# New Labs and (Going to see an ENT soon)



## jenny v (May 6, 2012)

In June my endo upped my Synthroid to 70mcg and had me stay at 5mcg of Cytomel. No big surprise that my FT4 jumped to the top of the range, but I'm thrilled my FT3 went up, too (it's been years since I've been over a 3.2!). However, my TSH didn't go down nearly as much as I expected it to and my hypo symptoms are back with a vengeance again (tiredness, constipation, and brain fog are my main problems).

She wants me to stay on the 70mcg Synthroid and 5mcg Cytomel and test again in 2 months, which I've agreed to. In the meantime, I've set up an appointment on 8/27 to see an ENT who specializes in thyroids and parathyroids because the weird issue of feeling like I have a golf ball stuck in the base of my throat is back. I randomly choke on food and now when I take a gulp of water it feels like it drains down my throat normally and then hits the area where the golf ball is, stops and then trickles slowly down. So weird! Anyone else ever have anything similar?

January 2013 labs (50mcg of Synthroid and 5mcg of Cytomel) were:
TSH: .008 (range .4-4.5)
FT4: 2.06 (range .82-1.77)
FT3: 4.7 (range 2-4.4)

April 2013 labs (50mcg of Synthroid and 5mcg of Cytomel) were:
TSH: 4.92 (range .4-4.5)
FT4: 1.19 (range .82-1.77)
FT3: 3.1 (range 2-4.4)

June 2013 labs (60mcg of Synthroid and 5mcg of Cytomel) were:
TSH: 2.91 (range .4-4.5)
FT4: 1.45 (range .82-1.77)
FT3: 3.2 (range 2.-4.4)

August 2013 labs (70mcg of Synthroid and 5mcg of Cytomel) are:
TSH: 2.28 (range .4-4.5)
FT4: 1.72 (range .82-1.77)
FT3: 3.6 (range 2-4.4)


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## Lovlkn (Dec 20, 2009)

Have you had TSI and TPO antibodies done lately?

My guess on your labs is antibodies are involved.

Ignore the TSH in dosing and try to focus on your FT-3 and FT-4.


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## jenny v (May 6, 2012)

Lovlkn, it's been over a year since I've had any antibody tests run. Last year, they were the lowest they've ever been, with my TPO Ab at 93 (range <30) and my TgAb <20 (range 0-40). I don't think I've ever had TSI run at all.

I guess I was just surprised that I am still having hypo symptoms (#$%* constipation is awful lately) right now since my FT4 is so high and my FT3 is the highest it has been in years. Maybe my body needs time to catch up?

On the golf ball lump, I should clarify that it's not painful, it's just always "there". At most, I would say it causes pressure or a tight feeling in my neck, but it's never been sore or painful. Just really annoying, lol!


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## Andros (Aug 26, 2009)

jenny v said:


> Lovlkn, it's been over a year since I've had any antibody tests run. Last year, they were the lowest they've ever been, with my TPO Ab at 93 (range <30) and my TgAb <20 (range 0-40). I don't think I've ever had TSI run at all.
> 
> I guess I was just surprised that I am still having hypo symptoms (#$%* constipation is awful lately) right now since my FT4 is so high and my FT3 is the highest it has been in years. Maybe my body needs time to catch up?
> 
> On the golf ball lump, I should clarify that it's not painful, it's just always "there". At most, I would say it causes pressure or a tight feeling in my neck, but it's never been sore or painful. Just really annoying, lol!


I agree w/Lovlkn. Your labs are odd and makes one think that blocking, binding and stimulating antibodies are afoot once again. They do wax and wane.

Your FT4 should not be that high because exogenous T3 (Cytomel) causes it to be lower and that TSH of course would put some of us in the bed for sure.


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## jenny v (May 6, 2012)

Andros, my body is a nutcase apparently, lol! I'm either hyper, hypo or unexplained.

I'm glad I'm going to the ENT on August 27 because a close friend at work today asked me if I knew the base of my neck looked swollen. My collarbones and substernal notch aren't as prominent all of the sudden. Wonder if my thyroid is irritated and swelled up?


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## jenny v (May 6, 2012)

Just an update!

I saw a new ENT today and he was fantastic! I actually said a silent prayer of thanks while in the room with him because he was so knowledgeable and understanding. He really palpitated my thyroid and said something is definitely off. He said the isthmus is swollen and that's why my neck has puffed out, he said my thyroid felt full overall and he also found what he thinks is an enlarged lymph node right below my thyroid (he actually pushed on it and asked me if I could feel it pushing into my trachea, which I definitely did!). He does 3-5 thyroid surgeries a week and said the last one he did was because a woman was having compression issues but did not have cancer.

Bottom line, I'm being sent to have another ultrasound and depending on what he sees on that, he says an FNA might be a good idea if the lymph node looks really bad or if my nodules have grown any.


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## joplin1975 (Jul 21, 2011)

I'm hoping you can get that surgery, Jenny -- it improves life so much!!!


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## Octavia (Aug 1, 2011)

Great update, jenny v!!!


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## StormFinch (Nov 16, 2012)

Huzzah! Saying my own thank you that you found someone worth staying with.


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## jenny v (May 6, 2012)

Thanks for the nice notes, everyone! This board is such a helpful place for people like me trying to find my way through this thyroid mess.

I'm just waiting for the imaging department to call me to set up my ultrasound appointment and we'll go from there. I'm interested to see if my thyroid has changed much since the last ultrasound (which was over a year ago). My last one showed my thyroid was studded with small hyperechoic nodules but none were large enough to biopsy. The swollen lymph node makes me a little nervous but one step at a time, I guess!


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## Velcro (Jul 26, 2013)

So glad you found a good Doctor! That in itself is priceless.


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## Andros (Aug 26, 2009)

jenny v said:


> Just an update!
> 
> I saw a new ENT today and he was fantastic! I actually said a silent prayer of thanks while in the room with him because he was so knowledgeable and understanding. He really palpitated my thyroid and said something is definitely off. He said the isthmus is swollen and that's why my neck has puffed out, he said my thyroid felt full overall and he also found what he thinks is an enlarged lymph node right below my thyroid (he actually pushed on it and asked me if I could feel it pushing into my trachea, which I definitely did!). He does 3-5 thyroid surgeries a week and said the last one he did was because a woman was having compression issues but did not have cancer.
> 
> Bottom line, I'm being sent to have another ultrasound and depending on what he sees on that, he says an FNA might be a good idea if the lymph node looks really bad or if my nodules have grown any.


Totally awesome. I am so glad you saw the ENT and got such a thorough exam. When is the ultra-sound scheduled?

Your body is not so unusual after all; you just needed an astute doctor!

Yay!


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## jenny v (May 6, 2012)

I actually had the ultrasound today--they called this morning and said they had the afternoon open, so I jumped on it! The tech wanded my entire neck because she said the orders asked for thyroid, parathyroid and lymph node pictures. I hope to hear back from my ENT in a few days.


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