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Nodules and Low TSH

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Thyroid Disorders
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Abilene
Veteran Member
Joined : Apr 2014
Posts : 986
Posted 5/2/2015 10:22 AM (GMT -8)
I've spent lots of time in the Chronic Pain forum during the past 16 months following cervical fusion surgery. My newest diagnosis leads me to this forum where I've already learned a great deal about a confusing (to me) subject.

An incidental finding on my cervical MRI over 16 months ago was thyroid nodules. I was sent to a surgeon who sent me to an endocrinologist to have a fine needle biopsy on two small nodules a year ago. The results were good/no cancer. I don't have test results, just remember it was all ok. Six months later the endo did another US and said nodules had not changed-good. Another six months later US showed the same results and first ever blood work for thyroid was done. It seems that blood work should have been ordered earlier but was overlooked, possibly because of my lack of symptoms and no family history. Results:

ULTRASENSITIVE TSH 0.079 L Range 0.500-4.700

Dr was surprised at this, had me come back in a month for more labs. Results 2 days ago:

ULTRASENSITIVE TSH 0.068 L (0.500-4.700)
FREE T3 3.4 (2.3-4.2)
FREE T4 0.99 ( 0.73-1.95)
THYROID PEROXIDASE AB 67 H (<9)
Blood Pressure 122/78

Dr said this shows hyperthyroid, must be treated even though I show no symptoms since it could cause heart problems. He gave me an Rx for Tapazole: 5mg SIG. and wants more labs in a month.

I've not filled it yet. I'm 65 years old, on no medications and would like to keep it that way unless really necessary. I've just been healing from the cervical surgery and taking everything easy for the past 16 months. HYPER does not describe me in any way! I've gained 8 lbs in the past year that I do not need to add to my already fluffy body so right now I'm starting to be much more careful about diet and will attempt to start moving more. Honestly, I'm quite lazy which has served me well while healing. I've done all my PT for neck and shoulders but not much other exercise.

I didn't have a good feeling about this doctor or his office. I expect to get a 2nd opinion soon or at least will discuss with PCP.

So, your ideas, please. Should this TSH be treated now?
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hypoHashi
Veteran Member
Joined : Jul 2012
Posts : 801
Posted 5/2/2015 8:47 PM (GMT -8)
Hi,
Your TSH is quite low, which indicate hyperthyroid, your TPOab are also elevated which in turn indicate Hashimoto's disease.

Hashimoto's disease can cause both hypo and hyper.

As to whether to treat now or not, I would say that hyperthyroid as well as hypothyroid patients often are not aware to their symptoms.

Make a quick research for hyper thyroid symptoms and see whether you have any !

Best,
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trader758
Veteran Member
Joined : Aug 2014
Posts : 752
Posted 5/2/2015 9:03 PM (GMT -8)
You need a 2nd opinion. Technically, youre hyper with Hashimotos. Its obvious by the suppressed TSH, low T4, and normal T3 that the nodules are actively making hormones. Considering your age and lack of symptoms, a doctor would take a wait and see approach with blood tests and US scans every 6 months, unless new symptoms arise.

You feel fine, nodules are not cancerous and not growing....theres no need to treat you right now. Again, you need a second opinion.
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Abilene
Veteran Member
Joined : Apr 2014
Posts : 986
Posted 5/4/2015 2:28 AM (GMT -8)
Thank you for your responses. I don't feel I'm having any symptoms. All this would not have been discovered if not for the MRI on my neck.
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Abilene
Veteran Member
Joined : Apr 2014
Posts : 986
Posted 5/8/2015 2:06 PM (GMT -8)
I have a 2nd opinion scheduled for early June with an Endo/Internal medicine doctor. That will be 6 weeks since the last labs were done. Of course I will take my past lab reports with me. I wonder if the new doctor will repeat labs that soon.

In the meantime, I'm quite motivated to being as healthy as possible, like having a better diet. I've cut out sugar and decreased other carbs, drinking lots of water. In the older threads here, I read that gluten is a problem for some with thyroid issues, because it causes inflammation, so I've cut down on that. I also read in several of the older threads that the problems with sleeping might be caused by sleep apnea, so have that checked. I've already checked that and started treatment 8 months ago. I sleep well. I'm working on being more active.

