Can someone interpret this ultrasound - Thyroid UK

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Can someone interpret this ultrasound

sbadd profile image
13 Replies

Is it possible that my thyroid is releasing excess???

ULTRASOUND NECK

History: Hypothyroidism. Feels pressure at neck. ?thyroid lump.

Findings:

Diffuse abnormality in the texture of the thyroid gland.

The gland is not significantly enlarged, the right 6.9cc and the left 2.8cc.

There is probably some mild increase in vascularity in the gland.

No mass or nodularity.

No lymphadenopathy.

CONCLUSION: Nonspecific diffuse changes in the thyroid, no suspicious feature detected.

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sbadd
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13 Replies
greygoose profile image
greygoose

Excess what? Hormone? If it were, you would be hyper, not hypo. :)

sbadd profile image
sbadd in reply to greygoose

Sorry yes hormone is what i meant, could it temporally release excess hormone and cause symptons of hyper, just trying to understand my symptoms atm one mainly being palpitations heart which are getting worse, was only happening a few times a day now almost constant and a feeling of restriction on neck and hot flushes, seeing endo in 2 weeks to further investigate?

greygoose profile image
greygoose in reply to sbadd

Palpitations can be a symptom of hypothyroidism, not just hyper. Restriction in the neck could be due to the thyroid swelling, not necessarily hyper. And hypos can experience hot flushes, too. But, blood tests should tell you if your thyroid is over-producing hormone. Don't you have any blood test results?

Do you have Hashi's? Have you had your antibodies tested?

sbadd profile image
sbadd in reply to greygoose

Yes i posted results a week or so back and you indicated undermedicated so hopefully i can get proper dosage once i see endo as doctors can be vague, ive been on the 75mg now for around 4 years previous 10 years was 50mcg, never seem to have had a problem on the recent dose until now after having b12 injections in jan my whole body has gone haywire

greygoose profile image
greygoose in reply to sbadd

OK, just reread your last post. So, you do have Hashi's. And, you were slightly under-medicated. But, since then, you could have had a Hashi's 'hyper' swing. Do you know how Hashi's works?

sbadd profile image
sbadd in reply to greygoose

No not really my doct reduced my meds in last 2 weeks to 50mcg then 25mcg my palps are worse but pins and needles i was having not so bad and my thyroid now reads

Tsh 4.89

range 0.40 - 4.00

Free T4 14

Range 9 -20

T3 was not tested as these were done by chance at hospital as he sent me there regarding tachycardia

greygoose profile image
greygoose in reply to sbadd

Your TSH is much, much too high for someone on thyroid hormone replacement. Should be 1 or under.

Your FT4 is not too bad, almost mid-range, but without the FT3, we don't know if you're converting T4 to T3. Why has your stupid doctor reduced your levo to 25 mcg? That isn't even a starter dose! He deserves to be shot!

OK, so Hashi's is an autoimmune disease, where the immune system attacks and slowly destroys the thyroid.

After every attack, the dying cells release their stock of thyroid hormone into the blood stream, causing the levels of the Frees to shoot up - FT4 to around 30 something, FT3 around 11/12 - and the TSH therefore drops to suppressed.

There is no knowing how long these high levels will persist, but eventually, they will drop by themselves as the excess hormone is used up or excreted, and not only will you become hypo again, but slightly more hypo than before, because there is now less thyroid to make hormone.

Therefore, it's very important that your doctor does not reduce your prescription, because you’re going to need it again! If you start to feel over-medicated at that point - some do, some don't - the best thing is to stop levo for a few days, then, when you feel hypo again, start taking it again. It's very important to know one's body, and how it reacts.

There is no cure for Hashi's - which is probably one of the reasons that doctors ignore it - apart from the fact that they know nothing about it, of course! But, there are things the patient can do for him/herself.

a) adopt a 100% gluten-free diet. Hashi's people are often sensitive to gluten, even if they don't have Coeliac disease, so stopping it can make them feel much better. Worth a try. Some say that going gluten-free will reduce antibodies – I’ve never seen conclusive proof of that, but, you should be aware that even if you get rid of the antibodies, you will still have Hashi's, because the antibodies are not the disease.

b) take selenium. This not only reputed to reduce antibodies, but can also help with conversion of T4 to T3 - something that Hashi's people often find difficult.

c) the best way to even out the swings from hypo to 'hyper' (often called Hashi's Flares, but that doesn't really sum up the way it works) is to keep the TSH suppressed. This is difficult because doctors are terrified by a suppressed TSH, for various false reasons, and because they don't understand the workings of Hashi's. But, TSH - Thyroid Stimulating Hormone (a pituitary hormone) - tries to stimulate the thyroid to make more hormone, but it also stimulates the immune system to attack. So, the less gland activity there is, the less immune system activity there will be, meaning less attacks, gland destruction slowed down and less swinging from hypo to hyper and back.

sbadd profile image
sbadd in reply to greygoose

Yes i cant believe how high the tsh has gone in 2 weeks test was taken around 1pm in the day and i hadn't had any thyroid meds that morning, my T4 was previously 17 and t3 5.1, im back on the meds now until i see endo, my symptons also fit b12 but recent active b12 test was good, reason i had injections was for low store levels of b12 but my body didnt like the injections i had horendous side effects that lasted months

greygoose profile image
greygoose in reply to sbadd

Your doctor tested two weeks after reducing your levo? This man has absolutely no idea what he's doing! So, why did he reduce the levo, anyway? An FT4 of 17 isn't high.

sbadd profile image
sbadd in reply to greygoose

He thought symptons were of hyper

greygoose profile image
greygoose in reply to sbadd

Stupid man.

sbadd profile image
sbadd in reply to greygoose

Thankyou for info, hope to get it sorted soon

SlowDragon profile image
SlowDragonAdministrator

The aim of Levothyroxine is to increase the dose slowly in 25mcg steps upwards until TSH is under 2 (many need TSH significantly under one) and most important is that FT4 in top third of range and FT3 at least half way in range

NHS guidelines on Levothyroxine including that most patients eventually need somewhere between 100mcg and 200mcg Levothyroxine.

nhs.uk/medicines/levothyrox...

Also what foods to avoid (eg recommended to avoid calcium rich foods at least four hours from taking Levo)

Clearly you need dose increase. Bloods should be retested 6-8 weeks after each dose increase (or if brand of Levothyroxine is changed)

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also extremely important to test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common, especially if Thyroid antibodies are raised

Have you had vitamin levels tested? If not request they are tested asap

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and fasting. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

Last Levothyroxine dose should be 24 hours prior to test, (taking delayed dose immediately after blood draw).

All four vitamins need to be regularly tested and frequently need supplementing to maintain optimal levels

Hashimoto's affects the gut and leads to low stomach acid and then low vitamin levels

Low vitamin levels affect Thyroid hormone working

Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten. Dairy is second most common.

According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find gluten free diet helps, sometimes significantly. Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)

Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies

While still eating high gluten diet ask GP for coeliac blood test first or buy test online for under £20, just to rule it out first

Assuming test is negative you can immediately go on strictly gluten free diet

(If test is positive you will need to remain on high gluten diet until endoscopy, maximum 6 weeks wait officially)

Trying gluten free diet for 3-6 months. If no noticeable improvement then reintroduce gluten and see if symptoms get worse

chriskresser.com/the-gluten...

amymyersmd.com/2018/04/3-re...

thyroidpharmacist.com/artic...

scdlifestyle.com/2014/08/th...

drknews.com/changing-your-d...

restartmed.com/hashimotos-g...

healthcentral.com/article/t...

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