Ultrasound scan and bloods done for enlarged th... - Thyroid UK

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Ultrasound scan and bloods done for enlarged thyroid

Kilff profile image
4 Replies

Hi

I posted three weeks ago, I have an enlarged thyroid which I can feel when I swallow and just feel it in my neck. I had an ultrasound two weeks ago, but no results back yet. The radiologist seemed to imply no biopsy was necessary and I have not been called back for a biopsy. I do have an endocrinologist appointment in a week’s time. GP did bloods, but only TSH, so I did private bloods. All listed below. Since I first noticed this lump in my throat (six months ago, it has increased a lot in size) I don’t really have any new symptoms. I feel ok, I have forever had insomnia and palpitations. I think the paplitations are worse recently. I am not really anxious. No weight loss, BP normal, HR might be a bit elevated over normal.

What is causing my thyroid to be large. My TSH is always at low end of normal. T4 seems to be at high end of normal.

I had low B12 in Feb 2023 with neuropathy, so over last 18 months have supplemetned B12 , also supplemented Vit D, so that my Vit D is deficient was a surprise to me. Over last year I have taken 120 tablets (i just counted tablets left in tub!) of high dose (25 ug) vitamin D, just asda brand. B12 was a good brand sublingual. I also supplemented iron for two months til I realised it was giving me heartburn and stopped. The neuropathy has mostly resolved after B12 supplementation, just a tiny bit of tingling in my big toes.

I’d appreciate things to mention to the endocrinologist if anyone has any insight. I was hoping to have scan results before I re-posted, but looks like they in no hurry to pass that on.

Private bloods taken 8 am fasted Monday 17th Feb

Inflammation

CRP HS 0.39 mg/L (Range: < 3)

Iron Status

Ferritin 65 ug/L. (Range: 30 - 264)

Vitamins

Folate - Serum 14.3 nmol/L. (Range: > 7)

Vitamin B12 - Active 80.5 pmol/L (Range: > 37.5)

Vitamin D 48 nmol/L (Range: 50 - 250)

Thyroid Hormones

TSH 0.567 mIU/L (Range: 0.27 - 4.2)

Free T3 5.2 pmol/L (Range: 3.1 - 6.8)

Free Thyroxine 20.9 pmol/L (Range: 12 - 22)

Autoimmunity

Thyroglobulin Antibodies 14.3 kIU/L (Range: 0 - 115)

Thyroid Peroxidase Antibodies <9.0 kIU/L (Range: 0 - 34)

GP bloods taken non fasted 11 am

Sodium 141 (137-144)

Potassium 4.6 (3.5-5.0)

Creat 60 (50-98)

eGFR >60

TSH 0.38 (0.3-4.9) last tested May2023 was 0.33

Calcium 2.41 (2.1 - 2.55)

Corrected Calcium 2.33 (2.12-2.62)

Hb 138 (115-165)

WBC 5.0 (4 - 11)

PLT 334 (150-400)

MCV 90.6 (83-101)

RBC 4.72 (3.8-5.8)

Hct 0.428 (0.36-0.47)

MCH 29.2 (27-32)

MHCH 322 (320 -360)

Neut 2.95 (2.0 -7.5)

Lymp 1.42 (1-4.5)

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Kilff
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4 Replies
SlowDragon profile image
SlowDragonAmbassador

Over last year I have taken 120 tablets (i just counted tablets left in tub!) of high dose (25 ug) vitamin D, just asda brand.

25ug is only 1000iu

That’s a low dose for someone with low vitamin D/thyroid issues

Suggest you change to better quality and higher dose vitamin D

Try 2000-3000iu daily

Retest in 3-4 months

You may need higher dose in winter than summer

U.K. government recommends everyone supplement vitamin D at least Oct to April

You likely need to supplement continuously

GP should advise on self supplementing if over 50nmol, but under 75nmol (but they rarely do)

mm.wirral.nhs.uk/document_u...

But, improving to around 80nmol or 100nmol by self supplementing may be better

pubmed.ncbi.nlm.nih.gov/218...

vitamindsociety.org/pdf/Vit...

Once you Improve level, very likely you will need on going maintenance dose to keep it there.

Test twice yearly when supplementing

Can test via NHS private testing service

vitamindtest.org.uk

Vitamin D mouth spray by Better You is very effective as it avoids poor gut function.

