Thyroid US results

[Kellyellen]

Please can anyone help me determine the likely next steps based on my US results. I do have a GP appointment booked to follow up.

The thyroid gland is enlarged with multiple nodules bilaterally.The nodules are avascular and well defined with micro-cystic spongiform appearances.The largest nodule within the right lobe measures 16 x11× 20 mm and largest nodule within the left lobe measures 37 x 27× 33 mm. No solid components or calcifications noted.No enlarged lymph nodes seen.CONCLUSION: Suggested benign U2 nodules

[SlowDragon Administrator]

next step get FULL thyroid including thyroid antibodies and vitamins tested

Details of private testing in your previous post here

healthunlocked.com/thyroidu...

Test early morning around 9am

[Kellyellen in reply to SlowDragon]

thank you, I’ve had full bloods/thyroid test and all normal - I haven’t had vitamins tested, is this something I will have to get done privately or does the NHS do this?

[tattybogle in reply to Kellyellen]

"normal" thyroid bloods include:

'genuinely normal for you' .

'normal for people who aren't you , so abnormal for you ',

'showing signs that the thyroid is beginning to struggle but not bad enough for the average GP to notice /or consider telling you about it yet '

and if only TSH was tested.. it can also include "hypothyroid due to central hypothyroidism which doesn't show unles you look at fT4 + TSH'

Therefore it's always a good idea to post the actual results and [lab ranges] for any thyroid tests that are reported to you as 'normal'

As for Vit testing ... NHS GP can easily order Vit b12/ Vit D /Folate /Ferritin if they choose to .. but they may not.

[SlowDragon Administrator in reply to Kellyellen]

looking at previous pos

FT4: 15.3 pmol/l (Range 11 - 21.2) 42.16%

FT3: 4.2 pmol/l (Range 3.1 - 6.8) 29.73%

Ft4 is on lower side and Ft3 low

You haven’t had TPO or TG thyroid antibodies tested for autoimmune thyroid disease

About 90% of primary hypothyroidism is autoimmune thyroid disease usually diagnosed by high thyroid antibodies

Low vitamin levels extremely common with autoimmune thyroid disease

Low vitamin levels often result of low Ft3

[Kellyellen in reply to SlowDragon]

hi SlowDragon, my gp tested my vitamin levels as suggested and also did a Fbc. Vitamins are all within range ( Serum ferritin only just 14 ug/L (normal range: 13 - 150)but my MCV is high (previous blood test in feb it was within range)

Mean corpuscular volume (MCV): 101.0 fL (normal range: 82 - 98)

do you have any wisdom on wether this might be related to my thyroid nodules? Thank you

[PurpleNails Administrator in reply to Kellyellen]

Please start new post with recent results, may be missed as older post & title relates to something different.

Only the person you replied to get notified of your new results, but new post more members will see.

Include vitamin test as in range is not same as optimal. 

Also include all FBC values as need to be looked at in context.  

Were antibodies tested?

If GP can’t agree to test. TPO & TG antibodies recommend you arrange privately.  

[SlowDragon Administrator in reply to Kellyellen]

Ferritin below 30 is deficient

You need FULL iron panel test for anaemia

High MCV suggests B12 or folate deficiency

testing.com/tests/mcv-test/

What were most recent B12 and folate results and ranges

[SlowDragon Administrator]

Definitely write new post with vitamin D, folate , B12 results

meanwhile Ferritin

Request Gp test for anaemia

Or use

Medichecks iron panel test 

Test early morning and only water before test

medichecks.com/products/iro...

Look at increasing iron rich foods in diet 

Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption

List of iron rich foods

dailyiron.net

Links about iron and ferritin

irondisorders.org/too-littl...

davidg170.sg-host.com/wp-co...

Great in-depth article on low ferritin 

oatext.com/iron-deficiency-...

drhedberg.com/ferritin-hypo...

This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.

healthunlocked.com/thyroidu...

Thyroid disease is as much about optimising vitamins as thyroid hormones

healthunlocked.com/thyroidu...

restartmed.com/hypothyroidi...

Post discussing just how long it can take to raise low ferritin 

healthunlocked.com/thyroidu...

Iron and thyroid link

healthunlocked.com/thyroidu...

Excellent article on iron and thyroid 

cambridge.org/core/journals...

Posts discussing why important to do full iron panel test

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

Chicken livers if iron is good, but ferritin low

healthunlocked.com/thyroidu...

Shellfish and Mussels are excellent source of iron 

healthline.com/nutrition/he...

Heme iron v non heme

hsph.harvard.edu/nutritions...

Ferritin over 100 to alleviate symptoms 

healthunlocked.com/thyroidu...

Great research article discussing similar…..ferritin over 100 often necessary 

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

Low Iron implicated in hypothyroidism 

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

We have received further information the lab about ferritin reference ranges. They confirm that they are sex dependent up to the age of 60, then beyond the age of 60 the reference range is the same for both sexes: 

Males 16-60: 30-400 ug/L

Female's: 16-60: 30-150

Both >60: 30-650 

The lower limit of 30 ug/L is in accordance with the updated NICE guidance and the upper limits are in accordance with guidance from the Association of Clinical Biochemists. ‘