Ultrasound Results Normal, Confused

[Andyb1205]

Got my ultrasound results, still no idea what the heck hit my thyroid hormones if not Hashimotos. Ugh. Results:

The right lobe measures 38mm in length and the left measures 37mm. The isthmic region measures 3mm.

No cystic or solid masses of other thyroid abnormalities detected.

Normal bilateral lymph nodes noted.

All other findings are unremarkable.

Summary: Normal thyroid ultrasound.

So fricking confused. In 2013 was the beginning of a horrible tonsillitis, had a tonsillectomy 6 months ago. I’ve considered that may have resulted in thyroiditis (hence increased TSH 8 months apart and decreased T4/T3) but does not explain the 70 pounds gained in 6-8 months in late 2008 to early 2009. Only half of that period I was sedentary (laid off work), otherwise was getting a good workout at the warehouse job.

I really hope that weight gain wasn’t due to lifestyle, when the tonsillitis hit years later I may have hurt my thyroid by prematurely going on 125mcg NDT. The way I see it, going off of thyroid medication could be a repeat failure, lost 2 years can’t lose 2 more (going off then going back on to the dose), only variable now is I have no tonsils. Bringing up my T4/T3 could be done sooner and I can see how I feel.

Only evidence I have is anecdotal, how I felt going off medication (weight gain, sleeping 12-16 hours, muscle cramps, barely digest food, waking up at night with pelvic/back pain trigger to go to washroom, same symptoms before going on NDT) and how I’ve been feeling as doses increased.

Only thing I can think of in regards to nutrient deficiencies since my Ferritin has always been fine (triple digits until very recently at 75) and Vitamin D is fine is the B12.

My first B12 result was 457 (156-698) but the supplements could’ve interfered, most recently 4 months ago was bit over range (discontinued supplements some months before that but may have lingered in system) but 2 years ago it was barely in range 166 (153-655). Will need to retest it soon.

I also have non-alcoholic fatty liver though that’s a chicken or egg question. Does the liver simply affect T4 to T3 conversion or can decrease both hormones?

Also diagnosed with PTSD, can that stress factor decrease thyroid hormones?

Having an MRI in December to investigate Temporal Lobe Epilepsy, can that affect thyroid hormones?

Seeing a Gastroenterologist in August. Have tested negative for Celiac and Lactose Intolerance, Hydrogen raises suggesting SIBO though I’ve read that can be connected to Hypothyroidism.

Off of thyroid medication (both before NDT (so before 2014) and when was off of it (2016) my digestive symptoms were similar to gastroparesis which I’ve read can be linked to hypothyroidism. Hard to digest food, several bowels, this however improved with thyroid medication (to at least reach formed and regular albeit constipated stools). But this can go back to the liver and again, chicken or egg dilemma.

Have considered that me and my brother should see a neurologist to investigate possible muscular dystrophy disorders. But I don’t see how that would decrease thyroid hormones, rather only increases chance for Hashimotos.

I considered that the chance to develop Hashimotos may run in the family, my brother who is 11 years younger has TPOab 32 (<35) though thyroid function fine for now. I do need to get my mother to check her thyroid function. The ultrasound report could be false but sometimes the most simple answer is the best.

I had created a thread earlier if you’d like to check the history of labs, but to sum it up.

TSH hits 5.30 and 4.20 8 months apart in 2013-2014, T4/T3 at 36%/24% of range, went up to 125mcg/2grains NDT for 2 years.

Manipulated to go off of it (TSH suppressed but T4/T3 in bottom third, barely in range B12, undiagnosed Vitamin D deficiency).

3 weeks later TSH restores to 2.50 and remains that way, meanwhile over 8 months T4/T3 (with unchanging TSH) were dipping to bottom/below range to finally stabilize at just below third of range (had regularly been on B12, B-Complex, and Vitamin D during period, Iron fine).

