Thyroid uptake scan - confused?

I received the thyroid uptake scan results and it shows borderline hypothyroidism, 6hr: 7% (5-20%) and 24hr 7% (10-30%). Also, shows a cold 2.2 cm nodule within right lobe, that we already knew about, plus four other smaller ones.

Labs show TSH 0.01 and t3 free and total and t4 free and total are "normal".

I'm knew and still learning, but does this info contradict, TSH shows over active and scan shows under? Thoughts on this would be greatly appreciated.

They are recommending biopsy of cold nodules. Any other ideas or tests people think should be preformed or things to be checked?

Many thanks!

5 Replies

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  • The TSH shows that the problem is either with your pituitary, or you hypothalamus, not your thyroid gland. Low TSH on its own does not automatically mean hyper, it's in conjunction with your Frees - the Frees would be very high if you were hyper.

    However, saying they're 'normal', is meaningless. What are the numbers and the ranges?

  • Thank you, Grey Goose. You mentioned pituitary in my other post and I have mentioned it several times to my docs, finally today they said they'd look into it, they don't know what tests to run for it. Do you know what would be good to check pituitary and or hypothalamus?

    I posted all the labs before so didn't know if I should include it again. Here they are:

    T3, free 3.9 (2.3-4.2)

    Free T4, index t7 2.6 (1.4-3.8)

    T4 thyroxine, total 8.1 (4.5-12.0)

    T4, free 1.3 (0.8-1.8)

    T3 uptake 32 (22-35)

    T3 total 114 (76-181)

    Thyroglobulin antibodies 1 (<or=1)

    Thyroid peroxidase antibodies 6 (<9)

    They are wanting to biopsy the 2.2cm nodule, is that a good idea or pointless if it's not the thyroid causing me problems?

  • Well, your Frees aren't in any way hyper - more or less mid-range. But, they aren't hypo, either. But, they don't correspond to your TSH. Very weird.

    I'm not sure of the tests done to check the pituitary - although the pituitary does secrete a lot of other hormones, so I think they check them. And also an MRI. He should send you to an endo for that.

    If the nodule is large, it's always worth a biopsy, just in case.

  • Thank you very much! An mri was mentioned, my doc wasn't sure but said she'd look into having one done, so sounds like that's good to do since you and her both mentioned it. On the web I found a bit about some of the pituitary blood hormones that can be checked. Also, a pituitary panel on blue horizon that might be on the right track for what they could do. Here's what the panel does: TSH, FSH, LH, Prolactin, Growth Hormone, Cortisol. Hopefully my docs do their homework over the weekend and come up with the right tests to run. Have the biopsy scheduled for Wednesday, might as well get it done for peace of mind then.

    I greatly appreciate your response!

  • You're welcome. And, yes, that BH test panel does sound the right one. :)

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