Confused newbie,,,, can u help please?

[shadrag]

Hi all,

Can u help understand my blood results please, Just a bit of background for you....

Late 2009 went to Docs complaining of various ailments..got blood test taken and results were borderline underactive thyroid, Doc said she wouldn't put me on meds at this point ,as once i started i was on for life.

Forward to Sept 2012 i feel a lump on my throat and was sent for an ultrasound, results for which came back as multi noduled goiter. Doc then said this was probably caused by underactive thyroid and she put me on 50mg levothyroxine and took blood tests. Meantime she arranged for me to see Endo, i was there for a total of 5 mins, wherein he asked if goiter was giving me a prob swallowing (mines apparently growing in the way, not outward). I said it wasn't , to this he just said Doc is doing all the right things checking bloods regularly etc and that eventually i would have to get my thryoid removed as it will "pack in". I didn't really know what to ask and the appointment was finished almost as soon as it started.

I've posted the results of the total of three blood tests that i have had to date , including that first one. The most recent blood test has resulted in my perscription being reduced to 25mg. I realise alot of people are on alot more that this but its just that I have felt great over the last 4 weeks, i am no longer depressed and moody, my energy levels are back and i feel "normal" (first time in a long time), however, i am a bit concerned that this reduction in perscription will set me back (the stone that i put on over few months came off after one month on the Levo).

Could anyone please help me understand the blood tests, is it good that the third test shows no TSH for example or is that bad. I see that my Free T4 seems to be now higher than the max range...is that bad? Apologies for the long post, but i just want to understand my condition. ( I am 54 year old female) thank u for taking the time to read.

1st test 18 th Oct 2012

Free T4 12.2 pmol/L (9.0 - 21.0 )

TSH 12.84 H mUlL (0.20 - 5.00)

TPO Antibodies 218.7 H iu/ml (0.0 - 34.0 )

2nd Test 27 th Dec 2012

Free T4 17.7 (9.0 - 21.0)

TSH 0.41 (0.20 - 5.00)

3rd Test 25th Feb 2013

Free T4 26.7 H (9.0 - 21.0)

TSH NOT DETECTED

oops...just noticed i've done this in blog by mistake, should i redo in "questions" sorry

[helvella Administrator]

That latest test shows that you were over-dosed - but the difficulty is that this could be the thyroid itself putting out too much thyroid hormone - rather than being caused by taking 50 mcg of levothyroxine.

I suspect that your thyroid has, for whatever reason, started to produce more thyroid hormone than it should. This can occur if a nodule goes "autonomous" - i.e. keeps pumping out thyroid hormone regardless of the TSH level. This is bad and you need to keep on top of it - in the worst case, your thyroid hormone levels could continue to increase. That would be dangerous.

I would be unhappy for you to wait longer than four weeks for another test. I am worried that you could be sailing right up. If in doubt, if you get any feelings that you might think are hyperthyroid, do not hesitate to see a doctor.

Has your diet changed recently? There are several foods which affect the thyroid.

Do you take any supplements? Several could be impacting your thyroid issues.

I am hesitating about sending you a link because it is a complex subject and the link is not an easy read. But even if you only look at the tables, they do list things that interact with thyroid:

thyroidmanager.org/chapter/...

Don't worry about getting lost - no-one is going to make you answer questions on it!

(I know next to nothing about multi-nodular goitre. So don't trust what I say! Check everything yourself, if you can.)

Rod

[shadrag in reply to helvella]

Thank u for yr response Rod.

My diet hasn't changed , nor am on supplements, the only thing i have done "different" is that for the last 3 weeks i have taken my Levo before bedtime. Maybe just a co-incidence but i have noticed a huge improvement in all health aspects.,,,,except for one....my insomnia.

I will look up Hyper now to see what signs i should be looking out for.

My weight was usually around 9 stone then back end of last year i consistently put on 1 lb a week until i was 9st 11 lb at Xmas but after month on Levo i went down to 9st 2 and i have stayed so for last two weeks.

I think i will request a blood test in 4 weeks time...thank u for yr comment

[helvella Administrator in reply to shadrag]

Hyper signs/symptoms here:

thyroiduk.org.uk/tuk/about_...

But be warned - all too many people find they get confused between hyper and hypo - simply because quite a lot of things can occur in either! And when you go from one to the other, it is often not at all clear.

As we are always saying, it could be important to check:

vitamin B12

folates

iron/ferritin

vitamin D

Please ask you GP to get them tested next time you see him/her.

[shadrag in reply to helvella]

Is is very confusing...like for instance my Doc said that i have a goiter because i am "underactive" and just reading things on this site...am i reading things all wrong ,when i'm thinking that i could possibly have Hashimotos because of my combination of symptoms ?

[helvella Administrator in reply to shadrag]

I am not at all surprised at you feeling confused.

That link includes this:

Thyroid autoantibodies (TPO and Tg) usually negative

So they think it less likely to be Hashimoto's - where antibodies would be raised. But you have raised antibodies - you you are already in the less-common group. And yes, I'd say that your antibody levels strongly indicate Hashimoto's. And symptoms are a nightmare!

[shadrag in reply to helvella]

Gulp.....so i've got these "nightmare symtoms" to look forward to. Gosh i thought things were looking up for me

[helvella Administrator in reply to shadrag]

Sorry - I meant that the way that the symptoms change over time is difficult to follow and you can change between hyper and hypo without recognising what has happened (for a while). In that sense a nightmare - not that the symptoms themselves will be a nightmare.

My bad expression.

[shadrag in reply to helvella]

No probs thk u for the information

[Hidden in reply to shadrag]

Things are looking up - you've responded to levo and have a better idea what to look out for. You've found this site for advice and support and you know to go back to your GP and ask more about those test results and implications... this is way more than I knew a year ago as a newbie - congrats and good luck!

[shadrag in reply to Hidden]

Thk u....hope Levo continues to work and yes i'm so glad i stumbled across this site, it gives u the confidence to "fight" yr corner with Doc, if reqd

[Hidden]

I have a multi nodular goiter and extremely high peroxidase. I am not on medication as my TSH is fine and I also feel OK.

I too saw an endo who explained the goiter but was unable to say how big it would grow etc etc. He told me that if I had any difficulties swallowing or breathing I should return. He also said that if the goiter got larger but not affecting the above, it could be removed for cosmetic purposes. I have looked up goiters and they can be huge!

I have regular 6monthly blood tests, take Selinium and B12 and am trying hard to follow a gluten free diet. I understand from this site that this helps the autoimmune disorder.

I have done some reading and it is really hard to determine the length of time the nodules remain cancer free. One article in a European Endo journal I read suggests 17 years!

I have had my goiter for 15 months and it has grown but not too much. I notice it as my neck has always been scrawny but others do not......I am using neck scarves and chunky necklaces as I am conscious of it.

Glad you are feeling better

[shadrag in reply to Hidden]

Hopefully its not a aforegone conclusion that all nodules do eventually turn cancerous

Hope your goiter continues to grow slowly....mines is growing in the way so not as obvious to the naked eye at moment but it just presents other problems in doing so, ah well, onwards and upwards, you take care.