Convinced doctor to trial me on Synthroid, on ADHD stimulants TSH drops ~1.5 points and remains around ~0.50 with no subsequent rise in T4/T3. TSH remains around ~0.50 on dosed 75mcg, 88mcg, 100mcg though improved symptoms in relation to, IMO, slowly moving FT4. Finally climbed to 112mcg Synthroid, TSH now 0.26 (just under range), T4/T3 at 37%/36%. Since TPOab and TGab in range, ultrasound performed and found normal ruling out Hashimotos.

[Rmichelle]

Hi there i see you have put the same post up 3 times, it can take anything from 5mins to 5hours to receive a reply sometimes, hang on in there and you will get a reply.good luck🌟🌟

[helvella in reply to Rmichelle]

Sometimes multiple posts are simple mistakes. However they come about, three identical posts cause confusion, especially if responses are spread across multiple threads.

For that reason, I have switched off replying on the two posts/threads which have not yet received any responses.

[Rmichelle in reply to helvella]

Thanks hevella, i just thought if someones new here they might expect to get a response straight away and if they do not hear they write another one. Xx

[Andyb1205]

Very interesting and confusing at the same time here.

“Clinicians should be particularly alert to the possibility of thyroid dysfunction in obese patients. The problem lies in identifying obese subjects who are affected by mild thyroid hormone deficiency On one hand, raised TSH may be a just a functional consequence of obesity. On the other hand, thyroid failure, especially the subclinical form, may go undiagnosed in patients.”

ncbi.nlm.nih.gov/pmc/articl...

However, in these cases mentioned where obesity led to a rise in TSH, Free T3 was also increased, both reducing after weight loss. That said, if I do not have positive antibodies and the ultrasound is normal then perhaps I don’t have Hashimotos.

What angers me is that this whole process began when the doctor I saw in 2014 not only said my TSH of 4.20 is fine rather than further investigating for Hashimotos. He turned down my request to have my Vitamin D checked because “that’s uncommon in Canada.” Instead he offered me antidepressants. I would’ve stuck through with getting the Vitamin D stabilized first. Since I was already dieting and exercising my ADHD driven self instead ran to a Naturopath. 😡

[Andyb1205]

Would be open to any suggestions on how to proceed. I will discuss this with my doctor, there’s a thyroid patient recommended GP I’ll also see soon for another opinion, and am in the waiting list to see a thyroid patient recommended Endo in Vancouver (for starters he prescribes T3 and listens to symptoms). Trying to explore if I should stay on medication until I see that Endo, or even possibly dose to bring up the Frees meanwhile.

Much appreciated, thanks!

[Mamapea1]

Andyb1205 ~ Imust confess I haven't read through all your posts, but I've skimmed over a couple of them, and you have had some good advice from members in the past 👍. My knowledge of thyroid disorders is fairly limited, and mostly confined to my own experiences, but I have suffered for many years from hypothyroidism😥.

It may be that you're searching too hard for an answer to your problem ~ I myself have had to self medicate with T3 after 25 years of inappropriate additional diagnoses and damaging prescriptions, and I was DIAGNOSED with Hashimotos in the beginning!😕.

I still don't KNOW for certain WHY this happened to me, and why I can't be completely well on T4 when some others are,but the fact is, I'm not, and it has caused me many problems. I may have resistance problems, slight genetic quirks, could be any number of related differences between myself and others.

We're all different, and respond to meds, illnesses and stresses differently and sometimes we end up being beyond the comprehension of Drs and their somewhat staid tests. My thyoid tests have looked perfectly fine on many occasions, and yet on T4 I feel just as ill when TSH is undetectable or over 100!😳

So the point is, we have to do whatever we can to get ourselves well ~ get all vitamins and minerals optimal, (and keep them there), heal gut issues and have a healthy diet ~ no PUFA oils, gluten, etc., daily gentle exercise, and try whatever thyroid hormones that make us feel well, whatever they may be.

Searching for a definitive answer can be like chasing unicorns, you may never find it, and you will just become more stressed and ill as time goes by. Thyroid problems can be massively affected by stress ~ I know this from personal experience😰.

