Hyperactive with Nodules. Please comment on latest results.

[Hugoo]

Hi,

Have been Hyperactive since January 2019. 2 Nodules one on each lobe. I am now 58 and female.

Taking Carbimazole 2.5 mg 3 x a week.

Had my telephone consultation today with bloods taken on 2/3/2022.

Results

TSH 3.54 0.35-5.00 mul

T4. 16.9 7.00-22.00 pmol/L

T3. 4.7. 3.80-6.70. Pmol/L

Results from last bloods 20/9/2021 ( same ranges)

TSH 3.39

T4 11.1

T3 4.9

In discussion with Endo they are ok results in range. Again was told that no cure for Nodules except RAI or surgery. Endo said I could initiate the process anytime. I said I will make a decision on our next call in 3-4 months.

What do you think about the T4 rising?

Could it have risen even more between March and today?

I feel very tired and joint aches. Still tinnitus and brain fog days. Can feel palpitations sometimes.

I feel very tempted to have the treatment after next call.

Thank you for reading

With many regards

[PurpleNails Administrator]

Your FT4 has risen quite a lot from 11% of range to 66%. It’s still in range so I would adjust anything yet. If it were to continue to rise you could increase carbimazole to every other day.

Your FT3 on the other hand has dropped very slightly from 38% to 31% through range.

How are your folate, ferritin, B12 & vitamin D level as the contrast shows poor conversion.

2/3/2022.

TSH 3.54 0.35-5.00 mul

T4. 16.9 7.00-22.00 pmol/L. (66%)

T3. 4.7. 3.80-6.70. Pmol/L (31%)

20/9/2021 ( same ranges)

TSH 3.39

T4 11.1 (27%)

T3 4.9 (37.9%)

Have you ever researched radio frequency ablation. It’s not offered in my area but I have known of others arranging a referral and traveling. It’s easier if near one of the hospitals which have it available.

[Hugoo in reply to PurpleNails]

Good to hear from you PurpleNails and thank you.My ferritin is never very good. I last had it done a couple of months back and it was under 30. I didn’t get called in for supplement though. The rest were in range.

I have never really understood about converting.

I have heard of ablation. Not offered in Hampshire.

[PurpleNails Administrator in reply to Hugoo]

Could you travel? I would struggle with travel so haven’t pushed for referral. It’s available in London UCLH or Royal Berkshire. From what’s I read you do need assessment prior to treatment and 2 biopsies prior to the procedure (local hospital should assist with that) you may need follow up also.

Under 30 ferritin is ferritin deficiency. Didn’t doctor do iron panel?

[Hugoo in reply to PurpleNails]

Thank you for this info. Will look at the Berkshire Hospital. No the doctor didn’t treat.

[PurpleNails Administrator in reply to Hugoo]

Some useful links

Royal Berkshire patient information about procedure

royalberkshire.nhs.uk/media...

Nice guidance

nice.org.uk/guidance/ipg562

Research articles.

ncbi.nlm.nih.gov/pmc/articl...

pubmed.ncbi.nlm.nih.gov/195...

RFA is rarely suggested as a potential option in areas not close to hospitals known to perform it. Most hospitals do not have an automatic protocol in place to refer patients. I have read reports of doctors saying there is no funding stream for it, and patients have had to collate the information themselves, some have contacted CCG for guidance of what treatment can be funded ect, in other words battle for themselves to be referred and treated.

The thyroid nodule must be benign & not overgrown ie not restosternal. Larger nodules swelling need repeated treatments.

There has been a few previous posts referencing RFA, which you can search for. of the handful of people that have previously posted about personal experiences most have had successful outcome. I also know of a poster who had adverse reaction to the way the local anaesthetic was administered. Complications in that respect are almost equal to surgery although the preservation of thyroid function on balance is better with RFA.

[Hugoo in reply to PurpleNails]

Thank you so much

[Hugoo in reply to PurpleNails]

I stand corrected . It was 45 but 24 the time before.