Sudden high thyroid hormones - no symptoms other than a lump and very itchy rash

[MiniMum97]

Posting for a friend. She has had Rheumatoid Arthritis for a number of years and was doing very well in recent months. In the last 5/6 weeks she has noticed a weird lump on her neck (not by her thyroid, it's under her jaw (see pic) - it's about a size of a grape), and has developed a very itchy rash which has spread from her neck to her chest and other parts of her body.

Gets worse with heat and moisture - has been back and forth to GP and tried various creams that help a bit but then don't - she tried Piriton for a bit which again helped a bit.

GP tested thyroid last week and unexpectedly came back with suppressed TSH (0.1 (0.27 - 4.2)) and raised FT4 (24.6 (12-22) and FT3 (8.6 (3.1-6.8). GP retested and called my friend today to say FT3 and 4 were significantly higher unfortunately my friend didn't ask for exact results.

My friend has NO other overactive thyroid symptoms but I've done a bit of research and note that an itchy rash that responds to antihistamines can be a symptom of an overactive thyroid.

GP has done an urgent endo referral now wants to start her on carbimazole.

No antibodies tests have been done at all.

I've explained there could be a number of explanations for an overactive thyroid including hot nodules, graves and a hashis flare. And it's not possible to establish the cause from the current tests.

I've explained the risks of carbimazole (white blood cell, liver and hypothyroidism) but also there is a risk of thyroid storm if her levels get v high and risk of heart issues or osteo if left long term.

I've explained ideally she will get TG, TPO and TSI abs tests, and a thyroid scan.

She's not sure whether or not to take the carbimazole or wait for further testing.

Any ideas on what this lump could be - it looks like it's too far back to be a gland??

I'll post another post with the rash as I can't post two pics.

Any other thoughts?

[greygoose]

Just my opinion, but I wouldn't take the carbi until all antibodies have been tested.

[MiniMum97 in reply to greygoose]

Thanks GG - why do you say this? What's your reasoning?

Any thoughts on what this lump could be?

[greygoose in reply to MiniMum97]

Well, high FT4/3, but not really high enough to be Grave's. Could be Hashi's. In which case, carbi is not the right treatment. And, from what I've observed, once an endo/GP has got you on carbi, s/he is very, very reluctant to take you off it, even when you go very hypo. So, best to be avoided if possible.

You can have a lump/goitre with both Hashi's and Grave's. But, I don't think carbi would actually get rid of the lump.

[MiniMum97 in reply to greygoose]

Yes thanks for that. I agree. I don’t think the lump is a goitre. It’s under her ear - can you see the pic. Could it be a lymph node there do you think? Looks a bit far back?

[greygoose in reply to MiniMum97]

I don't know anything about lymph nodes, so I couldn't say. But doubtful it's a goitre up there. It really needs scanning.

[MiniMum97 in reply to greygoose]

Yes I agree.

[dtate2016]

I think it could be a lymph node. And If she has been doing well and it come all of a sudden then, The likelihood that it’s coming from another source is great. For instance, has she been exposed to any farmyard animals, etc. eaten anything she normally does not eat? Begin using any kind of chemical new chemical - like hand lotions or vitamins, minerals?

Lymph nodes are all over the place and of course as you may well know they’re designed to absorb things that may cause us harm.

Recently had an experience like this myself. A giant lymph node came up under my jaw I mean like the size of a golf ball even bigger. It begin to close my throat a little bit. Scared me to death!

The doctor did not know what it was and prescribe me antibiotics. There was some problems obtaining the antibiotics problems at the pharmacy problems with my insurance card etc. (I live in the US). By the time I actually had the medicine in hand the itchiness and the redness had spread all down into my chest. (so from the time the symptoms begin to the time I had the antibiotic was over 60 hours) Somehow I sensed that I was getting better. I did not take the antibiotic. By morning the lymph node had reduced in size by a third.

It occurred to me then that I had eaten venison from another state and dressed by my brother-in-law. We had feasted on it for two or three days. I have never had an allergic reaction to venison before. (I have Hashimoto’s disease).

I called the doctor back and spoke to the nurse there and she agreed that it could be something the deer itself had eaten that I was allergic to.

The lymph node continued to reduce and the redness continue to spread but the itchiness begin to subside.

