# Second opinion on lab results



## lauren8544 (Oct 12, 2015)

I am currently being treated for multiple thyroid nodules. My physician first noticed thyroid enlargement during a physical in 2012. I was sent for an ultrasound and discovered to have two nodules > 1cm. It was benign, but I requested to be seen by an endocrinologist who recommended annual ultrasounds for 3 years. After the 3rd year, my family observed that my neck looked larger and that they were worried I was brushing off potential hypothyroid symptoms that I attributed to "normal for me." So I went back for an additional ultrasound. My hypothyroid symptoms are: low libido, thin hair, itchy skin, cold intolerance, trouble concentrating, weight gain, tiredness, depression, and constipation. However, they have never seemed very sudden to me. Looking back over the years I can see how some of them have gotten worse, but I attribute them to other things. For instance, I have always been a constipated person, but it was the worst when I was on accutane prior to 2011. I have gained ~40lbs since 2012, but I have not exercised regularly and I eat poorly. My libido has decreased, but I also got married in 2011, started the Nexplanon birth control in 2012. I recently tried to have it replaced with the non-hormonal IUD to avoid confounding conclusions, but alas, my uterus is too small for IUDs (5cm).

My lab results are below.

I am a 27 year old female. No other major medical issues aside from vulvar vestibulitis and bruxism (jaw clenching and teeth grinding at night). I have minor compression symptoms from the nodules: can't wear high necked shirts, occasional coughing, can sense the tightness in my throat. During this time I have also started snoring, and it has gotten worse. I'm worried it may be related through induced obstructive sleep apnea. I have woken many times coughing and gasping, but my husband has not independently observed me stop breathing.

2012: Enlarged thyroid, right nodule: 2.6 x 2.9 x 1.5, left nodule: 1.0 x 0.9 x 0.7; biopsied right nodule = benign; TSH = normal (1.2)

2013: Enlarged thyroid, nodules stable in size; TSH = normal (1.14); "enlarged but benign appearing bilateral lymph nodes"

2014: Enlarged thyroid: nodules stable in size; TSH = normal (0.8)

2015:

Enlarged thryoid: right: 6.7 x 2.4 x 1.8; left: 6.0 x 2.4 x 1.7

Right nodule: stable in size

Left nodule: 3.3 x 1.7 x 3.6

TSH = normal (1.84)

Free T4 = normal (1.33)

Anti-TPO = high (9.6 IU/mL) reference range is <9.0 IU/mL

My thyroid has always been enlarged (5.5 - 6.0 cm range), but this year is the largest its measured. 
I also had a complete blood count that was normal
My vitamin D and iron saturation were just out of range (low) and I was prescribed supplements.

I currently am scheduled to have a repeat biopsy due to the nodule growth. Statistically speaking, it is very likely to be benign, so I am wondering if I should still be worried about the size and growth of my nodules if the biopsy results are fine. My endocrinologist does not seem to concerned, but I am getting tired of being told everything is fine while my thyroid continues to grow. I would appreciate any thoughts as I've been looking at it so long that I don't whether or not I'm overreacting.


----------



## Andros (Aug 26, 2009)

Understanding the Thyroid: Why You Should Check Your Free T3
http://breakingmuscle.com/health-medicine/understanding-thyroid-why-you-should-check-your-free-t3
(Copy and paste into your browser)

Substances not found in normal serum (scroll down to autoantibodies)
http://www.thyroidmanager.org/chapter/evaluation-of-thyroid-function-in-health-and-disease/
(Copy and paste into your browser)

TPO and thyroglobulin
http://onlinelibrary.wiley.com/doi/10.1111/j.1699-0463.1994.tb04888.x/abstract
http://www.wikigenes.org/e/gene/e/7173.html
(Copy and paste into your browser)

Understanding Thyroglobulin Ab.
http://www.labtestsonline.org/understanding/analytes/thyroglobulin/test.html
(Copy and paste into your browser)

Thyroglobulin Ab and cancer
http://qjmed.oxfordjournals.org/content/59/2/429.full.pdf
(Copy and paste into your browser)

Welcome to the board!

Straight up? If I were you, I would see an ENT. Sounds like this thyroid should come out. I see no reason why you should have to continue suffering.

Have you ever had Thyroglobulin and Thyroglobulin Ab tests? If not, I think you should.

I also don't see where you have had a FREE T3 test.


----------



## joplin1975 (Jul 21, 2011)

I, too, would also recommend a surgical consult. You would not be the first person to have all or part of their thyroid removed due to compression symptoms.


----------



## Octavia (Aug 1, 2011)

joplin1975 said:


> I, too, would also recommend a surgical consult. You would not be the first person to have all or part of their thyroid removed due to compression symptoms.


Agreed. My nodule measured 2.5 cm in my ultrasound, and my biopsy was inconclusive. Two ENTs (separate offices/hospitals) advised me to have a partial thyroidectomy to get the nodule (and lobe) out due to its size and my discomfort. I'm really glad I did.


----------



## lauren8544 (Oct 12, 2015)

Andros said:


> Straight up? If I were you, I would see an ENT. Sounds like this thyroid should come out. I see no reason why you should have to continue suffering.
> 
> Have you ever had Thyroglobulin and Thyroglobulin Ab tests? If not, I think you should.
> 
> I also don't see where you have had a FREE T3 test.


I haven't had any other tests except for the ones I mentioned. At my last visit, I had to ask the endo to do more testing other than TSH. I requested a full panel, and mentioned T3, T4, and anitbodies by name, but they only ran T4, and Anti-TPO. If my biopsy is benign, I think I'll ask them to run everything else as last resort before talking to an ENT.


----------