Any physical (infections) or emotional stress can seriously compound thyroid issues so your PTSD is definitely a factor, unfortunately. I'm sorry you have that, and that you've been subjected to a stressful childhood😔.

However, as mental health issues used to be treated with T3, you may find it will help with this too, especially if combined with some GOOD counselling👍. I hope your new Dr will help you with this, and prescribe some T3 and address your SYMPTOMS, regardless of specific tests and other 'reasons'.

Failing this, why not source your own T3, stay on this forum for advice on dosing, etc., and judge by relief of symptoms, and metabolic clues. It really does sound like T3 is what you need.

Apologies if you've heard all this before, in other replies, but just my opinion. I do also think you need some help with the PTSD ~ it needs to be addressed, just as much as anything else.

I hope you won't worry too much about the reasons (although I do understand ~ I have many questions myself), but just concentrate on trying the T3, starting with very small doses ~ you may find everything so much easier to deal with then.😊 Good luck with the new Dr. 🍀

[Andyb1205 in reply to Mamapea1]

I really appreciate the kind! I’ve read that child abuse can affect many parts of the body including brain chemistry or even similar to brain trauma, that can explain a hypothalamic cause.

It really is like chasing unicorns at this point. Closest evidence I found for my biochemical presentation was this.

“On serum samples, the diagnosis of CH is usually suggested by the finding of low FT4 concentrations associated with low/normal TSH levels (60, 61). Nevertheless, some CH patients with a predominant hypothalamic defect have high serum immunoreactive TSH levels but are devoid of full biological activity. In these cases, TSH elevations are similar to those generally found in subclinical or mild primary hypothyroidism and may lead to the misdiagnosis."

academic.oup.com/jcem/artic...

"Moreover, serum levels of TSH are

usually low to normal, or even slightly elevated, in patients with tertiary (hypothalamic) hypothyroidism. Tertiary hypothyroidism can be misdiagnosed as a condition of primary hypothyroidism. Therefore, measurement of circulating anti-thyroid autoantibodies and thyroid ultrasonography should be carried out in every patient with central hypothyroidism."

qbpatologica.files.wordpres...

[Andyb1205]

Is it suggested to increase the dose in small increments like 12.5mcg or 25mcg?

Feeling so tired and cold these days, growing impatient. These will be 5 tough weeks before I do the labs, might just ask the doctor if I can do it a week sooner!

I am just so confused, lost, frustrated and trying my best to remain optimistic but physically am horrible. I screwed up so badly these past 5 years, wish I had taken the time to find this forum sooner and properly plan my steps.

A couple years ago I was finally feeling optimistic as I was ready to get serious and stop self medication, was at a decent weight 40 pounds lighter. But stupid me decided to make a plan to go off NDT because doctors know best. I thought it’s a win win situation where either the doctor is right and I didn’t need thyroid hormones or at least he can see himself the drastic worsening of my health and use his brain putting one and two together. But he just gave me the middle finger despite seeing me for a year and half and said I don’t want to see you again. Told my mother that even if the Prime Minister himself called him he won’t see me. Idiot could’ve been up front about me needing a firm diagnosis from the beginning instead of leading me on, trialing Synthroid until my TSH is suggestive of hyperthyroid... with T4/T3 at third of range!!!

Life was going great, got into McGill, then I don’t know what the hell happened to my body. It’s a testament to courage of the human spirit that so many on this forum have suffered for not just years but decades. We all have been so mistreated by the so-called experts, discriminated against for a condition we didn’t choose to have.

[ondrej41]

There can be another explanation of elevated TSH without signs of Hashimoto - elevated cortisol

ncbi.nlm.nih.gov/pmc/articl...

[Andyb1205 in reply to ondrej41]

I have had all of the pituitary tests done, was all fine I’m afraid. There is an idiopathic cause but whatever it is, I need to focus on simply raising the thyroid hormone levels.!

[ondrej41 in reply to Andyb1205]

Well, it says, about elevated in range cortisol, not extremely. Just thought it might be interesting.

[Andyb1205 in reply to ondrej41]

Ah I missed that part. Will give it a thorough read!