Technitium uptake?

[shz1]

Hi,

Can anyone help interpret the results of a technetium thyroid uptake scan?

I have a multinodular goitre with no worrying nodules confirmed by ultrasound scan and also nuclear scan.

I had a technetium uptake scan and the results show a percentage uptake of 0.4%.

Is this good or bad?

Bloods -

TSH 0.15 mU/L (normal range 0.30 - 4.5)

Serum Free T4 17.2 pmol/L (normal 11.0 - 22.0)

Serum Free T3 4.6 pmol/L (normal 3.1 - 6.8)

Cortisol 267 nmol/L (normal >133)

[helvella]

I know nothing about technetium scans - but this link just might help.

radiopaedia.org/search?q=te...

[PurpleNails Administrator]

I’ve seen different ranges for uptake scans. There should be a target range & similarly with blood test results this likely varies depending on how the machine or technology is set to calculate it.  

The amount of material administered & time allowed between receiving it and scan taken a would also vary the expected uptake. 

I have had an uptake scan but the report never specified an %, but from the image pattern it was evident I had a concentrated area hyper functioning nodule & the thyroid was virtually entirely suppressed. 

Your blood test show your TSH is low but your thyroid levels are within range, FT3 is low in range. 

Have you had thyroid antibodies tested? 

Do you current take any thyroid \ antithyroid medication?

[shz1 in reply to PurpleNails]

Hi, thanks for your reply.

I had antibodies tested, I have antibodies but they’re under the limit.

I’m not on any medication

[PurpleNails Administrator in reply to shz1]

Which antibodies as there are numerous types.

What was result & lab range?

 TPOab (Thyroid Peroxidase antibodies) 

TGab (Thyroglobulin antibodies)   

Both TPO & TGab signify thyroid autoimmune affecting thyroid - can be either under active or over active.  

If hyper Graves suspected this can be confirmed by 

TSI - Thyroid-Stimulating Immunoglobulin (signifies hyper Graves) 

TRab - TSH receptor antibodies (TRAb) (signifies Graves test blocking, neutral & stimulating antibodies) 

[shz1 in reply to PurpleNails]

TPOAb 13.5 kIU/L (normal range 0 - 34)

TGAb 17.8 kU/L (normal range 0 - 115)

[PurpleNails Administrator in reply to shz1]

TPO & TG negative.

TSH should not be so low.  

You’d expect it to be in range or high to reflect low FT3. 

Might be worth asking for TRab or TSI be tested.  

If FT4 & FT3 are high for you enough to lower TSH you may have Graves autoimmune, but to me the thyroid levels do not look high enough. 

Have you previously had hyper symptoms at any stage?

This could indicate an issue with hypothalamus or pituitary…Referred to as “Central” or “secondary” hypothyroidism / as the issue is not primary (with thyroid).

Doctors likely will not look to diagnose / treat unless FT4 & FT3 fall under range.

From the scan report there is some issues with thyroid.  Could be both issues involved? 

Any blows to head especially frontal or severe blood loss eg during traumatic birth? 

[shz1 in reply to PurpleNails]

No head injuries, one delivery wasn't straightforward, traumatic to me but but nobody called it traumatic or mentioned severe blood loss?

I will ask about the extra antibody tests, thank you for all your help