Swollen Thyroid and normal thyroid function - Thyroid UK

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Swollen Thyroid and normal thyroid function

Monique1980 profile image
13 Replies

Hello, I am hoping someone may have some advice for me. I have Graves and my thyroid was become increasingly swollen over the last few weeks and I have had 3 full thyroid function tests completed in the last 6 weeks, 2 of which have came back normal and the last I am still waiting for.

My thyroid feels enlarged in my throat and has been giving me a hoarse and croaky voice. I am also experiencing hot flushes, twitches, fatigue and muscle ache.

I also had a CT scan on my thyroid yesterday which came back normal so my GP is unsure what is causing my issues.

I am currently not on medication and considered euthyroid.

Has anyone experienced anything similar?

Thanks x

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Monique1980
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SlowDragon profile image
SlowDragonAdministrator

Please add most recent results and ranges Test early morning for highest TSH

TSH, Ft4 and Ft3.

Thyroid antibodies

TPO and TG antibodies- can be high with Hashimoto’s or Graves

TSI or Trab antibodies- only high with Graves’ disease

Vitamin D, folate, ferritin and B12

Monique1980 profile image
Monique1980 in reply to SlowDragon

Hi SlowDragon

I struggle to get my results out of my surgery but have just been given these,

Serum free T4 level 16.8 pool/L (11.0-22.0)

Serum TSH level 0.67 miu/L (0.27-4.2)

The thyroid function test wasn’t run.

This is all they have tested me for.

SlowDragon profile image
SlowDragonAdministrator in reply to Monique1980

So you will need to test privately

Test early Monday or Tuesday morning

List of private testing options and money off codes

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

Medichecks Thyroid plus antibodies and vitamins

medichecks.com/products/adv...

Graves Disease antibodies test - has to be by private blood draw…not DIY finger prick

medichecks.com/products/tsh...

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins

bluehorizonbloodtests.co.uk...

Only do private testing early Monday or Tuesday morning. Watch out for postal strikes, probably want to pay for guaranteed 24 hours delivery

Link about thyroid blood tests

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

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

Link about Graves’ disease

thyroiduk.org/hyperthyroid-...

pennyannie profile image
pennyannie

Hey there again :

We spoke around 2 years ago and I left you digging out your initial blood test at diagnosis and the proof of Graves disease by either a TR ab or a TSI over range and positive antibody test ???

That is an enormous trunk you have there Monique !!

I'm a bit confused as your other post mentions a very high T3 reading and now we have a T4 and a TSH but no T3 reading.

We really do need to see a TSH , T3 and T4 from the same blood to say anything sensible.

I notice you are not taking any medication at all now, how are you feeling in yourself apart from the obvious as detailed above, and do you have eye discomfort ?

The most current research is suggesting that the longer the patients stays on the AT medication the better the outlook of remission:-

pubmed.ncbi.nlm.nih.gov/338...

You might like to dip into Graves - which is an auto immune disease said to be driven by stress and anxiety - elaine-moore.com

Monique1980 profile image
Monique1980

Thanks pennyannie SlowDragon , as I mentioned getting my results out of my gp is hard work. I went to the surgery yesterday and they said they could only give me my latest test results even though I asked for all my tests since diagnosis. I told them I needed them and was eventually told they would call me once they came available.

I had a advanced private test with Medichecks in March 2021 so I have rebooked another one with them ASAP. I’ll post results of those once received.

Below is what I managed to find at home:

Diagnosis test December 2018

TSH - less than 0.03mU/L (0.35-5.5)

Free T4 - 26pmol/L (10.0-19.8)

TSI - 3.02iu/L (0-1.3)

March 2019

TSH - less than <0.03mU/L (0.35-5.5)

Free T4 - 18.1pmol/L (10.0-19.8)

Serum CA 125 - 23kU/L (0.0-35.0)

June 2019

TSH - 4.01mU/L (0.35-5.5)

Free T4 - 12.6pmol/L (10.0-19.8)

Thyroid Peroxidase Antibodies- 32iu/ml (0.0-60.0)

CRP - <4mg/L (0.0-6.0)

September 2019

TSH - 2.54mU/L (0.35-5.5)

Free T4 - 13.6pmol/L (10.0-19.8)

August 2020

TSH - 1.97mU/L (0.35-5.5)

Free T4 - 11.9pmol/L (10.5-21.00)

December 2020

TSH - 2.24 (0.35-5.5mU/L)

Free T4 - 13.4 (10.5-21.0pmol/L)

CRP - <4mg/L (0-5mg/L)

March 2021 (private)

CRP - 0.55 (0-5mg/L)

