help - I’m new to this

[Firtyqwerty]

good morning ,

I am a middle aged lady who was diagnosed incidentally with thyroid nodule back in August 2023 . I had a U3 diagnosis of right lobe thyroid nodule . Had FNA in October 2023 no frank malignant cells to see so was classed as thy2c and was discharged from ENT . In January this year I started with horrendous anxiety, palpitations , dysphagia and general unwellness . I was checked over by Rapid diagnostic clinic , bloods ok CXR clear , uss abdo ok . I have been reluctant to have CT scan due to thyroid lump and history of AML on both sides of family . I have asked for amytriptilline and propranolol as my BP was raised . The Dr’s think I’m mental but I feel like there are hormones pushing my bp up and causing his anxiety . I feel like I’m dying and watching the world from above like I’m not really here . I have never looked into problems with my thyroid but could this be related 🤔.

I have an appointment with my ENT consultant next week but have never seen an endocrinologist . Could somebody help please . I don’t know about t2 and t3 blood results

[PurpleNails Administrator]

Welcome to forum.

ENT will look at potential psyical issues from a does this need surgery viewpoint & will discharge if found clear but it’s unlikely same department will test thyroid hormones. They would have assumed GP will monitor that & refer you to endocrinology if necessary.

What has GP tested? For full thyroid function you need

TSH, FT4 & FT3

TPO & TG antibodies so see if affected autoimmune

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

You need to obtain either online results or a printout with lab ranges.

Always check the results yourself. Sometimes only TSH is tested. & results get missed. In range is deemed fine, but depending on where levels are, - in range isn’t necessarily ideal.

I had a FNA on large nodule & told all fine. I specifically asked if levels were really ok? & was told yes - but the lab has missed off thyroid function, the results which were tested were in range. It was months later before it was noticed.

Then going through historical hospital records I found an abnormal results 4 years prior which had never been followed up.

I had high thyroid levels & undetectable TSH.

Anxiety can be caused by low & high hormones.

[Firtyqwerty in reply to PurpleNails]

Hi , thank you for reply , nobody has ever tested my thyroid function . I don’t know what my T3 & t4 levels are . Did you have a thyroidectomy with lump ? It is so complex and overwhelming , I don’t know where to start . Will my GP do all these blood tests or can I get them done privately ?

[PurpleNails Administrator in reply to Firtyqwerty]

I would have thought if a nodule was detected which required FNA someone might have thought to test function.

Read this page comparing symptoms for hypothyroidism & hyperthyroidism. They are shown as the extremes of typical symptoms however in reality (there can be an overlap)

thyroiduk.org/signs-and-sym...

Full list of hyper symptoms

thyroiduk.org/wp-content/up...

Full list of hypothyroid symptoms

thyroiduk.org/wp-content/up...

Tick off which apply & take to doctor. GP may test TSH only, if in range lab will not test further.

May be quicker to arrange privately. That way you can get an entire picture I one go. Including antibodies & key nutrients for example.

Order a kit online and sample can be taken by fingerprick test at home, sample posted back & results available online often very quickly.

Sample recommended to be taken at 09.00 fast overnight, avoid biotin 3 days before test.

See link for private companies with discounts with many packages & options.

thyroiduk.org/testing/priva...

I also recommend you obtain the hospital report relating to your previous ultrasound? Scan & pathology from FNA. often there can be tiny details about thyroid health that don’t get communicated to you.

If ENT won’t post see if hospitals has record department on website. Usually there’s a set form to submit request for copies (sometimes ID & witness signatures are required). I previously organised via email.

My nodule hyper functions, it’s now controlled with anti thyroid to lower what new hormone can be produced. It was missed by doctors for many years.

[Firtyqwerty in reply to PurpleNails]

Thank you so much for the advice and information . TBH I can’t believe I have a large thyroid nodule and smaller ones appearing and I’ve just been discharged from ENT with no testing of function or follow up 🤔. I have the lab result from the thyroid FNA and it doesn’t give me many clues except there weren’t enough cells in the samples but it’s probably a colloid cyst ? My partner has under active thyroid and has coeliac disease but the doctors have never told him there could be a correlation between the two . I really don’t understand how Drs don’t do full thyroid screening when people have hormonal symptoms . I have a lot of research to do I think . Here we go again as the Drs couldn’t diagnose Reactive Arthritis and I had to ask to be referred to a rheumatologist and ask to be tested for HLa B27 gene , of which I’m positive !

[PurpleNails Administrator in reply to Firtyqwerty]

Having one autoimmune issue can mean having other are more likely. I have a colloid nodule without autoimmune.

Nodules can occur with or without autoimmune. Most do not function (are cold) but some over function (hot or toxic) .

Doing the right test is the only was to unpick what’s going on. Ultrasounds do not establish function.

[Firtyqwerty in reply to PurpleNails]

It is fascinating , when you say the correct test , do you mean a full thyroid screen or another FNA ? They haven’t said if my nodule is hot or cold ! I am very in the dark with all this 😞but thank you for your support.

[PurpleNails Administrator in reply to Firtyqwerty]

Testing thyroid levels. This will show function a ultrasound scan won't. Scan shows size and health of thyroid. You often need both to investigate nodules fully.

[Firtyqwerty in reply to PurpleNails]

Thank you I will get my thyroid levels checked .