Hope everyone is safe and well during this pandemic. Ever since the pandemic started and the stress went overboard, I've started having this thin red/dark line on the side of my neck. It comes and goes, for the last two days it's been there. Somedays it disappears. There's not much discomfort apart from a very slight itchy feeling. I'm a man in my early 30s and don't smoke and only have a beer over the weekend. I have been researching, but haven't found an answer as yet for this weird line on my neck. My mother has had thyroid throughout most of her life post having children. Could you please tell me who I should approach for this? I'm worried because negative thoughts are the first one to fester.
Your diagnosis or guidance would be very helpful in me finding a correct course of action and medication. I haven't gotten my full blood culture done right now but have it scheduled.
Thanks!
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MairaN88
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MairaN88, Your diagnosis or guidance would be very helpful in me finding a correct course of action and medication.
Welcome to the forum. Please understand that this is a patient to patient support group, No-one here is medically qualified so cannot diagnose. You need to visit a medically qualified doctor for that.
If you get blood testing done for possible thyroid disfunction and then post the results here, members can offer their thoughts and suggestions. The minimum testing you would need to get is TSH, FT4 and FT3.
There is some information for someone suspecting a thyroid problem but not yet diagnosed here thyroiduk.org/if-you-are-un...
Thanks a bunch for sharing the link! I understand I need to go to a medical professional for correct diagnosis but currently not wishing to step out due to the third Covid wave. Even if patients/members can give their opinion on my symptoms, as shown in the pic, that would be helpful too! 😊I'm trying to get a tele medicine appointment too.
The discolouration by itself wouldn't indicate a thyroid problem, but neither does it rule out the possibility. Without blood test results as mentioned above, it's impossible to say anything useful really.
Yes, he prescribed me levothyroxine 25mg (Called Eltroxin in India) and also a USG Thyroid. My ultrasound reports detected two solitary anechoic cysts. That report has me freaked out pretty much because now my doctor has requested an ultrasound monitored FNAC (fine needle aspiration) for the cysts. Attaching my thyroid ultrasound results below.
Many on here will tell you that 25 is only appropriate for very oldpeople and normal starter dose is 50. Then test every six weeks and raise dose till tsh is around 1 and T3 and t4 are high in ranges.
The red line might be a reaction or sensitivity to something as you describe it as intermittent and itchy.
If you speak to chemist they can likely recommend an antihistamine and or cream to help relieve it.
Anxiety can trigger rashes and thyroid issues can also contribute to both rashes & anxiety.
As you have family history I think a blood test checking your thyroid levels are a good idea.
A blood culture looks a blood bacteria what you need is a thyroid function test.
A full thyroid function involves:
TSH (Thyroid Stimulating Hormone) a pituitary hormone which rises if thyroid levels are low
FT4 - (free thyroxine) which drop is hypothyroid
FT3 - (tri-iodothyronine) the active hormone. Which drops If hypothyroid.
When GPs suspect a thyroid issue the lab test the TSH and only if this is abnormal. Then thyroid hormones are tested.
It really a screening type test rather than compete check, unfortunately the TSH isn’t always a reliable measure. So you need to find out what’s being tested if a full test hasn’t been done. Have you had checks in past? If might be work checking to see. You can request past test results or your practice may offer online access. If a full function hasn’t been tested there are private options. This can be done at home via fingerprick sample & post.
If any of the thyroid result are not ideal you can look at testing thyroid antibodies & nutrients. Some companies offer a full thyroid package testing thyroid function, antibodies & nutrients in one small sample.
Hi . The high TSH and the positive TGab .... yes , unfortunately this does look like you have autoimmune hypothyroidism .
BUT, if this is your first 'over range 'TSH result , it needs to be repeated to confirm it's not just a one off that might return to normal later on.
When the thyroid hormones T4 /T3 are still 'in -range' and the TSH is under 10 the NHS will usually want to wait 3 months to do a repeat test.