Long story - but to the point, our bodies are amazingly capable of eliminating poisons, recognized or not. Bee venom, for instance is a mild poison. Think broadly, what exposure may have occurred / still occurring? It has also been my experience, dealing with Hashimotos, that different food allergies have developed (and disappeared) from time to time. Once, our local grocer began to sell beef from a cheaper source (less than Grade A Choice) - it was full of growth hormones, etc. even as little as 2 ozs of this beef gave me “hangover” like symptoms - no alcohol involved! I could eat beef from anywhere else but there.

Hope this helps. Would be interested in hearing how this resolves. Will be watching for other posts.

[MiniMum97 in reply to dtate2016]

Interesting. Thanks for your reply.

[Hidden]

Re lymph nodes, I didn't know the location either but looked it up:

webset-lms.com/vtct/Course....

"CERVICAL NODES

The cervical nodes are located in the chest region. These nodes are arranged lower jaw border, around the front and back of the ears, and deep in the neck area amongst the larger blood vessels. They help drain the skin of the face, scalp, nasal cavity tissues and the pharynx."

More information and a diagram here:

healthguidance.org/entry/15...

"Because enlarged lymph nodes on your neck may be caused by an infection, it doesn’t always indicate serious diseases such as cancer or other worst case scenarios that you might come up with. Do you have an earache or sore throat lately? If yes, nodes near the infected area could swell. It is a sign that your body is doing its job to fight off foreign organisms, you may see a doctor to treat your illnesses, but you shouldn’t be worried by the enlarged lymph glands. However, if there’s no fever present, then you definitely should see a doctor.

Sometimes your lymph nodes swell very rapidly and painful. The nodes may stay enlarged for two days or for up to two weeks and there’s no real cause for concern. On the other hand, heat and redness that come from the swollen area are signs that you should see your doctor. The rule of thumb is, you don’t need to see a doctor if you have enlarged lymph nodes on the neck that accompany a slight cold, wait for 3 or 4 days before seeing a doctor. "

Hope that helps. But it doesn't really explain the sudden thyroid change. Except an infection can make it go haywire if you already have an autoimmune condition

[MiniMum97 in reply to Hidden]

Thank you so much that’s really helpful. That diagram shows lymph nodes in exactly that spot. Yes have discussed that it could be an infection induced thyroiditis.

[Tina_Maria]

I would advise your friend to make an appointment with their GP and demand a full blood panel. That lump could be an enlarged lymph node and a full blood count will give you an indication, if there is something going on in that system.

Without wanting to cause concern and although very rare, there is a connection with thyroid abnormalities and lymphoma (which can present with a lump and rash/itching), hence the full blood test can certainly exclude this.

I agree with others, that I would not consent to taking carbimazole, before they have done a full thyroid panel, including antibodies. Again , only a full panel will give you an exact indication of what's going on.

[MiniMum97 in reply to Tina_Maria]

Hi Thanks for this. GP has run a load of blood tests. I haven’t seen them all but strongly suspect an FBC has been run. I’ll double check with my friend. I’ll get her to push for her antibodies to be checked. Thanks again v helpful responses on here from everyone. Much appreciated.

[MiniMum97 in reply to Tina_Maria]

I've just seen her FBC and her white blood cell count is low (just under range). She's been referred for a 2 week wait appt for a scan which is in 2 days. Very worrying.

[Tina_Maria in reply to MiniMum97]

Hi there, so sorry to hear that - hopefully they will get to the bottom of this quickly, I can imagine that it is a worrying time. I keep my fingers crossed for your friend and hope they find the cause and can sort it quickly. All the best! x

[Cjaydoubleyou]

Hi, hopefully you see this. Did your friend ever find out what was wrong? I have the exact same happening to me... I haven’t been formally diagnosed with anything yet but the doctors are thinking auto immune. I’ve got the worst rash on my chest and arms at the moment, worsened by water... I’ve had it for about two weeks, along with my usual ‘flare up’ symptoms. Also I’ve been diagnosed with hypothyroidism, this was about 5 years ago, i gave up taking the medication... for re-tested and levels were normal...

another very strange symptom I have is instant pain in my shoulders when I’ve had just 1 sip of alcohol... it’s so bad I have to go home to bed. I’m so desperate for some sort of answer...