How can I have an enlarged thyroid and yet have normal thyroid function?

[Simonron]

A PET scan shows half my thyroid is 3.5 cm wide now. A biopsy shows abnormal cell that could be cancerous, so I am scheduled to have that half removed. How can it be working properly if it's got that big ?

[SlowDragon Administrator]

Just testing TSH and Ft4 is completely inadequate

Have you had FULL thyroid and vitamin testing including both thyroid antibodies

Definitely get full testing BEFORE hemi-thyroidectomy and 6-8 weeks after operation...far too often people left with no replacement thyroid hormones

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 you have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies

Ask GP to test vitamin levels

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water .

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

Is this how you do your tests?

Private tests are available as NHS currently rarely tests Ft3 or thyroid antibodies or all relevant vitamins

List of private testing options

thyroiduk.org/getting-a-dia...

Medichecks Thyroid plus ultra vitamin (doesn’t include folate)

medichecks.com/products/thy...

Thyroid plus vitamins including folate (private blood draw required)

medichecks.com/products/thy...

Medichecks - JUST vitamin testing including folate - DIY finger prick test

medichecks.com/products/nut...

Medichecks often have special offers, if order on Thursdays

Thriva Thyroid plus vitamins

thriva.co/tests/thyroid-test

Blue Horizon Thyroid Premium Gold includes vitamins

bluehorizonbloodtests.co.uk...

If you can get GP to test vitamins and antibodies then cheapest option for just TSH, FT4 and FT3

£29 (via NHS private service ) and 10% off if go on thyroid uk for code

thyroiduk.org/getting-a-dia...

monitormyhealth.org.uk/thyr...

Medichecks - JUST vitamin testing including folate - DIY finger prick test

medichecks.com/products/nut...

[Simonron in reply to SlowDragon]

Ah - I've just seen this post. Many thanks. I saw a similar posted answer from you and have linked it to the facebook group facebook.com/groups/restles... . I think I am out of time .

[Angel_of_the_North]

It probably isn't. Are you fit and healthy, with plenty of energy, no anxiety or low mood, no weight gain or excessive loss, rarely catch colds or bugs, no constipation or diarrhea, get to sleep easily and sleep through the night? Thyroid can increase in size to make up for not being fully functional.

[Simonron in reply to Angel_of_the_North]

Ha - I'm , well, I was fit enough for me. I have had ME in the pas. I'm overweight and loath exercise for the sake of it. I don't drive though, have been Veggie for over thirty years and have had to use a CPAP machine for the last five to get much sleep at all - and - I have terrible RLS / PLMD - see my link above. Oh and I think life could be a lot simpler - I am exposed to just about every stress on the list, but I'm not on antidepressants - I write comedy podcasts.apple.com/podcast/.... I cover my problems there by the way too.

[SlowDragon Administrator in reply to Simonron]

As a vegetarian you will need daily B12 supplements and to regularly retest iron and ferritin

What are your most recent vitamin results?

academic.oup.com/nutritionr...

The present review of the literature regarding B12 status among vegetarians shows that the rates of B12 depletion and deficiency are high. It is, therefore, recommended that health professionals alert vegetarians about the risk of developing subnormal B12 status. Vegetarians should also take preventive measures to ensure adequate intake of this vitamin, including the regular intake of B12 supplements to prevent deficiency. Considering the low absorption rate of B12 from supplements, a dose of at least 250 μg should be ingested for the best results.3

[Simonron in reply to SlowDragon]

Hum. I have had low feratin, and low B12 - and have had injections in the past ( two years ago ) to bring them up. I am told that my blood results are low but OK at the moment. Frankly I have always doubted that so I have ben taking B12 from time to time and iron supplements. To further confuse matters, I take Lansoprazole for acid reflux - due to a hiatus hernia. I fear that will further reduce vitamin absorption. I've got lots of very irritating complaints, none really major, all under some form of treatment, but, I think, taken altogether they add up to something greater than the sum of the parts.

I've looked for the results but I can't find them...

[SlowDragon Administrator in reply to Simonron]

Well most hypothyroid patients have LOW stomach acid...causes acid reflux too...virtually identical symptoms to high stomach acid...but very different treatment

Thousands of posts on here about LOW stomach acid...possibly more misdiagnosed/mistreated than hypothyroid

healthunlocked.com/search/p...

Links about low stomach acid

nutritionjersey.com/high-or...

articles.mercola.com/sites/...

thyroidpharmacist.com/artic...

stopthethyroidmadness.com/s...

How to test acid levels

healthygut.com/articles/3-t...

naturalendocrinesolutions.c...

Yes Ppi lowers vitamins...especially B12 and magnesium

pulsetoday.co.uk/clinical/m...

gov.uk/drug-safety-update/p...

When you start on levothyroxine you will need GOOD vitamin levels