( if these are private test results and your GP is not aware your TSH is this high you should let them know about these results now... they don't usually accept private tests , so will need to do their own , and they don't always wait 3 months if symptoms are a problem and TSH is clearly more than just 'borderline' . in these circumstances some are happy to just wait 6/8 weeks )
since it is in your family, and since your TSH is as high as 8 , and TGab are positive , it is pretty likely to be autoimmune hypothyroidism , and it pretty likely you will need to be prescribed Levothyroxine at some point ....... if TSH gets to 10 then it's an immediate diagnosis,/prescription of Levo .... but while it's 'over-range but under 10 ' they like to be a bit more cautious before prescribing lifelong replacement thyroid hormones and will take into account if symptoms are a problem or not .
Do you have any symptoms of hypothyroidism ? (there are lots ! of them )
( sorry, I wrote this without looking where you live first .. ignore the 'NHS' bits if not in UK)
Hi! Thank you so much for your response. I got the tests from a reputed recognized lab, which costed a lot. So, I do hope the GP recognizes them 😂 I'm based out of Asia (India) so NHS wouldn't apply.
As for my medical history, I wasn't diagnosed with thyroid till yet, but that rash/inflammation on my neck which doesn't itch, made me want to do a full blood checkup and test everything. The only 3-4 things that came out marked were raised TSH/Tg Antibody Levels (which I've attached), slightly raised LDL Cholesterol Levels (129mg/DL), which could be due to the weight I've put on (atleast 8-10kgs) since COVID began with lesser movement due to lockdowns and deficiency in Vitamin B12 and Vitamin D3. I don't know if raised TSH/Tg Antibody go hand in hand with raised LDL Cholesterol Levels (overall Cholesterol is within limit), but the lab doctor did advise for a TSH re-check in 3-4 weeks. She says TSH is erratic and can have different values, even due to change in weather. So I'll wait to get another full Thyroid test after 4-6 weeks.
Regarding symptoms, I only have the inflammation/red line on my neck which is brownish in the morning but disappears by the evening. I can only think that the brown welt or discoloration is due to my immune system attacking my thyroid? The weight gain I've had has been gradual like normal. It wasn't erratic and I haven't been an extremely fat/obese individual, I played the drums non stop for 15 years till 2019, till the world came to a pause and almost everyone I know got fat or unhealthy due to sedentary lifestyles in lockdown. I'm about 175cms (about 5.85 feet) and my ideal weight should be around 70-75kgs. I'm tipping towards a 93kgs which is 18kgs overweight (which isn't good). I hope to reduce my weight gradually. I've always been somewhere around 72-77 kgs throughout my 25-30 years. I'm 33 now. Any tell tale symptoms I should specifically look out for?
Due to my genetic potluck. I've gotten varicose veins (spider veins) from my father too. Which I've had since late teens. These are due for a doppler/ultrasound but I don't imagine that varicose/spider veins could be linked to thyroid or higher LDL cholesterol?
Thanks for your time and patience in responding. I greatly appreciate it 😊
Hi , yes , it does look like a 'good' lab .. i noticed the 'comments to aid interpretation' are MUCH better and more accurate /informative than some we see from other labs.
The TSH is a 'bit variable' it's true ... but to be fair it's not often as variable as 'up to 8 and back down to normal again' .. (the most common level for 'normal' is actually about 1 ish )
Raised cholesterol is known to be a direct consequence of Hypothyroidism. and it will usually lower again once the hypothyroidism is treated.
Weight gain while having nowhere left to go drumming in a pandemic ? .. well yes .. there is that ... But to be honest it's very likely that at least some of the extra weight is directly to do with hypothyroidism ... (due to slowed down metabolism)
I don't know much about varicose veins (lucky me ) but others might know if there is a connection .
Also . the red line ? .. well it's a new one, i've never heard of it before in relation to thyroid .. But that's the thing with thyroid hormones .. since they affect nearly every cell and every organ in your body , and since we are all so very different in our genetic make up ... we tend to see all sorts of 'apparently unconnected' things happen to individuals as a result of incorrect thyroid hormone levels. So you can't rule it out even though it's a weird one.
An example :
I went hypo (autoimmune), but i never put more than a tiny bit of weight on despite 4 /5yrs of being undiagnosed/untreated ... but i did get a 'puffy' looking face/cheeks/eyelids and the bridge of my nose , between my eyes ,became 'fat'/lumpy.
The lack of weight gain was probably why no one thought to check my thyroid bloods for years .. its a misconception that 'all hypo's gain lots of weight' we don't always .
