# RAGING headache, nodules, and why does my doc want my prolactin levels tested?



## Lauruffian (Jul 31, 2013)

Hey there. I'm fuzzy headed from this effing headache so I'll be brief and hopefully make sense.

I (40yro female) was diagnosed with Hashimoto's Thyroiditis three days ago and started 50mcg of synthroid the next day. The next day, I was sent out for a thyroid ultrasound, and I just found out today a nodule was found during that u/s and I'm being referred to an endocrinologist. What can I expect from that point? What have your experiences been with nodules?

Second, that headache. Oof. It woke me up. Back of my head, top of my head, raging pain all day that laughed in the face of the 800mg of ibuprofen I downed. I've been getting these more and more often, and up to this point (like so many of my other symptoms) assumed it was something else--menstrual migraines, that sort of thing, except I get them at all times of the month. They're becoming more frequent, and in short, they suck. I still managed to function today, but it was still rough. Right now the pain has subsided but I'm foggy headed and I'm queasy. Loud noises are not my friends. (Thus my two young sons are playing in the backyard.)

I called my doc asking about the headache and she sent a pain prescription I'll likely ignore (she said it was up to me, so I'm not dismissing her advice) because I hate pain meds.

But, what I found interesting was she wants my to go get my bloodwork done now, now in 3mos, and she had me add prolactin to my tests. Huh? I know that stuff from when I breastfed my sons. What does it have to do with Hashimoto's?

Incidentally, other tests they're going to do are:
* Rheumatoid factor (because I told her 15yrs ago when I first complained of joint and body aches, they thought it was RA since my RF was a high number, even if all the symptoms and descriptions didn't match).
* Thryoxine (T4)
* Triiodothyronine (T3)
* TSH, 3rd generation
* Vitamin D, 25-hydroxy (it was low when they tested it in May)

Anyway, any experience/insight on the headache, nodules, and the prolactin test?


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## joplin1975 (Jul 21, 2011)

Nodules over 1cm should be biopsied...under 1cm & they should be monitored. Some folks get RAIU scans to further evaluate the nodules.

Make sure those t3 and t4 tests are frees, not total.

Have you had your antibodies tested?

I don't know much about headaches so I can't comment but I do hope it goes away soon.


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## Velcro (Jul 26, 2013)

My nodule was found accidently when they were searching for what autoimmune I had (due to blood work throwing some weird stuff). My thyroid labs were fine, but they sent me to the ultrasound 3 years ago to be precautionary. They found one tiny nodule, it was 4.5mm. So they have had me go back yearly to watch it. Last year, the first nodule had grown to 5.5mm and I developed a second one and it was even smaller, 3mm. So this year I go, and now the first is almost 7mm, the second is 4mm and they found a third nodule at 4mm.

Yes, Joplin was right, they normally wait until they are over 1cm to do an FNA. Because I have developed now a third one and the others are growing, plus they are all solid, my ENT wanted to go ahead and do the FNA on the 7mm. The results came back that it's a follicular nodule but inconclusive on cancer, so we are going to redo the FNA in November to see if we get more of a definitive answer this time. If it comes back the same, he said he will recommend removing the thyroid....didn't say if he was thinking PT or TT. I'll cross that bridge if we get there.

Did they say how big your nodule was?

P.S. I started having major migraines last October that lasted all the way through January of this year, and then they stopped. My Rheumy has no idea why at this point, but I'm continuing to throw weird blood work, so they are still trying to figure it all out.


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## Andros (Aug 26, 2009)

Lauruffian said:


> Hey there. I'm fuzzy headed from this effing headache so I'll be brief and hopefully make sense.
> 
> I (40yro female) was diagnosed with Hashimoto's Thyroiditis three days ago and started 50mcg of synthroid the next day. The next day, I was sent out for a thyroid ultrasound, and I just found out today a nodule was found during that u/s and I'm being referred to an endocrinologist. What can I expect from that point? What have your experiences been with nodules?
> 
> ...


