Thyroid ultrasound

[A1Amber]

I had a thyroid ultrasound today. I have Hashimotos and in the last two and a half years have developed a hoarse voice, tightness in throat.

Two years ago I had an ultra sound done in a local hospital who reported to my Gp 'fine'. The result on my online medical record said X701s. I do not know what this means.

Since the voice/throat symptoms persist I was referred to a large city hospital and the ultra sound was done today. This ultrasound seemed to me more thorough. The ent consultant said my thyroid was atrophied and in her opinion it had been for a long time.

Could anyone explain what this all means please?

[Jaydee1507 Administrator]

An atrophied thyroid just means it has been damaged by your Hashimoto's disease and not able to produce the thyroid hormone it once did. Pretty normal for someone with Hashi's.

When you last posted you were under replaced. Did you get a dose raise?

You were also not converting well so perhaps the low FT3 will be causing your remaining symptoms. Have you thought how you might get some T3 added to your Levo?

Did you get the B complex as recommended? OPTIMAL vitamins are required for our thyroid hormone to work effectively.

[A1Amber in reply to Jaydee1507]

Thank you for your reply.

I haven't had any changes to my medication. I did consult a private endo. Almost £600 in fees for 3 telephone appointments! And a conclusion that my 200 mg levothyroxine was OK. This endo recommendation through someone on this site.

My GP said he's satisfied my dosage is correct.

I take the B12 Vit D and Selenium.

[Jaydee1507 Administrator in reply to A1Amber]

I'm sorry you had a fruitless encouter/s with an Endo. Thats really not good when its so expensive. I can only suggest trying a different Endo and putting together your case for added T3. Take documents or email them with the percentages through range along with your symptoms.

As far as your GP goes, I would try a different more amenable GP at the same practice. Take along evidence from here of keeping the TSH lower as per Tattybogles pinned post. With this condition you have to become your own health advocate. Arm up with a small amount of knowledge, a touch of confidence and tackle your GP.

Your folate was very low in your last vitamin results. You really do need a good B complex like Thorne Basic B.

[radd]

A1Amber,

I too had a hoarse voice , dry raspy cough and tightness in my neck for years pre diagnosis. Thyroid gland damaged used to be less clearly defined in the text but now it is stipulated that Hashi antibodies (TPOAb's) cause fibrosis of the follicular cells, and TRAbs cause atrophy through blocking actions. 

In the conventional medicine world there is a distinct lack of knowledge surrounding thyroid antibodies and both Hashi and Graves Ab's are not usually tested together as it is thought we can only have one condition or the other. But it is common for Hashi diagnosed people to have an atrophied thyroid gland (I have) evidencing a TRAb presence at some point and your endo was obviously clued up to have TRAb’s tested. Although it was suggested the blood was too old your previous TRAB’s test result was just over range! Did you ever get a retest? 

After the gland has atrophied you will need total replacement meds and many of us require a little added T3 due to not only impaired T4-T3 conversion through lack of TSH (and possibly genetic mutations) but to replace the T3 that was produced directly by the now missing thyroid gland. 

200mcg levo is quite a fair dose not to be alleviating quite severe symptoms or correlating in labs. If iron and nutrients are good then another common problem is issues with our sex hormones involving excess binding proteins that risk binding thyroid hormone meds. This makes the ‘frees’ reduce (available to become actitive) and inactivating the little 'free' we have. Are you still having periods? Have you had oestrogen and progesterone tested?

[A1Amber in reply to radd]

Thank you for replying to me Radd. I am grateful that you have both taken the trouble to respond and to have read my earlier posts.

My Gp surgery whilst pleasant are firmly saying all is well. Despite these symptoms which tell me it's not! The Trab test was done on NHS at the request of the private (telephone only!) endocrinologist. I was told by the Gp firstly that the lab had reported the blood was too old yet a result was posted on my online medical record.

My GP organised more recent blood tests which I think may include the hormone tests you mention. Since no one has contacted me I presumed they were OK.

The results were

Serum follicle stimulating hormone level 80.0 lU/L

Serum oestradiol level 93 pmol/L

I am 66 and after having a Mirena Coil at the age of 37 never had another period. The coil was removed in my mid 50's and I was never aware of any menopause symptoms until 2 years ago. I now have sudden flushes/sweats and heart racing to over 100 bpm when at rest.

Whether my thyroid plays any part in this I do not know.

The hoarse voice, tightness in throat, swollen eyelids ( had reduced peripheral vision) are being looked at by ENT and Opthalmic departments not Endocrinology.

I have a letter from my GP dated 3 years ago saying perhaps I might see a private endo myself as in our County that would be difficult to do under NHS

Well I've done that. Spent a lot of money, am no wiser and have not progressed.

The discovery yesterday that my thyroid is 'dead' means what? I really do not know.

[radd]

A1Amber,

Atrophy means your thyroid gland has shrivelled and is non-functioning. When mine was last scanned it was like a dried up pea almost non-existent. When your thyroid gland was intact it was positioned directly below the larynx sharing arteries, etc. Thyroid hormone receptors have even been found in the larynx and why we can experience voice changes.  

When we remain under medicated (or with the right amount of meds but which aren't working well), the adrenals step in to compensate. If cortisol is low, then adrenaline will be used instead, hence the sweats and pounding heart.

Thyroid hormones that aren't being well utilised are not always just pee'd away but changed into inactive metabolites as a sort of safety mechanism. It can be difficult to reverse this action but optimising iron and nutrients is helpful and aiming to reduce autoimmune low grade inflammation. Vit D, Vit C, fish oils and curcumin are all natural inflammatories. FSH & Oestrogen levels are normal for menopause. 

Have you read ‘The Root Cause’ by Isabella Wentz? She offers a good understanding on how Hashi and autoimmune conditions effect the body. I’m sorry to hear about your poor eyes. Ensure the Opthalmic Department know you previously had elevated TRAbs and should be therefore mindful of thyroid eye disease. 

[A1Amber in reply to radd]

You are really well informed Radd! I thank you for passing on your knowledge. I shall read 'The Root Cause'