My ankle reflexes had slowed ( ankle reflex 'return rate' test~ this was one test the GP did when he eventually suspected thyroid might be the problem)
I felt horribly fatigued and had difficulty walking up hills fast .. ended up walking more sideways than uphill !
My lower arms and wrist aches constantly , and also kept getting tendonitis in my wrists .. which stopped me drumming
I kept getting Bursitis on my knee joints ('Housemaids Knee') despite only being 34yrs old .
I did feel cold nearly all the time, (but i live in UK !) which is a fairly classic symptom and was wearing more clothes than everyone else indoors .
Understood! I have knee ache too, but that is because of runner's knee, or patellar tendonitis/chondromalacia. It could be possible that I have had thyroid for years, but never been diagnosed correctly.
Did all the symptoms you mentioned go away after treatment? Especially fatigue and the joint aches?
I think the next best course of action for me would be to head down to the Endocrinology department and share my results for guidance on next steps.
Sort of ... i felt a bit better for a couple of weeks on 50mcg , then it tailed off.. then felt about 75% better when i was on 100mcg , but it didn't last more than a couple of months , then dose was increased to 150mcg which kept me feeling about 75% better for about 20 years . I never did find a way to get the other 25% of my 'old-self' back .. but don't let that depress you ... i was obviously quite different to you .. MY TSH was 'only' 5.7 /6,8 at diagnosis , but my TPOab were >3000 [0-50] .... and more to the point i'd already had really bad symptoms that caused me to change my life significantly for 4/5 yrs before i finally got recognised and treated.
Also . i didn't have the internet back then (i'm 55 now ) to ask other thyroid patients for advice /experience ... so when GP said "your thyroid is treated now , so the other 25% must be 'something else', maybe some antidepressants, or talking to a counsellor will help ? " .. i thought they must be right, and stopped looking for ways to improve my thyroid treatment. .... big mistake ... should have looked more carefully at everything that i read about on here .
I'm so glad to have the opportunity to hear about your experience and also wanted to thank you for the amount of information you have shared with me. Seriously! Something in the back of my mind was always telling me to get a blood test done to check my thyroid.
My mother was expecting me and had hypothyroidism during her pregnancy, so I guess I inhereted it from her. As for her symptoms, she tells me her face had bloated up, she had liquid around her heart and had to be on bed rest for the majority of her pregnancy, so I could be safe. She had very thin hair, her nails were brittle, she looked anaemic as per her.
I will perhaps have to act upon this immediately if I can in any attempt control or reverse any damage that has already happened. The GP at the lab told me your antibodies are less in comparison to the 1000 we see, but they can continue to increase if there isn't correct medicinal intervention.
Come to think of it, there are days that my body feels extremely tired after a normal day of driving around and visiting friends. Even on days I used to drum, there were days my energy would just be low. I couldn't feel my 100% everyday, but I attributed that to improper sleep or just not being mentally at rest/ having bad days.
The more I read about thyroid, the more I understand the impact this small gland has on the human body.
I'll visit a doctor and report back with their diagnosis in the coming weeks! 😊
Thank you so much! I just hope it's just normal skin inflammation and not a sign of anything else.
Also I went back into my medical reports and realized we failed to act upon an already elevated TSH level of mine from blood work test done in 2017, and my level was at 5.1 back then. That in itself is above the reference range of 0-4.5.
Does that mean that if I acted upon it in 2017, my TSH would not have hit 8.92 now?
Both ranges, being 5.1 and now 8.92 are subclinical hypothyroidism. Only thing is that I didn't get a Tg Antibody test in 2017. This careless overlooking of mine has me quite angry on myself. But could anything be done even at that stage? Isn't it a wait and watch game before it become 10 or the Tg antibodies are >1000?
Again, I'm so glad I joined this forum. It has made me connect the dots today 😊
So in UK , for 'sub-clinical' hypo if TSH is 'over range but under 10' , AND there are symptoms of hypothyroidism: ..... then GP's 'may consider a trial of levothyoxine' to see of it improves symtoms........... they are told to take TPOab antibodies into account (they don't test TGab ), if TPOab are over range it means they feel more confident to start treatment at the sub clinical stage. (Sub-clinical means TSH over-range but fT4 still in range)
But , even in India ,you might not have been able to get anybody to take you very seriously back then :
TSH was only 'a little bit' over range in 2017
and you only seem to have TGab not TPOab
TPOab are more universally accepted as being specifically autoimmune thyroid.. TGab are said to have 'other' causes.. not sure how true this is .
