Significance of nodules

[Mag999]

My TSH has been slowly rising over the last 6 months, from 2.4 to 3.8, in the context of b12 and d deficiency, low normal iron folate, and high morning cortisol, waiting for results on 24 hour saliva test. I have had severe fatigue, muscle pain weakness and cramping which is worsening despite regular b12 injections. I just had an ultrasound of thyroid and have several nodules around 8 mm. overall thyroid is not enlarged and the doctor said it’s basically normal. Is this something I need to follow up, monitor or is it really insignificant? I’m desperate to find a reason for all the symptoms as my life has basically come to a halt, unable to work. Thank you.

[PurpleNails Administrator]

Your TSH is rising, and is far to close to heading in the upper part of range, a healthy level is around 1.

TSH is highest in morning when fasting (except water). What time was sample taken?

TSH alone is totally in adequate. The TSH is from the pituitary and increases as the thyroid struggles. Do you have a test of actual thyroid hormones, (often not tested if TSH in range!) FT4 & FT3.

You previously test negative with TPO and Tg antibodies?

Do you have recent folate, ferritin & vitamin D?

What prompted the scan? Thyroid nodules are quite common and often completely ignored by medics unless significantly affecting thyroid function or causing compressive issues ie affecting your swallowing, breathing or growing downward.

Obtain scan document from hospital so you can check the exact comments on the report.

Is you GP planning to repeat testing the rising TSH?

[Mag999 in reply to PurpleNails]

I can’t get copy and paste to work. I tested negative for antibodies my free t3/4 were bottom of range, vit d was 20 went up to 150 now dropped again to 64, ferritin and folate are normal but in bottom third so am trying to up all of these into higher end. I have had sore throat, choking, singing voice gone for couple of years, always feels like a lump in my throat. Family history, all the women on mums side were/are hypothyroid. Will ask for scan report, my impression from dr was there was nothing to worry about but am so unwell at the moment with no clear answer

[PurpleNails Administrator in reply to Mag999]

Has improving nutrients helped symptoms at all?

When was last test?

Apart from B12 are you taking other medications, supplements, herbal remedies?

[Mag999 in reply to PurpleNails]

No, am supplementing vit d, b complex, iron and injecting b12, all on advice from this forum and pernicious anaemia forum, but am worse now this has all happened in last 6 months after a couple of years of vague fatigue, weird panic attacks which came out of the blue and then stopped for no apparent reason. I also had to have ovaries removed, had mumps, bladder infections all of which got blamed for my symptoms but much worse in last 6 months I’ve been to a&e with suspected stroke, neurological symptoms, crashing fatigue, still don’t have full use of my left arm but the only thing that comes up is low b12 and d, the slightly downward trend on thyroid panel, and being at bottom of ref range for pretty much everything, but of course if you are in range then you are normal. Never felt less normal.

[PurpleNails Administrator in reply to Mag999]

Have you seen the advice on forum re biotin?

Does the b complex include biotin (b7) this is known to skew thyroid results in some testing methods. Recommended any level of biotin not taken 7 days prior.

Also lots of advice re vitamin d, important cofactors magnesium and K2.

Is your GP unhelpful. Often they do nothing unless you are persistently raising issues & following up yourself (which I see you are doing).

[Mag999 in reply to PurpleNails]

Gp is helpful but not sure who to refer me to! I do feel she will listen and I will go back to her once I get these adrenal results. Will check out biotin, I need to get my head round all these vits and mins!