me if I wanted it removed or not but didn't give me any information to guide me. I asked what would be the implications of having it removed and he said all operations carried risks. I also asked about the implications of not having it removed and he said that there would only be a problem if it grew and affected my voice or breathing. So I didn't really decline it, I just wasn't given any reason to opt for it. When I asked if it was linked with the lower TSH he said he wouldn't know and that my GP would need to go into that out with me. At my previous doctors I was asked to come in every 6 months for a blood test just to monitor these levels. but the surgery I have swapped to hasn't asked me back in, nor has there been any follow up after these tests. Having never had any health problems until the last year or so (I'm now 57) I don't know how things work. I don't want to be negligent and not go back if I should do, but as I am actually feeling well I don't know whether I need to go back and ask to be monitored.

[greygoose in reply to AliHy]

If I were you, I'd go back in three to six months, and ask for the normal thyroid tests, plus antibodies : TRab to see if you have Graves (over-active thyroid) and TPOab and TgAB to see if you have Hashimoto's (Under and over active thyroid).  

[AliHy in reply to greygoose]

Thank you - that's confirmed what I was thinking I should do. In the meantime I'll aim to keep feeling well.