And a TSH of 5 is still in the 'could just be a fluctuation' box .
Also , even if you could have got anybody to start treating you then ... you might by now be wondering if you did ever need to be on Thyroid Hormone Replacement for life ,, or if it was going to improve by itself ...and once you've started on Thyroid Hormone replacement , you no longer have any proof about how much worse it would have got , because from that point on your TSH is directly controlled by your dose. .
So don't beat yourself up... you immune system is already doing a good job of beating your thyroid up .. no need to join in
Hello! So I got myself checked up by an Endocrinologist. He checked my neck for lumps or nodules that were poking out but couldn't find anything. He then asked me to get a USG ultrasound of my thyroid to see the condition and told me to get on eltroxin 25mg (levythroxine). I asked him if I could reduce my weight and not start right now as the TSH is 8.92 and T3/T4/Peroxidase are normal and my antibodies are just at 180.
He said it's better you start it sooner and I didn't like that diagnosis because I don't have any symptoms apart from the neck rash and weight—weight which had accumulated from not being able to move much during COVID.
I did agree for the ultrasound. Now here's the kicker. The right and left lobe thyroid sizes are normal and everything else is normal but there are two anechoic solitary cysts which the ultrasound detected. These cysts are 1.92 x 2.12mm in diameter for the left lobe and 4.13 x 4.85mm for the right lobe. My endo now wants me to get an ultrasound FNAC (file needle aspiration) to check if these anechoic cysts are malignant.
The sonologist suggested that the rash on the neck doesn't seem to be connected to the anechoic cysts in the thyroid. The cysts could be there by birth and this is just a "chance" that we came upon them. She told me not to worry but I haven't reached out to her for the ultrasound FNAC procedure. I really don't want my neck to be punctured. I'm getting quite anxious also because now the scare of malignancy or benign is driving me nuts.
Anechoic mean no or less echos. The more solid the tissue the more echoes are received so the findings are suspected to be fluid filled or other possibly is air filled.
The report mentions no calcification which if present can raise concern level.
The report has omitted mention of the health size or central bridge (isthmus) but this likely means nothing remarkable, documented confirmation would be preferable.
Are you reluctant about the procedure or is there another concern?
I can reassure you it’s a straightforward quick process, by guided ultrasound. I was given a local anaesthetic & discomfort minimal. Sometimes confident doctors do complete quickly without local. Ask beforehand what they plan to do, & if the plan to do both areas. Fluid drained from cyst almost always refills.
I was told gently bite end of my tongue, this is to minimise swallowing & movement. Once numb the needle is passed a few times. I was able to work a busy shift after procedure as was only expecting a scan, I think the worry about having it done might have been far worse.
19 per of 20 samples do not require follow up.
Sample Collection failure can be quite high, more so with solid areas.
I think even though low risk of an issue a FNA is worthwhile as precaution. That’s is a large area & most nodules / cyst under 1cm are often observed but larger sized ones are investigated.
25mcg is a low starting dose, usually it’s 50mcg unless infant, elderly or with heart concerns. Doses initially do top up levels but once as TSH adjusts and thyroid tries to make same level of hormone this doesn’t maintain. So you may find in 2 months time you need a dose increase.
Is a plan in place to reassess levels and look at increasing in 6-8 weeks time?
Thank you so much for your reply! I can check with the ultrasound sonologist if there were any findings for the isthmus. Also what would calcification in the cysts signify? If it was present. And if the cysts are anechoic, that means that my left/right lobes could have airspaces. Are the airspaces normal to have?
One of the reasons I don't want to go for FNAC at the moment is that the rash which is present on my neck, is not getting diagnosed and I can't tell whether it is linked to my T.S.H or my thyroid or the cysts, or if it is a completely unrelated dermatological issue. The rash doesn't hurt, it's got no itch as such and it does spread down right under the adams apple. Should I first go for a consultation to a dermatologist and then later for an FNAC?
Also are there chances of the the cysts getting bigger if I choose to not get an FNAC? A big worry for me is malignancy and the fact that the doctor is not explaining things properly. I'm not confident in the doctor who did my ultrasound. I don't know if I'll be comfortable with her poking needles into my neck.
