Subclinical hyperthyroidism / multi nodular goi... - Thyroid UK

Thyroid UK

142,293 members167,661 posts

Subclinical hyperthyroidism / multi nodular goitre - confused!

treevee profile image
17 Replies

Hi

I have subclinical hyperthyroidism and MNG - probably one of more of these nodules may be "hot". Here is my latest set of results, which are pretty much typical of most of my tests. Antiobodies are within range so all good there. I'm a menopausal woman aged 61.

My endo is keen to:

1. test to see if nodules are toxic

2. put me on carbimazole or PTU similar

3. there was also talk of RAI treatment and / or surgery down the road....

She tells me that it is low TSH which causes symptoms like loss of bone density and atrial fibrillation. From my reading I was thinking that it is high T3 which usually causes these symptoms, and of course TSH is a pituitary hormone isn't it? So my question really is, if the thyroid is itself regulating and keeping my T4 and T3 within the limits is this OK? Should I be looking at using pharm products or not? At the moment I am taking herbals - motherwort, bugleweed and L-carnitine which seem to keep everything chugging along in this manner.

I really am loathe to be having radiactive iodine in my system and am very sensitive to pharm drugs and lactose intolerant so it is not a straightforward decision. I'd like to go back to my next appointment with some ideas and more insight, and would very much appreciate any thoughts you might have - especially from those who are or have been in a similar position.

Thank you 😀

Written by
treevee profile image
treevee
To view profiles and participate in discussions please or .
Read more about...
17 Replies
TiggerMe profile image
TiggerMeAmbassador

If you ignore your TSH result (which most of us do) your actual thyroid hormone levels are in a very happy place and I certainly wouldn't recommend changing anything, there may be a feedback loop issue which means your pituitary (responsible for TSH levels) is a bit on the wonk

You are correct in thinking it is low or high fT3 that can cause bones an issue but yours is in a good place 🤗and sounds like you feel well?

Agree to them keep monitoring you and check for hot nodules but refuse any interference!

TSH 0.072 mIU/L (0.27 - 4.2) -5.0% 😐

Free T4 (fT4) 19.3 pmol/L (12 - 22) 73.0% 😁

Free T3 (fT3) 5.3 pmol/L (3.1 - 6.8) 59.5% 😁

T4:T3 Ratio 3.642 😁

treevee profile image
treevee in reply toTiggerMe

Hi Tigger! Thanks so much for your response.

I thought I must have misunderstood. I said to her " I thought it was the thyroid hormones which give symptoms if they are high" she said "no it's the low TSH". Doesn't make sense really does it? I do wonder.... are they pulling wool over eyes or do they not understand thyroid function? Or is there some other narrative?

Anyhow yes I am inclined to agree with you, this is how we have kept it for the last 4 years since I discovered I had low TSH (thanks GP - not) and nodules (despite being told my thyroid was fine and no lumps). It's just the change of specialist between regions which has led to me seeing someone new.

Out of interest what would be the advantage of investigating the hotness of the nodules - presumably that wouldn't really change much if I am not going to have any treatment anyway?

Yes I do feel well in myself thank you. Occasional anxiety and my bone density is definitely a bit low, but that is likely because of early menopause after chemo 13 years ago, and taking tamoxifen. I don't think it has anything to do with the thyroid per se.

Once again thank you :-)

pennyannie profile image
pennyannie

Hello - Apologies -

I've just replied - but on your previous post !!

You should get notified :

treevee profile image
treevee in reply topennyannie

Got it! Thank you - I'm bookmarking those articles to take to my next appointment!

greygoose profile image
greygoose

Why do they suspect a hot nodule when your Frees are good? A hot nodule wouldn't reduce TSH without raising FT4 and FT3. That's not logical.

