'hot' thyroid nodules

[assambeatty]

I suspect I may have hot or autonomous thyroid nodules.

Does anyone have any experience they can share about getting a diagnosis please?

My history in brief: discovered a visible nodule four years ago. An ultrasound scan revealed 4 or 5 in total. They are benign. About 6 months after this, I began to experience extreme anxiety type systems. It was a sudden onset. Of course, we were in the middle of a pandemic so this seemed a possible explanation. A locum GP advised another ultrasound scan but it was denied.

Four years on and I now know a little about hot nodules and I do feel this could be why I am experiencing such debilitating and often highly erratic mood shifts. I want to be as well informed as I can about how to ask for this to be tested.

Many thanks

[tattybogle]

The first step is to ask GP to run thyroid blood tests.

TSH and fT4 , and preferably fT3.

( they may only be able to do TSH initially , depends on where you are )

If you have a hot nodule you would expect to see a low TSH , with a high fT4 and /or fT3 (basically a hyperthyroid pattern of results )

Ultrasound can't show the function of a nodule ,just its presence ... so if blood results suggest hyperthyroidism then you'll need referral to an endo to confirm the cause ie Graves / or Hot nodule / or something else.

they use a different test to show the function of a nodule . ( i think it's a called a thyroid uptake test . but not sure as i've never had one)

PurpleNails will know, she has a hot nodule.

[SlowDragon Administrator]

You need thyroid antibodies and vitamins tested too

Nodules often present with Hashimoto’s

Anxiety is common hypothyroid symptom

Are you male or female

Approx age?

For full Thyroid evaluation you need TSH, FT4 and FT3 tested

Also both TPO and TG thyroid antibodies tested at least once to see if hypothyroidism is autoimmune

Very important to test vitamin D, folate, ferritin and B12 at least once year minimum

Low vitamin levels are extremely common when hypothyroid, especially with autoimmune thyroid disease - hypo or hyper

About 90% of primary hypothyroidism is autoimmune thyroid disease, usually diagnosed by high TPO and/or high TG thyroid antibodies

Autoimmune thyroid disease with goitre is Hashimoto’s

Autoimmune thyroid disease without goitre is Ord’s thyroiditis.

Both are autoimmune and generally called Hashimoto’s.

Significant minority of Hashimoto’s patients only have high TG antibodies (thyroglobulin)

20% of autoimmune thyroid patients never have high thyroid antibodies and ultrasound scan of thyroid can get diagnosis

In U.K. medics hardly ever refer to autoimmune thyroid disease as Hashimoto’s (or Ord’s thyroiditis)

Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins

Post all about what time of day to test

healthunlocked.com/thyroidu...

Testing options and includes money off codes for private testing

thyroiduk.org/testing/

Medichecks Thyroid plus BOTH TPO and TG antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes BOTH TPO and TG 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

[PurpleNails Administrator]

I have left sided thyroid swelling, an ultrasound detected a nodule & as over 5cm I was given fine needle aspiration. I’d had bloods also done.

I chased up results and was told every fine no further action . I remember saying really? There’s no issue with function? It’s been marked NFA everything’s fine.

I had minor symptoms such as mild palpitations, Increased appetite, weight gain (opposing of norm). Low energy, dry eyes, itchy skin. Anxiety around driving car. Higher occurrences of migraines.

I went back to doctor about 8 months later when my fingernails began detaching. Turns out the requested thyroid function test hadn’t been processed. All the returned results were in range & pathology confirmed benign nodule but no one noticed function hadn’t come back!

I tested negative for antibodies so had thyroid uptake scan, this basically “lights up” where the thyroid functions so can been seen on image. The patterns are distinct, mine showing a focal (hot nodule) area the rest of thyroid suppressed.

Having access to / or copies of blood test results is huge factor in tracking your health. You need to know both what’s being tested & what the results are.

Getting a full picture in 1 one go via private company might speed things up. Often doctors do not complete a full test.

Anxiety can be due to hypo & hyperthyroid. Theres many varied symptoms which occur with thyroid issues & there’s also quite an overlap with hyper (over active) & hypo under active.

[assambeatty in reply to PurpleNails]

Thank you very much. I can relate to much of what you say and it is helpful to understand that there is quite an overlap with hyper and hypo indicators. It sometimes feels like such a mixed bag of issues that I am not completely sure which it is or even if a hot nodule function could be kind of erratic. Sometimes I feel there is a pattern, other times it feels erratic. Clearly my next step is to ask for tests or go private. Many thanks again.

[assambeatty]

Thank you for all of the really helpful comments tattybogle, slowdragon and Purplenails. This feels like a bit of minefield so I am very grateful for your thoughts and advice. I need to work out a plan now.

In answer to question I am female, late 50s. I had a very early and straightforward menopause (15 years ago) so I know it's not that.

When I began to experience awful anxiety with real physical symptoms I panicked and, of course, that made everything worse. It was terrible. A well known antidepressant/anxiety med. made it even worse, frighteningly so. Prior to this, I was a fairly chilled yoga bunny type, not without my worries but I dealt with stuff. Suddenly, every aspect of life was simply overwhelming. Because I was persuaded that it was anxiety with no underlying cause, I have worked really hard on mindfulness etc. and as a result I cope better but I still feel there is something behind it all and with the presence of multiple nodules, this has to be a possibility.

Thank you again. I may come back with questions ...