Well for one thing, I can't imagine a doctor Rx'ng a pain medication for a headache w/o knowing the cause of that headache. I am glad you have not taken it.

Have you taken your blood pressure?

I guess the prolactin test is to see if the pituitary gland is functioning properly?

What does it say about the nodule? Size, solid, cystic, vascular?


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## Lauruffian (Jul 31, 2013)

I don't know the size or description of the nodule--they're mailing me a copy of the report. My GP is now passing my case along to the endocrinologist, which she said she would if they found anything in the ultrasound. Basically, it was, "There is a nodule, so you need to go to an endocrinologist"--let the endo take it from there. When I get the report, I'll share the details.

*joplin9175*, my antibodies were what diagnosed me with Hashimoto's (well, that and my symptoms). My TPO-Ab count was 404 (normal range 0-34).

Headache seemed to fade through the day, though I felt in a fog most of the late afternoon/early evening. Oof. *Andros*, it's amazing how quickly some docs prescribe pain meds. I've had two back surgeries, and all the pain specialists wanted to do was drug me. Um...find out what's WRONG first before giving me opiates, okay?? I had to push for an MRI. One argued with me, even, about pain meds before reluctantly agreeing to the MRI. Then I never saw him again because the results showed such severe damage, it was do not pass go, go straight to the neurosurgeon.

That said, my GP is wonderful and she probably was offering those even though she knew I probably wouldn't take it.

Could it somehow be related to the thyroid? The headache was in the back of my head, almost base of my neck. My left side is really sore and swollen feeling today, and I'm pretty sure the nodule is on that side (I saw the tech measuring it). Right under the ear and jawbone, that sort of area.

Oh, the education I am getting. Prolactin and the pituitary??

Thanks so much everyone.


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## sjmjuly (Mar 23, 2012)

I suffer from bad headaches too and ended up in the ER on pain killers as a result. Come to find out it was Synthroid causing mine. As soon as I switched to Naturethroid the headaches went away and I haven't had once since.


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## hashimotocoaster (Mar 22, 2013)

Do you have a history of migraines? I agree that finding out the cause is important (it could be your thyroid being wacky?), but if it turns out you ARE having migraines, I have to advocate for having a pain med around to take as needed. I don't like taking anything I don't have to take--the only med I'm on regularly is Synthroid--but I wouldn't trade my migraine med for the world. It's saved me from misery too many times. There's nothing noble about suffering unnecessarily.

That said, until you find out what's going on--this is going to sound crazy, but if you're located where there are 7-Eleven convenience stores, Slurpees are your best friend. Brain freeze helps reduce the pain.


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## Lauruffian (Jul 31, 2013)

I do get migraines, but they tend to be in one very specific area--the right-top side of my head. Plus, the next day my head feels like I have a bad scalp sunburn. This headache was in a completely different location (felt like my whole head, ugh), and there is no sunburn feeling today.

But, like migraines, loud noises make me cringe. Ugh.

*sjmjuly*, I just started the Synthroid four days ago. I've been getting these headaches for a long while, and I think this was the third in four weeks or so.


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## CA-Lynn (Apr 29, 2010)

High prolactin levels might be indicative of pituitary microadenoma or a deviation of the pituitary stalk. Any of these things can cause a shift in how hormones are processed.


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## BlindMag (May 17, 2013)

I know this thread is a few days old, but wanted to weigh in - pituitary tumors often secrete prolactin, so it's a first step in eliminating a pituitary tumor, which can prevent your thyroid medicine from working correctly. Don't be alarmed if she wants to test your cortisol levels next.  (My doc worked in reverse - she saw my cortisol was high and then tested my prolactin, which came up normal)
Since your headaches are increasing in regularity, I would definitely start keeping a headache journal (I use the iphone app iHeadache). I started recording all of mine, and it made me realize I was having one migraine a week followed by a mini migraine four days later. I'm still working on figuring out the cause! I've gone through the whole pituitary tumor testing process and they determined that that's not it, so now I'm going to a neurologist.

Maggie


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