There’s a version made that also contains vitamin K2 Mk7.

One spray = 1000iu

amazon.co.uk/BetterYou-Dlux...

It’s trial and error what dose we need, with thyroid issues we frequently need higher dose than average

NHS Guidelines on dose vitamin D required

panmerseyapc.nhs.uk/media/2...

Vitamin D may prevent Autoimmune disease

newscientist.com/article/23...

Web links about taking important cofactors - magnesium and Vit K2-MK7

Magnesium best taken in the afternoon or evening, but must be four hours away from levothyroxine

betterbones.com/bone-nutrit...

medicalnewstoday.com/articl...

livescience.com/61866-magne...

sciencedaily.com/releases/2...

Recipe ideas

bbc.co.uk/food/articles/mag...

Interesting article by Dr Malcolm Kendrick on magnesium

drmalcolmkendrick.org/categ...

Vitamin K2 mk7

betterbones.com/bone-nutrit...

healthline.com/nutrition/vi...

SlowDragon profile image
SlowDragonAmbassador

Folate - Serum 14.3 nmol/L. (Range: > 7)

Vitamin B12 - Active 80.5 pmol/L (Range: > 37.5)

Exactly what B12 supplement have you been taking

How low was B12 before you started supplementing

Are you vegetarian or vegan

folate is possibly on low side

What’s the range 7-60?

With serum B12 result below 500, (Or active B12 below 70) recommended to be taking a separate B12 supplement

A week later add a separate vitamin B Complex 

Now your serum B12 is over 500 (or Active B12 level has reached 70), you may be able to reduce then stop the B12 and just carry on with the B Complex.

If Vegetarian or vegan likely to need ongoing separate B12 few times a week

Highly effective B12 drops

natureprovides.com/products...

Or

B12 sublingual lozenges

uk.iherb.com/pr/jarrow-form...

cytoplan.co.uk/shop-by-prod...

In-depth article on different forms of B12

perniciousanemia.org/b12/fo...

B12 range in U.K. is too wide

Interesting that in this research B12 below 400 is considered inadequate

healthunlocked.com/thyroidu...

perniciousanemia.org/b12/le...

And why aiming to keep B12 over 500 recommended

perniciousanemia.org/b12/le...

Great reply by @humanbean on B12 here

healthunlocked.com/thyroidu...

Low folate

supplementing a good quality daily vitamin B complex, one with folate in (not folic acid)

This can help keep all B vitamins in balance and will help improve B12 levels too

Difference between folate and folic acid

healthline.com/nutrition/fo...

Many Hashimoto’s patients have MTHFR gene variation and can have trouble processing folic acid supplements

thyroidpharmacist.com/artic...

B vitamins best taken after breakfast

Igennus B complex popular option. Nice small tablets. Most people only find they need one per day. But a few people find it’s not high enough dose and may need 2 per day and/or may need separate methyl folate couple times a week

Post discussing different B complex

healthunlocked.com/thyroidu...

IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 5-6 days before ALL BLOOD TESTS , as biotin can falsely affect test results

endocrinenews.endocrine.org...

In week before blood test, when you stop vitamin B complex, you might want to consider taking a separate folate supplement (eg Jarrow methyl folate 400mcg) and continue separate B12 if last test result serum B12 was below 500 or active B12 (private test) under 70

SlowDragon profile image
SlowDragonAmbassador

I’d appreciate things to mention to the endocrinologist if anyone has any insight.

Request they test for Graves’ disease antibodies - autoimmune hyperthyroid

TSI or Trab antibodies tested

And ask about possible hot nodule too

Kilff profile image
Kilff in reply toSlowDragon

Hi slowdragon, thanks for your replies, I will to answer your questions:

B12 supplement is Igennus Super Vitamin B12-Complex 1000mcg Sublingual, Methylcobalamin Methylated, 180 Servings, Clean Label & Vegan, 3 High Absorption Forms, Sugar-Free Melts, 1-a-Day

My B12 level in 2023 was 285. Iam not a vegetarian.

I have been supplementing magnesium also for a while.

I stopped all supplements for good three weeks before blood tests.

The vit D I have been taking I noticed prevented my normal winter temporary depression.

I will switch to a better Vit D source.

I will ask to be tested for Graves, but I still don't really understand why my thyroid is enlarged when all thyroid hormones are ' normal '.

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