Can you suggest anything else I can do to help myself now? I don't seem to be having any symptoms and I'd just like to keep it that way longer. Is that anything I have any control over?
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trader758
Veteran Member
Joined : Aug 2014
Posts : 752
Posted 5/8/2015 5:13 PM (GMT -8)
Yes, your new doctor will want new labs that soon to establish a baseline, and have results from a lab he uses and feels comfortable with. Honestly, it sounds like youre doing everything right and taking an active approach to healing and keeping things in check. about the ony thing you could add would be a daily selenium supplement to help keep the Hashimotos antibodies in check. But your antibodies are pretty low, so thats your call. Be proud, you feel well and have the upper hand at the moment. God bless you, good luck!
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Abilene
Veteran Member
Joined : Apr 2014
Posts : 986
Posted 6/13/2015 6:13 PM (GMT -8)
I had my 2nd opinion appointment. This Endo agreed with the first one, but explained everything much better. She had me fill the same Rx the first dr had given me for Tapazole 5mg. Labs were repeated and my TSH was a bit lower now at 0.04. This dr will do labs again in 6 weeks and also repeat the US. I was examined and asked more questions searching for symptoms but I just do not have them now. So she said I'm sub-clinical hyperthyroid. She did not mention Hashimotos until I asked about it and she said Yes, that's what this is.

She also cautioned me about internet researching for thyroid disorders. She said she has seen far too much inaccurate information related to thyroid. Except for that comment I liked this doctor very much and will continue to see her. I will also continue to research. Some may not be accurate, but some may be very helpful. I will just have to be very careful what I accept. Going from NO knowledge to SOME from being on this site was very helpful to me. Thank You!!
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Abilene
Veteran Member
Joined : Apr 2014
Posts : 986
Posted 7/14/2015 9:52 PM (GMT -8)
I've been taking Tapazole 5mg. for 6 weeks now, had labs done today and will see the doctor again on Friday. I'm eager to see what's going on now.

Quest Diagnostics lab informed me I have an outstanding $5oo charge. It seems in my previous lab work there were two tests Medicare did not cover-Vitamin D and Dihyroxyvit D. Wow! Those were expensive tests! I was told and signed a paper before blood was drawn telling me my insurance might not cover everything so I would be responsible. So it sounds like I'm responsible! I will talk to the doctor about it Friday, just in case there is some way to justify those tests that will satisfy Medicare. My supplement won't cover what Medicare does not approve. This may have been a rather expensive lesson for me.
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eat2bwell
Veteran Member
Joined : Sep 2014
Posts : 534
Posted 7/15/2015 4:23 AM (GMT -8)
Low magnesium levels have been linked to thyroid problems. Might have your magnesium levels checked. If you do not want to take a supplement use a diet consisting of high amount of green leafy vegetables. That is how we get our magnesium. You may want to get your iodine level checked. Lack of iodine has also been linked to thyroid problems.
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Abilene
Veteran Member
Joined : Apr 2014
Posts : 986
Posted 7/20/2015 10:20 AM (GMT -8)
I already take otc magnesium and eat well. Thanks for advice.

UPDATE: Saw my dr Friday. TSH is now .34 (range .4-4) so dr is pleased with that change. Other #'s are similar to what they have been. I'm feeling even more tired, lazy. Dr said I could take Tapazole every other day and that should still help me but also help the tired feeling. More labs in 6 weeks. Still no Hyper symptoms so I'm Subclinical hyperthyroid.

Doctor put new codes in for Vitamin D tests and said that should satisfy Medicare-so glad to hear that-$500 glad! I'm a bit low on D so will start taking that, too.

Post Edited (Abilene) : 7/20/2015 12:24:46 PM (GMT-6)

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eat2bwell
Veteran Member
Joined : Sep 2014
Posts : 534
Posted 7/22/2015 4:09 AM (GMT -8)
You can get the test done for a lot less money if you go to the labs directly.

http://www.accesalabs.com/vitamin
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