Ferritin - 31ug/L

Folate - 4.32ug/L

B12 - 44.7pmol/L

Vit D - 29.4nmol/L

TSH - 2.55

Free T3 - 4.56

Free T4- 15.8

Thyroglobulin Antibodies <10 Kiu/L

Thyroid Peroxidase Antibodies 22.7 kiu/L

April 2021

TSH - 2.72miu/L (0.35-5.5)

Free T4 - 14.1pmol/L (10.5-21.0)

MEDS STOPPED 9TH JUNE 2021

July 2021

TSH - 1.11miu/L (0.27-4.2)

Free T4 - 15.7pmol/L (11.0-22.0)

October 2021

TSH - 0.75miu/L (0.35-5.5)

Free T4 - 14.5pmol/L (10.5-21.0)

Apr 2022

TSH - 0.67miu/L (0.27-4.2)

Free T4 - 16.4pmol/L (11.0-22.0)

July 2022

TSH - 0.67 (0.27-4.2miu/L)

Free T4 - 16.8 (11.0-22.0 pmol/L)

pennyannie profile image
pennyannie in reply to Monique1980

Can you please add the ranges for each result please :

Monique1980 profile image
Monique1980 in reply to pennyannie

Hi pennyannie , I have added in the ranges to the above post

pennyannie profile image
pennyannie in reply to Monique1980

I've already replied below - thank you :

pennyannie profile image
pennyannie in reply to Monique1980

So, in December 2018 -

I think the cut off point for the TSI - Graves antibody is 1.30 - 1.40 so a result of 3.20 is definitive.

Your TSH is likely under range at 0.03 and your T4 looks a little high, but could be in range :

With an AT drug prescribed the following couple of years look like you would expect with a TSH rising into the range and a T4 falling back down into presumed range.

The CRP is an inflammation marker showing your body inflamed.

March 2021 - the private blood test :

Ferritin, folate, B12 and vitamin D all look too low - were you advised and did you start supplementing anything - if this is Medichecks I have the ranges as I use this company and I now aim for a ferritin of around 100 : folate 20: B12 active 75++ and vitamin D 100 :

The other antibodies are for Hashimoto's AI thyroid disease and negative.

We do have a TSH at 2.55 with a T3 at 4.56 and a T4 at 15.80 - no ranges ;

so from a conversion standpoint your doing ok and your conversion ratio coming in a little fast at around 3.46 - generally ratio is said to somewhere between 1 / 3.50 - 4.50 - T3/ T4 - and you just need to divide your T4 by your T3 to get the answer.

Since stopping the AT drug your TSH has started to go down and your T4 slowly go up i and in July just gone your T4 is coming into the range at around 58% :

Throughout this period the NHS have not tested T3 and this needs to be seen in conjunction with any TSH and/ or T4 reading from the same blood to be mean anything.

Hope that helps a bit :

Monique1980 profile image
Monique1980 in reply to pennyannie

Thanks, yes I am using Medichecks for my private testing. I was told to take vitamins after this for folic, vitamin d and B12. I also take a Selenium suppplement. Thanks for the vitamins levels, I am retesting with Medichecks on 19th September so will use this as a guide.

SlowDragon profile image
SlowDragonAdministrator

2018

What’s the range on TSI result?

your vitamin results are terrible….

March 2021

CRP - 0.55 (0-5mg/L)

Ferritin - 31ug/

Folate - 4.32ug/L

B12 - 44.7pmol/L 

Vit D - 29.4nmol/L 

TSH - 2.55

FT3 - 4.56

Ft T4- 15.8

Thyroglobulin Antibodies <10 Kiu/

Thyroid Peroxidase Antibodies 22.7 kiu/L

Are these tests from Medichecks?

Was test done early morning, ideally around 9am

Are you vegetarian or vegan?

Ferritin is deficient

B12 extremely low, probably deficient

Folate inadequate

Vitamin D insufficient/deficient

What vitamin supplements are you currently taking

Optimal vitamin levels are

Ferritin at least over 70 and nearer 100

Active B12 at least over 70

Serum B12 at least over 500

Folate at least half way through range

Vitamin D at least over 80nmol

SlowDragon profile image
SlowDragonAdministrator

still no range on TSI test result

Ft4 was only mildly raised….if TSI test isn’t over range….this looks like Hashimoto’s rather than Graves’ disease

But if TSI is over range…..then Carbimazole or PTU dose was a bit high

Strongly recommend getting vitamins retested and improving to optimal levels

Get coeliac blood test done before considering trial on strictly gluten free diet

Monique1980 profile image
Monique1980 in reply to SlowDragon

thanks SlowDragon The results came in a letter from my endocrinologist with no ranges. I checked online for normal ranges and added those in above

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