Thyroid swelling

[Berryholly]

About 2.5 years ago I noticed my neck looked a bit swollen and I feel like it’s got steadily more pronounced. Blood tests (FBC and U&Es and free T3, free T4 and TSH) are normal and my ultrasound was normal and the GP couldn’t feel anything when he felt my neck.

I’m 31, a midwife doing shift work and around Sep 2019 I came off lucette contraceptive pill (2 months later first noticed the swelling.) I then had IUD inserted (kyliena) in Nov 2019. I’ve also put on about 2 stone since starting my degree but I don’t have the best eating habits. What should I do going forward? I really notice the swelling in photos (I feel like it looks like the shape of an upside down kidney bean along the base of my throat) and I’m scared it’ll get worse. Also worried I have something wrong with my thyroid and it’s just not showing up on tests yet. Sorry for the long message! I just don’t know where to turn next (I’m assuming I’ll need private investigations) thanks!

EDIT:

Last set Nov 21

FT3 - 5.2 (range 3.5-6.5)

FT4 - 13.3 (range 10-20)

TSH - 2.39 (range 0.35-4.78)

UPDATE:

Thanks so much for all your advice everyone! I’ve booked an advanced thyroid screen with medichecks. Feel so much more positive xx

[PurpleNails Administrator]

What were the TSH, FT4 & FT3 results. Normal means “in range” might mean just within range and your thyroid level may be very low.

EDIT Also, was 2019 the most recent test? you need current ones & alway obtain and view a copy of any scan report. The are often details about the health of thyroid which pass as normal but can indicate potential issues.

[Berryholly in reply to PurpleNails]

Last bloods taken in Nov 21:Free T3 5.2

Free T4 13.3

TSH 2.39

Should I be asking for full thyroid screen with minerals? The GP is very reluctant to do anything further because nothing abnormal so far.

[PurpleNails Administrator in reply to Berryholly]

Can you add ranges please (ranges vary between labs). They look within range by most ranges we see, but FT4 on lower side.

[Berryholly in reply to PurpleNails]

Thank you so much for your replies! First time I’ve felt like I have a plan!

Ranges FT3 5.2 (3.5-6.5)FT4 13.3 (10-20)

TSH 2.39 (0.35-4.78)

[PurpleNails Administrator in reply to Berryholly]

For those ranges FT4 is 33% of range & FT3 is 56.67%.

Higher the TSH the more thyroid is struggling so while in range Doctors will recognise not a thyroid issue. Poor nutrients can lower TSH.

Higher FT3 can sometimes show that the body is prioritising maintaining FT3 levels as normally FT3 is fractionally lower percentage wise to FT4. FT3 is mostly converted from FT4 & usually FT4 & FT3 should be well balanced.

It’s worth monitoring and testing for antibodies if not already tested. Presence of antibodies will show if autoimmune damage is occurring and worsening underactive levels would inevitably continue. This should convince a open doctor to begin treatment before levels drop to severe hypothyroidism.

I’d recommend a test with function, antibodies & nutrients first. (Eg Medichecks or blue horizons). Then if there is a pattern of reducing levels dr should be prepared to repeat. If Doctor won’t retest you can use a basic function test of TSH, FT4 & FT3 privately will monitor levels a few months later. (Eg monitor my health test)

[SlowDragon Administrator in reply to Berryholly]

Please add ranges

Assuming Ft4 range is 12-22 ….Ft4 is low

Yes suggest you get FULL thyroid and vitamin testing including thyroid antibodies

What vitamin supplements are you currently taking

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested.

Very important to test vitamin D, folate, ferritin and B12 at least once year minimum

Low vitamin levels are extremely common, especially with autoimmune thyroid disease (Hashimoto’s or Ord’s thyroiditis)

Autoimmune thyroid disease with goitre is Hashimoto’s

Autoimmune thyroid disease without goitre is Ord’s thyroiditis. Both are autoimmune and generally called Hashimoto’s.

In U.K. medics hardly ever refer to autoimmune thyroid disease as Hashimoto’s (or Ord’s thyroiditis)

Recommended on here that all thyroid blood tests early morning, ideally before 9am

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

List of private testing options and money off codes

thyroiduk.org/getting-a-dia...

Medichecks Thyroid plus antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins by DIY fingerprick test

bluehorizonbloodtests.co.uk...

Come back with new post once you get results

[Berryholly in reply to SlowDragon]

I’m not currently taking any supplements. I’ve been nervous to take anything that might make the goitre worse. What would you recommend initially? A multi vit? Thanks! x

[SlowDragon Administrator in reply to Berryholly]

Don’t start any supplements

Test and come back with results

Multivitamins never recommended on here

[greygoose]

Hmmmm... Looks like your thyroid is struggling a bit.

TSH is too high. A euthyroid TSH is around 1, never more than 2, and you are technically hypo when your TSH gets to 3.

FT3 - 5.2 (range 3.5-6.5) 56.67%

FT4 - 13.3 (range 10-20) 33%

So, your FT4 is too low. A euthyroid FT4 would normally be around 50%.

A euthyroid FT3 would normally be just slightly lower than the FT4.

Your FT3 is much higher than the FT4. This often happens when the thyroid is failing. It makes more T3 than T4 to maintain T3 levels at the expense of T4, to keep you alive.

So, whilst you're not actually hypo yet, you might become so. Therefore, you need to continue testing to see what happens. And, most importantly, get your antibodies tested to see if you have Hashi's - Autoimmung Thyroiditis - you may well have because it sounds as if your thyroid is inflammed.

There are two Hashi's antibodies: TPOab and TgAB. The NHS (I assume you are in the UK?) will only test TPOab. But, if either of them are high, it will suggest Hashi's.