Hello
I have hashimoto's (2021 diagnosis), but thyroid markers have always been "normal".
I have just had them re-done and a thyroid scan and have the following results:
TSH - 5.65
T4 - 9
Scan:
- Thyroid texture is hypo with micro nodularity
- Mild hypereamia noted
- No focal lesion
Can anyone help me understand the scan results? I have tried googling but not got very far in understanding what this means.
Thanks!
Welcome to the forum katyy94x,
So we can offer better advice, can you tell us more about your thyroid condition, eg when you were diagnosed, ongoing symptoms, current medication & dosage etc.
Can you add the reference ranges to your blood test results, as these can vary between laboratories. TSH should always be under 2, so your elevated result shows your thyroid is struggling. Do you have a result for FT3?
Can you share any antibody and key vitamin tests (ferritin, folate, vitamins D and B12)
If your GP is unable to complete all the above (eg if TSH is within range, some surgeries may not be able to access FT4 and FT3 tests), you could look to do this privately, as many forum members do, for a better picture of your thyroid health:
thyroiduk.org/help-and-supp...
Hey
TSH ref is 0.35 - 5.50
T4 - 7.86 - 14.41
No medication for it as i am fighting for an endocrinology referral, hence these tests and scans. Do you understand the scan language? I don't want to freak myself out unnecessarily on google lol but think hypo means hypoechoic maybe?
ESSENTIAL to regularly retest vitamin D, folate, B12 and ferritin
When were these last tested
Please add most recent results
What vitamin supplements are you taking
Low vitamin levels tend to lower TSH
With high thyroid antibodies (hashimoto’s) and symptoms you should be started on Levothyroxine after 2 separate blood test results with TSH over 5
ALWAYS test thyroid levels early morning, ideally before 9am and only drink water between waking and test - this gives highest TSH
have you had coeliac blood test
If not Gp should test as per NICE guidelines
Thanks so much for this it’s so useful! I did get this test done at 7:30 am without eating as I’d managed to find that out myself when booking the bloods! Can’t remember for previously tests what time they’ve been though as I didn’t know this before.
I do have low Iodine, B12 and Ferritin when last tested in 2021 so will get these checked again. I had no idea this can lower TSH results! I’ve had symptoms for years but also have PCOS so think a lot gets blamed on that. But the last year my left side has been on/off painful and inflamed.
Might sound odd but when I press just above the left side it almost clicks as if there’s fluid in there popping? Nothing says anything about a cyst on the scan report though.
I’ve been told by doctors previously they don’t want to prescribe levothyroxine yet because then I might go hyperthyroid - obviously I don’t want that!
Also - celiac!!! I have had awful reactions to gluten recently, to the point I have no intention of touching it again. Never would’ve put these two together so will defo ask about this test too.
Gluten intolerance and autoimmune thyroid disease
No point testing for coeliac if already on gluten free diet
Hashimoto's affects the gut and leads to low stomach acid and then low vitamin levels
Low vitamin levels affect Thyroid hormone working
Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances.
Most common by far is gluten.
Dairy is second most common.
A trial of strictly gluten free diet is always worth doing
Only 5% of Hashimoto’s patients test positive for coeliac but a further 81% of Hashimoto’s patients who try gluten free diet find noticeable or significant improvement or find it’s essential
A strictly gluten free diet helps or is essential due to gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)
Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and may slowly lower TPO antibodies
chriskresser.com/the-gluten...
amymyersmd.com/2018/04/3-re...
thyroidpharmacist.com/artic...
drknews.com/changing-your-d...
Non Coeliac Gluten sensitivity (NCGS) and autoimmune disease
pubmed.ncbi.nlm.nih.gov/296...
The predominance of Hashimoto thyroiditis represents an interesting finding, since it has been indirectly confirmed by an Italian study, showing that autoimmune thyroid disease is a risk factor for the evolution towards NCGS in a group of patients with minimal duodenal inflammation. On these bases, an autoimmune stigma in NCGS is strongly supported
nuclmed.gr/wp/wp-content/up...
In summary, whereas it is not yet clear whether a gluten free diet can prevent autoimmune diseases, it is worth mentioning that HT patients with or without CD benefit from a diet low in gluten as far as the progression and the potential disease complications are concerned
restartmed.com/hashimotos-g...
Despite the fact that 5-10% of patients have Celiac disease, in my experience and in the experience of many other physicians, at least 80% + of patients with Hashimoto's who go gluten-free notice a reduction in their symptoms almost immediately.
Similarly few months later consider trying dairy free too. Approx 50-60% find dairy free beneficial
With loads of vegan dairy alternatives these days it’s not as difficult as in the past
Post discussing gluten
I’ve been told by doctors previously they don’t want to prescribe levothyroxine yet because then I might go hyperthyroid - obviously I don’t want that!
They are talking rubbish
You’re hypothyroid, you need starting on replacement thyroid hormones
PCOS and Hashimoto’s frequently linked
Here’s link for how to request Thyroid U.K.list of private Doctors emailed to you, but within the email a link to download list of recommended thyroid specialist endocrinologists
Ideally choose an endocrinologist to see privately initially and who also does NHS consultations
thyroiduk.org/contact-us/ge...
BEFORE booking any consultation get FULL thyroid and vitamin testing done
Testing options and includes money off codes for private testing
Medichecks Thyroid plus antibodies and vitamins
medichecks.com/products/adv...
Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins
bluehorizonbloodtests.co.uk...
Only do private testing early Monday or Tuesday morning.
Link about thyroid blood tests
thyroiduk.org/testing/thyro...
Link about Hashimoto’s
thyroiduk.org/hypothyroid-b...
Symptoms of hypothyroidism
thyroiduk.org/signs-and-sym...
Tips on how to do DIY finger prick test
support.medichecks.com/hc/e...
Medichecks and BH also offer private blood draw at clinic near you, or private nurse to your own home…..for an extra fee
“Thyroid texture is hypo with micro nodularity”
I think in this case it could mean the texture shown on ultrasound is in keeping with hypo results (hypo-echo-ic means dense tissue which has different meaning) this can be seen with nodules & scarring. Including autoimmune damage.
Micro nodules are nodules under 1mm.
“Mild hypereamia noted” This refers to vascularity of thyroid which is altered as the tissue has altered.
“No focal lesion” means there no seperate abnormal area . The thyroid is the same through out.
Are there any conclusions in the scan report? & are there any suggestions of follow up?
This is so so helpful thank you so much. I’ve asked for the full report and the doctor to update his letter to the endo as lots of it just had ‘inaudible’ in it where they’ve obviously used a dictator to write up.
So sounds like my thyroid in general is dense and has at some very small nodules, and there’s increased blood flow/vascular activity - presumably because I have Hashimoto’s so the vascular action would be expected given the autoimmunity issues?
They’ve sent this to an endocrinologist asking what to do as my TSH is elevated but t4 is fine. I have been trying to conceive for years with no luck and recently found out TSH should actually be below 2.5 if trying to conceive, which is actually why I went back to the GP asking for help as fertility have completely missed possible thyroid links.
I do have low Iodine, B12 and Ferritin when last tested in 2021 so will get these checked again.
Inaudible is ridiculous. You need a complete report!
If the dictation is correct & my interpretation, I think that’s what the scan is showing.
Increased vascularity tends to increases as thyroid is stimulated & works harder to keep up with demands. It’s seen with thyroid abnormalities both hypo & hyper autoimmune.
FT4 is lower in range & FT3 not tested. would be good to test & repeat iodine & other nutrients recommended by others.
Thyroid ultrasound scan 
scan
First thyroid scan advice
Ultrasound Thyroid Scan
