just a question

[lelliecake3]

I have a multi modular goiterand receiving no treatment.

My TSH is 0.58 just above the lowest threshold, and was 0.75 2 years ago, I have not had T3 or T4 blood tests done.

My symptoms are as follows: Fatigue, Increased sensitivity to cold, Increased sleepiness and Dry skin, increased pressure in my throat, clearing of throat (with no chest pain).

I am concerned that this goiter could lead to something else. My mother and maternal aunt and uncles and 2 cousins have all had thyroid issues

Hope you have some ideas

[greygoose]

Hi lelliecake3, welcome to the forum.

I'm afraid we don't have enough information to be able to help you. Just testing TSH tells you next to nothing unless it is high. So, not only do we need to see the FT4/3, but also antibodies: TPO and Tg. A multinodular goitre is often caused by Hashi's - Autoimmune Thyroid Disease. In which case it's not going to lead to anything. But to if you have Hashi's you need your antibodies tested, and/or an ultrasound of your thyroid.

A goitre is just a swollen thyroid, and it could be swollen for many reasons. And nodules are very common and 99.9% of the time absolutely harmless. So don't worry too much, but do get full thyroid testing so that we can see what's wrong.

[PurpleNails Administrator]

Welcome to forum.

The TSH (thyroid stimulating hormone) is a pituitary hormone which signal the thyroid.  Unfortunately it doesn’t confirm the status of thyroid levels (FT4 & FT3) because it can be unreliable.  

It’s generally the case that low under range TSH indicates high FT4 & FT3 & high TSH means the thyroid levels are low - the pituitary is signalling the thyroid to work harder, but not fool proof. 

Doctors go by TSH & assume if that’s in range so will thyroid levels. but without testing that’s not certain 

For a complete picture you need FT4 & FT3.  Many arrange private tests because NHS don’t test further if TSH is in range. 

Nodules are very common & and vast majority do not affect function or cause a growth issue. 

Here’s a link by thyroid UK which lists some private companies. Includes discount codes for some.

thyroiduk.org/help-and-supp...

Tests can be completed by fingerprick test via post, post early in week to avoid weekends delays. You can arrange private blood draw for extra fee.

range of options, from thyroid function only, to recommended nutrients - folate, ferritin, B12 & vitamin D. TPO & TG antibodies.

Recommended tests are early morning, fast overnight, stop biotin supplements 3/7 days prior to test (can interfere with test).

[annnsandell]

Hello Lelliecake3.

Has a health professional diagnosed a multi-modular goiter or have you had a scan which is a normal first check? A TSH of that level does not signal Levothyroxine is required but without other tests, they won't know what is happening. You particularly need antibodies tested to check for Autoimmune Thyroid Disease. If it is your GP you are seeing, and they cannot diagnose why you have a goiter that is large enough to trouble you, they should refer you to a specialist.

[lelliecake3 in reply to annnsandell]

diagnosed by an endocrinologist and then a scan

[annnsandell in reply to lelliecake3]

Endocrinologist has followed that up with? If not, why not?

[lelliecake3 in reply to annnsandell]

didn’t think it need anything. I have emailed my go with my concerns

[lelliecake3]

little update sent an email to my doc voicing my concerns and surprise they phoned me yesterday to go and see her on Friday so fingers crossed. I know it may not be anything to do with thyroid/goiter but some is not right. Thanks for all the advice

[lelliecake3 in reply to lelliecake3]

So bloods done and tsh is now 0.88 and free t4 is 12.2 range is 9 to 19.9 so none the wiser now