Possible reasons why my thyroid nodule is growing?

[kaju20]

I have been to my gp about the discomfort I was getting swallowing, having any clothing around my neck and the migraines i was getting when my nodule felt particularly swollen, they did the tests and sent me for an ultrasound 2020 march time. Said there was nothing to be concerned with.

Since then I have had more flare ups, and now the nodule is very noticable. It doesnt go down at all. So I paid for a medichecks advanced thyroid blood test. Everything seems to be in range apart from the thyroid peroxidase antibodies.

I'll write out my results with the medicheck ranges. If any one has any idea where to go from here as symptoms are progressively getting worse. Acne, growing nodule, dry skin, thirsty all the time, constant migraines, back of neck and shoulder blade pain. I had a gallbladder attack that I had to go to A&E for (as I didn't know what it was at the time) .

Endo in the hospital discharged me saying my readings were nothing of concern. So not sure where to go from here.

Medicheck results:

Inflammation CRP HS (Range <5) 0.34mg/L

Iron (Range 13-150) 93.2

Folate (Range >3.89) 10.03ug/L

B12 (Range >37.5) 107pmol/L

Vit D (Range 50-175) 67.4nmol/L

TSH (Range 0.27-4.2) 0.86mlU/L

Free T3 (Range 3.1-6.8) 4.17pmol/L

Free thyroxine (Range 12-22) 15.8pmol/L

Tyroglobulim antibody (Range <115) 10.9klU/L

Thyroid peroxidase antibodies (Range <34) 47klU/L

So as you can see the peroxidase antibodies were above normal. What does that mean please?

Many thanks

[radd]

kaju20,

TPOAb attacks an enzyme found in your thyroid gland, called the Thyroid Peroxidase which is essential in the production of the T4 and T3 thyroid hormones.

If left untreated over time these antibodies may cause inflammation, lumps/nodules until eventually the thyroid gland is destroyed and hormone depleted, requiring replacement meds.

The standard care for a Hashimoto’s patient is to wait until the immune system has destroyed enough thyroid tissue to classify them as hypothyroid. They are then medicated with Levothyoxine and if they start to exhibit other symptoms commonly associated with Hashimotos such as depression or insulin resistance, they’ll get additional drugs for those problems.

Without addressing the underlying cause the immune system will continue to attack and the meds might not work very well. Knowing of a Hashimoto diagnosis early before the thyroid gland is too damaged gives scope to reduce antibodies and slow the progression. Some have even managed to halt the disease and encourage more normal thyroid function, thus avoiding the need for hormone replacement.

An excellent read to explain the process is ‘The Root Cause’ by Isabella Wentz.

[kaju20 in reply to radd]

Great thankyou. I cant seem to find help as yet. GP is indifferent and even when I was referred to the endo a year ago I asked him about the possibility of a cyst found on my pituitary glad being the possible cause, his answer was "I dont know, I'm just the guy that cuts the thyroid out."

This isabella wentz has a few books I see. I'm just wondering should I get her 90 day plan to try that as I imagine I wont be finding any help anytime soon. Maybe I could try that?

[radd in reply to kaju20]

kaju20,

A cyst on your pituitary gland could well be contributing to your health issues and headaches. It could be causing secondary (or pituitary) hypothyroidism in addition to your early onset Hashimotos.

In this scenario your thyroid hormone results would be low in range and yours are (FT3, FT4 and TSH). It is complete rubbish they have dismissed it and I agree with PurpleNails below to be politely persistent for further investigations.

If they are still uncooperative ask why your TSH level is low when it should in theory be higher as it tries to encourage more T4 & T3 hormone. Also you could ask to have thyrotropin-releasing hormone (TRH) tested. This is secreted from the hypothalamus to encourage TSH and if there is a problem in the pituitary gland the results would be raised.

Any Isabella Wentz book is good as she explains autoimmune so well, and how to calm immune responses, and a diet clean-up is always good 😁.

