THYROID: Not well seen, probably small/atrophic.

[vocalEK]

Is this result (an incidental finding during a P.E.T. scan for cancer) reason enough to convince my doctor that, even if I had lots of TSH, it wouldn't do any good because of my tiny thyroid?

Not that I need a good argument at the moment, because my doctor has kindly agreed to prescribe T3 and has refrained from clawing it back because of my barely measurable TSH. (Thank God I don't live in the U.K.)

I was just curious whether a tiny thyroid could be counted on to put out adequate hormones.

[helvella Administrator]

I really don't know. But it seems to make sense.

[tattybogle]

I follow your logic .. your thyroid is probably not capable of producing much T4 or T3 if it has shrunk so much they cant clearly find it. But the argument will make no difference at all to a GP's view of 'low TSH' .

They aren't interested in the TSH level to see the feed forward mechanism ie. "how much is it stimulating your thyroid to produce T4/3"

... they are interested in your TSH level to see the feedback mechanism ie."how much T4/3 does your hypothalamus /pituitary think you have ? to little ~ too much ~ or adequate ? "

So, proving that you have no thyroid left for TSH to stimulate makes no difference to their thinking on low TSH.. they associate very low TSH with the hypothalamus / pituitary sensing that there is too much thyroid hormone in the body ... (so it doesn't produce any more TSH).

The real problem is in getting this point across to them :

The risks shown in research to be associated with the low TSH seen in hypERthyroid people (with 'too high T4/3' ) .....cannot be directly applied to people taking thyroid hormones , (who's TSH is now very low even though their T4/3 are nowhere near as high as someone with that low TSH who wasn't taking oral thyroid hormone replacement.)

Once we are taking T4 (or T3).. we see the relationship between TSH level and T4/3 levels change .. we then see people with results showing relatively higher T4/ relatively lower T3 and relatively lower TSH (than untreated people , or hypERthyroid people)

So the 'low TSH' risks don't necessarily apply to us in the same way.

The risks were always coming from the high T4/3 levels .. never the low TSH .

That's the point you need to convince them of .. not whether your TSH has any job to do anymore .. but whether your TSH level still represents the same levels of T4/3 in all the tissues of the body, as it did before you got your thyroid hormones by eating them.

[Miffie]

I had a thyroid scan some years ago. The consultant told me my thyroid was tiny the smallest he had seen. “More like a currant than a plum” in his words.The letter back to the GP stated small and consistent with long term hypothyroidism. I was diagnosed as a child in 1960 so that fitted. The GP I was with at the tim3 always dosed by symptoms over test results so it was not a problem. My current surgery are rubbish re thyroid and ignore everything but TSH. After 5years of nonsense I finally got an endo to tell them it is OK for mr to add self sourced NDT to levo. Amazingly the same endo advised scan results are irrelevant.

Hopefully you will never come up against such nonsense.