New diagnosis of Hashimoto's disease

[Scorpi00]

I just got diagnosed with Hashimoto's disease. I am in the beginning stage of it where my TSH levels are normal but I have high antibodies levels. I also have an enlarged thyroid and a decent size nodule on the left side. There are times where I feel like my thyroid is irritated and my throat feels tight and has something in it. My voice can get hoarse from time to time as well. Is there something that the doctors can give me to relieve these symptoms besides Aleve or something like that? Or is it even better to take out the nodule or even the whole thyroid itself?

[FancyPants54]

Goodness me never have your thyroid removed unless you are diagnosed hypERthyroid and even then think hard. So many people rue the day.

I don’t know what to recommend for the other part of the question.

[Litatamon in reply to FancyPants54]

Surgery is always last resort, and of course due to cancer is a given.

But your statement is way too narrow. I chose biopsies and scans for my nodules. Knowing that I was struggling with breath and swallowing, both felt that I could live with it. You start to not remember normal.

Then I almost drowned. When I am a strong & confident swimmer. And this was happening in mere minutes of joyfully jumping off my sister's boat.

At the same time coincidentally my endocrinologist did a physical test that showed me - she was just testing + how the size and placement were affecting breath and voice.

And I realized the connection. And my outlook changed. I had had zero interest in surgery.

And here I am happy with the total thryoidectomy and thrilled with the outcome a la positive changes. And this is coming from someone who is still struggling with replacement hormones. Do I wish I had a thyroid? Absolutely. But I could not believe the difference after surgery. The obstructed feeling is gone. And I don't start wheezing when hardly doing a thing. Too many changes to list. I would choose it again in a heartbeat. And of course respect and know there are many who regret they chose it.

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Also, we are not offered radio frequency ablation in our country due to cost. However, my surgeon has worked on patients that have gone abroad & across the border to the States for the procedure. Why? Because everything had grown right back over time. So it is not always the gem.

As for supplementation shrinking nodules, the definitive research is not there. And even the Synthroid pamphlet states that is is not for that outcome. Of course who wouldn't give it a go though regardless, if there was hope for it to help.

[PurpleNails Administrator]

Welcome to forum

The TSH thyroid stimulating hormone is a pituitary hormone which signal thyroid to produce, the higher the level the lower doctors assume your thyroid levels are but the TSH is very unreliable, it many be in range but that doesn’t mean your thyroid levels are.

You need to know what you FT4 & FT3 are (actual thyroid hormone) the unbound levels are what you need to know the (Free)  Thyroxine(T4)  & free Triiodothyronine (T3).

Also important to test folate, ferritin, vitamin D & B12.

Which anti bodies were tested ? TPO - there are other thyroid antibodies always add result & range (ranges vary between labs) 

A struggling thyroid will swell as it working hard to keep up.   Nodules will swell too but most nodules do not function, some do function normally (or same as rest of thyroid) rarely they over function.

Have you had a scan to confirm is nodule is solid of cystic (fluid filled).   There’s a possibility adequate replacement allows the thyroid to reduce in size.

If you have compression issues with thyroid swelling or growth eg downward behind Breast bone.  If Thyroid was to impact on voice, swallowing or breathing then surgery if necessary regardless of function.  

Sometimes Nodules can be targeted with a less invasive treatment called radio frequency ablation.  It’s limited where I am to a few hospitals & patients are not automatically referred, but the options may be different where you are.

Surgically either 1 lobe or entire thyroid is removed.

[Scorpi00 in reply to PurpleNails]

I will post my lab results:

TSH: My value: 1.43 mIU/L

Standard range: 0.40-4.50

T4 FREE: My value: 1.3 ng/dL

Standard range: 0.8 - 1.8 ng/dL

THYROGLOBULIN AB: My value: 2 IU/mL

Standard range: < or = 1 IU/mL

THYROID PEROXIDASE AB: My value: 387 IU/mL

Standard range: <9 IU/mL

These things were the only things tested. Also got a biopsy done on that nodule. They found polymorphous lymphocytes and scattered Hurthle cells. No cancer though which is good.

I had a ultrasound done as well. Found out that nodule is solid and is about 2.3 cm. It is either non-functioning or normal. Would you happen to know if they can reduce the size of it even if it is solid? If not, I may have to have that remove which should help with the size of my thyroid. That would be better than taking out the whole thyroid.

[PurpleNails Administrator]

Your FT4 is 50% of range.   That might be normal for you or it might not,  Knowing what FT3 is would be useful.

Without know FT3 Hard to say if you need replacement,  if FT4 & FT3 become low then you would.  

You have antibodies so you need to monitor levels and start replacement as they approach the bottom of range.  

When on replacement most feel well with FT4 top 3rd of range & FT3 at least half way.

It’s possible adequate replacement reduces thyroid & nodule but not a guarantee.  

Radio frequency ablation is for solid / benign nodules - it percutaneously target the nodule the electrode is heated and destroy nodule.

Surgery doesn’t isolate the nodule from thyroid it’s either the entire lobe / or full  thyroid is removed.  Something to do with the vascilture of the thyroid.