[kaju20 in reply to radd]

Thankyou so much, this is all very practical. Knowledge is power as they say. I'll dig out my results from a year ago. Try and get what I can tested with the gp so that they have it on record otherwise I'll try find a private test. It will be a job convincing them to scan my pituitary again. But if I lead them there as it were. Asking for the tests you suggested and questioning is the best chance. Thankyou. In the meantime i will try out that 90 day plan. I've been trying my best to supplement and clean up my diet but not entirely sure what I'm doing so will be good to have a guide

[PurpleNails Administrator]

Has your doctor seen how swollen it currently is? Do you feel it has grown? Do you ever have any pain around the collar bone? does it ever effect your breathing, swallowing or voice, make sure you let your doctor knows if it does.

The swelling is low down in the neck where the thyroid is situated. The photo looks like the swelling is in the centre rather than on either lobe of the thyroid.

Your levels won’t prompt a doctor to investigate as they are in range. When were the result taken, are they recent?

[kaju20 in reply to PurpleNails]

Hi, yes, I get all the symptoms you mentioned. I spoke to the gp only today and he said that my results are "on the fence". On feb 19th I specifically asked for the peroxidase antibody test as I'd only had that done as a private test. I wanted them to have that on their records. I asked him about it. He agreed there were antibodies but will want a repeat test in 6 weeks time. I told him for the last couple of years I've been in chronic pain in the right side of my head, jaw, temple, shoulder, neck (basically wherever theres a lymph node) that my eye lid has been dropping on and off for months now and that in the last couple of weeks my right eye keeps going blurry and he said as I was diagnosed with chronic fatigue about 12 years ago that's what it was. I told him my nodule has grown. I have photos to show but he said my bloods are fine so made absolutely no comment on the nodule. I asked for a repeat ultrasound as the last one was a year ago. He said to wait until I have another blood test. I honestly dont know where to go from here when physical symptoms mean nothing it seems. I appreciate that's what alot of people experience. I just want to find out what's causing this but cant get a referral if they dont even believe I have a thyroid issue

[PurpleNails Administrator in reply to kaju20]

Thyroid levels aside & it’s good they are repeating it in 6 weeks...what does he think is the cause of the pain and apparent compressive issues. Ask again for a scan. Be politely persistent. Are there other doctors at the practice. A nurse sent me for a scan & was shocked 2 doctors had dismissed it. I sometimes think unless you keep raising the issue they assume it’s all gone away. Like you said he didn’t mention the nodule, doctors are good at not answering questions too.

Do you have a copy of the previous scan findings? Often a specialist analysis is sent to GP ( without images). Make sure you review a copy yourself.

[kaju20 in reply to PurpleNails]

Thankyou so much for replying. This particular gp has been very rude to me in the past. Dismisses me, I think because of the chronic fatigue label that was given years ago that wasnt really based on anything. I'd just come back from brazil having survived hemeralgic dengue fever. I went to get help for the damage it had done and they decided it was chronic fatigue. I suspect that's what hes putting the pain down to. Easier to say that it must be chronic fatigue. He made absolutely no comment on the pain. I do agree though. Politely persisting. I think this will be the last time I speak to him if he dismisses me again. I think he will. I'm just scared what he'll write on my notes, will it make the next gp dismiss me too.

I've just tried setting up an online profile to access all my test results. I usually get my blood tests printed out so that I can mention or question levels that seem out. My kidney urea was out of range but his reply was that's fine. Even when they're out of range there's alot of margin apparently. I've been recommended to read isabella wentz, I see she has a 90 day plan book. Do these work? Or help? I'm just wanting to try something while I'm waiting to find someone who can help me find out what's causing this

[PurpleNails Administrator in reply to kaju20]

I’m not familiar with wentz but I’m sure others can comment with personal knowledge.

I don’t have an autoimmune issue and have never looks into this side of things. Many recommend gluten free. I’m sure Many people credit improved health using special regimens.

You may be helped and learn a great deal from the advice in such books and as you say it will allow you to help yourself. In general managing stress, along with good diet, healthy lifestyle & ensuring nutritional levels optimal will improve overall health.

Online access is also a great step. I find it extremely useful. You may be required to submit ID. I can now view referral documents & letters from specialists, test results and appointment notes. At first you are given a basic access, usually summary notes & medication list. There is a further step to request access to your full medical record. The practice has one calendar month to ensure it is processed correctly under GDPR guidelines.

[kaju20 in reply to PurpleNails]

Thankyou so much for the information, I'll try get full access. Useful to know I have a month. I was given an access code. Maybe a temporary but I'll look into having full access. Thankyou so much, really appreciate your time