Blood in normal range- large goitre- vitamin B low

[Nattii]

Hi everyone,

I'm really confused and I hope someone can help or offer advice.

I have been suffering with symptoms of underactice thyroid for over 10 years. Each time my bloods are in range (last one TSH 3.2 and T4 18.

My GP has continually refused to refer me to endocrinolgy and told me I'm depressed.

Saw a consultant for something unrelated and he saw on an ultrasound that my thyroid was swollen and referred me.

Endocrinology consultant said my bloods etc were fine but I had a very large goitre and has prescribed thyroxine to try and shrink it. Also a barium swallow and ct scan to see if it is pressing on my gullet/windpipe.

Also he stated that my vitamin B level (didn't say which one?!)was 0.20, can that be right??

He has said I need to contact my GP as he will ask that I start therapy for this right away.he says he's prescribing 20,000 units.

I guess my questions are;

Can I have a goitre and have normal thyroid function? And what will happen if it doesn't shrink?

What therapy is it I'm starting and why am I low on vitamin B?

Haven't managed to speak to my own GP to ask questions yet as they haven't received any information from the consultant.

Sorry that was long!

[greygoose]

But you don't have normal thyroid function. You are in-range, but the ranges are wrong. You are hypo as soon as your TSH hits 3 - but no point in trying to tell a doctor that, they just have no idea what it's all about and are fanatical about ranges.

I would imagine the B vitamin he tested was B12. That's the one that is usually tested. But, I don't understand the result. Is it really zero point two? How is that even possible? And if that is true, you should be tested for Pernicious Anemia straight away, and put on weekly injections, never mind a piddling little... what is 20,000 units? What a unit? Normally, with a very low B12, you would want about 50,000 mcg daily sublingual methylcobalamin. I think you ought to check up on that result. Ring the endos secretary, and ask her to send you a copy. It's your legal right to have one.

Most hypos are low in vit B12, because hypos usually have low stomach acid, and can't absorb it. But, if you have autoimmune thyroiditis - did they test your antibodies? - then you could also have pernicious anemia.

[Nattii in reply to greygoose]

That's what I thought re the vitamin B, he rang me yesterday with the result so I was writing it down as he was telling me and he said 0.20. No explanation of the units etc just that he would tell my GP to get it started.

Tried to call GP today but they hadn't received his fax yet. I'm hoping they will have it tomorrow and I can go in and speak to someone who can explain it better.

At the beginning of my appointment he told me there was no way he would be prescribing me any thyroid meds with my current blood results even though I had nearly all the symptoms. He said antibodies were slightly up but nothing that concerned him.

It wasn't until he saw/felt my goitre that he changed his mind.

[greygoose in reply to Nattii]

So, you do have Hashi's! Autoimmune thyroiditis. If your antibodies are over range, then you have it, whether he's concerned about it or not! That's what ranges are for. And, as you do have Hashi's, it's only right that you should be starting levo now, to nip it in the bud, so to speak.

In that case, you really do need to be tested for Pernicious Anemia, because once you have one autoimmune disease, you're likely to get another. Make sure your doctor does it.

[Nattii in reply to greygoose]

Thank you so much 😊 I will definitely make an appointment to discuss things in more detail then.

[greygoose in reply to Nattii]

You're welcome. Good luck!

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It is perfectly possible to be in the normal ranges with a large goitre, but your TSH is not normal, should be a lot lower than that. I was diagnosed as euthyroid with a goitre which was gradually strangling me. I am unsure as to how effective taking levo would be regarding a goitre, 'cos I was never offered any. I can, however, say that you will not get surgery until your situation gets to the point of being worrying. You would be very aware of it if the goitre were constricting your breathing as it would affect your speaking, a bit like John Wayne, needing 2 breaths for a short sentence. Surgery is dangerous.