I will get another TSH test in 2 weeks to check if the same result comes. The doctor suggested to start with 25mcg and to increase it with time.
My gut feeling : if you currently feel basically 'well' , and can get on with your life ...then watch and wait for another ?year while having a go at carefully increasing you fitness again. (but keep an eye on TSH fT4 levels, cholesterol levels, and any hypo symptoms)
Have the FNA done because otherwise i suspect you'll just drive yourself nut's worrying about cancer.
You clearly do have an autoimmune thyroid problem, your raised TPOab & raised TSH confirms it, so it IS likely that at some point it will get bad enough that you actually WANT to take thyroid hormone, But that point could be years away (or even theoretically 'never')
Starting to take thyroid hormone is rarely an easy ride while you find the right dose... and taking fixed dose of thyroid hormone does inevitably interfere with your own bodys ability to respond autonomously to changes in demand for T4/T3 .
So if you currently feel well , why 'go there' before you have to ?
But remember , it is undeniable , with TSH at 8 ish you are probably already at slightly increased risk of certain health issues ..... heart issues, bones , cholesterol .
See this bmj.com/content/366/bmj.l4892 look at graphs in fig 1. some risks do go up pretty sharply once TSH starts to approach 10. (this is on patients on Levo , and they acknowledge there are some limitations to this study , but its still something you should read and consider as part of your decision about when /if to start Levo.
Presence of calcification can be an indicator with malignancy, but does not confirm it. It would also be is more common when there is a solid component to cyst. As you have neither solid areas or any form of calcification mentioned, that is good.
Air filled areas are quite usual, whereas thyroid nodules are very common.
Usually cysts remain the same, rarely they shrink by themselves, sometimes they do grow. Only monitoring can tell you for certain. You do have positive autoimmune so longer term you are likely to see changes to the thyroid.
A dermatologist might diagnose a separate issue or you might find adequate replacement hormone is what resolves your skin issue, but that will take time to know.
It’s always recommended to take replacement hormone for at least 6 weeks of continuous & consistent dose before measuring levels, theres no benefit in testing in between because your levels are in process of adjustment.
If you do not have faith in your doctor I can understand you wanting to delay. Once you have consulted with dermatologist and tried replacement levo you may feel confident it’s not necessary to check as the risk is so low, but if it is going to worry you might be best to have it done. Can you speak to doctor more about how it would be preformed, how often they do procedure, try and get some reassurance?
If you have hypothyroidism it is possible to have some skin changes. You've not given any past history in your profile but I am assuming you have hypothyroidism.
The following might put your mind at rest as worry can take up a lot of our day:-
Skin problems. Thyroid disease can cause a wide variety of skin issues depending on the problem. Patients with hypothyroidism often experience skin that is pale, dry and cool to the touch; itchiness and flaking are common. This disorder can also cause red or swollen skin, puffiness and velvety dark coloring in the folds of the skin. People with hyperthyroidism often have moist, warm skin and redness in the face and palms. They may experience thinning skin, as well.
Hi, thank you so much for your response. My medical background has been varicose/spider veins (which I have inhereted from my father). That was the extent of my knowledge, but now after daring to get my blood test results, I might have hypothyroidism, which is inhereted from my mother (yay!). Genetic potluck winner!
I've attached my test results above for reference Please let me know your opinions.
UPDATE: I got the following tests done and it seems I have subclinical hypothyroidism. I'm yet to schedule an appointment with a doctor but I have attached my test results. Please feel free to offer your guidance and suggestions.
Update—My endo told me to get on levy thyroxine 25mg (called Eltroxin) in India. I don't particularly want to start thyroid replacement as my TSH is still 8.92 and T3/T4/Peroxidase are normal, with just the antibodies being at 180. Got a thyroid ultrasound and found two solitary anechoic cysts. Attaching the report here.
Could the cysts be linked to the rash? My doctor has now asked me to get an ultrasound guided FNAC which is needle aspiration. Should I be getting the needle aspiration done for biopsy?
This is also a common indicator of Diabetes or pre-diabetes. Have you had your HBA1C checked ? I have this exact thing and had total thyroidectomy and diabetes Diagnosed much later.
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