What time of day was the blood draw for this test?

treevee profile image
treevee in reply togreygoose

Hi! I really don’t know the answer to that I’m afraid! I always do blood tests first thing in morning.

treevee profile image
treevee in reply totreevee

Although sometimes my T4 is right at the top of the range.

greygoose profile image
greygoose in reply totreevee

Do you have Hashi's?

treevee profile image
treevee

No not Hashi's, antibodies well within range!

Sub-clinical hyper and MNG

greygoose profile image
greygoose

You can have Hashi's without over-range antibodies. And if your FT4 fluctuates without changing your dose, it does sound like Hashi's. Have you had a thyroid ultra-sound?

treevee profile image
treevee

yes plenty - several nodules on right lobe - T4 always in top quarter of range so doesn’t wobble much.

treevee profile image
treevee

That’s all I know - a few nodules, none looking nasty, clear on biopsy - I don’t have a written report.

humanbean profile image
humanbean

What does MNG stand for?

helvella profile image
helvellaAdministrator in reply tohumanbean

multi nodular goitre :-)

helvella - Abbreviations, Acronyms, Latin

A document containing a list of many of the abbreviations, acronyms and Latin terms you are likely to find when reading documents about thyroid. Don't assume an old copy is up to date!

dropbox.com/scl/fi/jks8k4c3...

Last updated 28/12/2024

helvella.blogspot.com/p/hel...

humanbean profile image
humanbean in reply tohelvella

Thank you.

humanbean profile image
humanbean

She tells me that it is low TSH which causes symptoms like loss of bone density and atrial fibrillation.

I don't believe this at all. I think my symptoms are much more closely correlated with my Free T3 than my TSH.

I wonder if your doctor could diagnose someone with Central Hypothyroidism. Somehow I doubt it. That is where the thyroid is healthy but the pituitary can't produce enough TSH for the patient's needs.

I actually think your thyroid hormone results are fine for most people. Your low TSH doesn't appear to be affecting your T4 and T3 to any great degree. If you feel well I would ignore the doctor. If you don't feel well I would suggest trying to optimise your nutrient levels before trying to reduce your thyroid hormones or increase your TSH. Having done that you should then get a new set of tests done.

treevee profile image
treevee

Thanks for your input humanbean - yes I am working on everything like nutrient level, gut function etc etc like crazy for several years now and still my thyroid levels never change. I regularly test about every 6 months.

I am inclined to agree with you, it’s just that you kind of come out of the appointment doubting yourself if you know what I mean? I need to be more resolute, I’m not there for an argument I really just want to be monitored and checked in case the situation gets any worse - it’s been stable for some years now so I can’t see it changing any time soon. Will plod on!

Your point about central hypo is interesting too. The answer is probably not! I don’t think this will apply in my case bc my T4 and T3 are in upper half of range and I think if that was a problem then they would tend to be low and I would have hypo symptoms?

In the meantime I am looking for a good bone health supplement if anyone can recommend? I already take Mg and D/K2…

Not what you're looking for?

You may also like...

Toxic multi nodular goitre

Ultrasound showed no enlargement of thyroid, just heterogenous (bumpy?) appearance with (due to?)...
Bluesammy profile image

Hyperthyroidism toxic multi nodular goitre - the next step

Saw my endo 3 weeks ago and after 6 months of 40mg carbimazole a day my T4 is down to 10 from 39.8,...
CSK1 profile image

severe subclinical hyperthyroidism

Hi all. I am new to this site but I have been using the AF HealthUnlocked site for a number of...
pkc05 profile image

Multi Nodular Goitre

Has anybody got this? I’m due for a CT scan next week and surgeon consultant after. What...
Lissaok profile image

Goitre but normal results??

I wonder if anyone can help please? I have a goitre and thyroid nodules which were seen on a scan a...
Oliviasmummy profile image

Moderation team

See all
Jaydee1507 profile image
Jaydee1507Administrator
PurpleNails profile image
PurpleNailsAdministrator
Buddy195 profile image
Buddy195Administrator

Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.

Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.