# Ultrasound report



## shomols (Feb 16, 2011)

Hi, Just received a copy of the ultrasound report and the nurse said no nodules. But I wonder what the rest means. I haven't been in to see the doctor yet and thought you might have opinions on the results below:

"The thyroid gland is diminutive. The right lobe measures 2.9x1.3x1.2 cm. The left lobe measures 2.8x1.2x1 cm. Both lobes of the thyroid gland demonstrate mildly inhomogeneous echotexture. There are no focal solid or cystic masses identified. No evidence of thickening of the thyroid isthmus. There is no pathologic parenchymal hyperemia demonstrated.

Impression: Diminutive imnhomogeneous thyroid gland without focal solid or cystic mass."

What are your impressions.

Laurie


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## Andros (Aug 26, 2009)

shomols said:


> Hi, Just received a copy of the ultrasound report and the nurse said no nodules. But I wonder what the rest means. I haven't been in to see the doctor yet and thought you might have opinions on the results below:
> 
> "The thyroid gland is diminutive. The right lobe measures 2.9x1.3x1.2 cm. The left lobe measures 2.8x1.2x1 cm. Both lobes of the thyroid gland demonstrate mildly inhomogeneous echotexture. There are no focal solid or cystic masses identified. No evidence of thickening of the thyroid isthmus. There is no pathologic parenchymal hyperemia demonstrated.
> 
> ...


Hi Laurie!! It appears that your thyroid gland is irregular in appearance and maybe shrunken.

What has your doctor commented? Are you on thyroid medication? Have you had labs recently that you would like to share w/us. Please include the ranges with the results.

Are you symptomatic?


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## shomols (Feb 16, 2011)

I am currently taking 60 armour, 25 synthyroid. It seems to be helping. I was on 90 armour and my tsh was .003. I didn't feel great at that either. My T3 was over the range and T4 was at the lower end. (Both Free t's)

I didn't get a copy of the last labs yet. I am being tested again the first week of June. They are testing both frees and ferritin, vitamin d and tsh.

I had an ultrasound 2 years ago and it showed two nodules and now there are no nodules. I didn't realize they would disappear.
Laurie


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## Andros (Aug 26, 2009)

shomols said:


> I am currently taking 60 armour, 25 synthyroid. It seems to be helping. I was on 90 armour and my tsh was .003. I didn't feel great at that either. My T3 was over the range and T4 was at the lower end. (Both Free t's)
> 
> I didn't get a copy of the last labs yet. I am being tested again the first week of June. They are testing both frees and ferritin, vitamin d and tsh.
> 
> ...


Laurie.....................not sure that nodules do disappear. Ultrasound may not picked them up on this go around.

Were you taking additional T4 with the Armour when your FT3 was over the range?

And, how are you feeling right now this minute? How long have you been on your most current dose regimen?


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## shomols (Feb 16, 2011)

Thanks, I wasn't taking additional T4 when the t3 was over range. I am feeling better but still not good. Have so much fatigue. Some nights I come home and just fall asleep. I have good days but more days with exhaustion. I am taking iron too and hope my levels have gone up. I am using a testostrone cream every other day to bring those levels up.

I need to send the copy of the report to the doctor working on my thyroid. She is an OB-GYN and I do like her. She stepped up and is taking control. The winter was really long and I was hoping I would be much better by now.

Why did my thyroid shrink? Also I had the ultrasound done at a different place this time. Maybe they didn't pick up the nodules.
Laurie


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## Andros (Aug 26, 2009)

shomols said:


> Thanks, I wasn't taking additional T4 when the t3 was over range. I am feeling better but still not good. Have so much fatigue. Some nights I come home and just fall asleep. I have good days but more days with exhaustion. I am taking iron too and hope my levels have gone up. I am using a testostrone cream every other day to bring those levels up.
> 
> I need to send the copy of the report to the doctor working on my thyroid. She is an OB-GYN and I do like her. She stepped up and is taking control. The winter was really long and I was hoping I would be much better by now.
> 
> ...


I do have a comment to make based on many years of observation. Those who take addtional T4 with their Armour never ever feel well. When taking any form of T3, it is normal for the T4 to be lower in the range on lab results.

You do need the amount of T4 contained in Armour for Deiodinase Conversion.
http://en.wikipedia.org/wiki/Deiodinase

But only that amount which is 38 mcgs. per grain. They really do have that down to an exact science.

Also, mixing synthetic with dessicated porcine in my very most humble opinion is not a good idea.

For whatever the above is worth, I am just trying to help you feel better.

It would probably be a good idea to get RAIU (radioactive uptake)of your thyroid to get a clear idea of what is going on.

There are many reasons why the thyroid would shrink. If you are on thyroxine, that would.............; also infection could...........just a myriad of things. Exposure to radiation. And so on.

This article discusses it a bit.......
http://www.kumc.edu/endocrine/Hashimoto.pdf


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## lainey (Aug 26, 2010)

A couple of thoughts:

Re: your labs.

When taking desiccated thyroid, the patient should be dosed until the Free T3 is in range--preferably the upper third of the range. With these medications, the TSH and Free T4 will naturally appear suppressed. Doctors who prescribe these medications, and patients who take them should be familiar with this. Your results are consistent with this, BTW, and you probably should not be taking the extra T4 (which converts to more T3) to bring the T4 into range--it is not supposed to be when on desiccated thyroid.

Re: your ultrasound.

While it is not common, a non-functional thyroid, especially in a patient with such a suppressed TSH as yours, can atrophy as it is inactive. Nodules can disappear for the same reason--especially if they are on the smaller side. While it is not common to use suppressive therapy anymore to shrink nodules, in some patients it still does happen. IMHO I would attribute your ultrasound report to your medication regimen, and don't see the report as problematic, really.

Your symptoms, however, combined with your unusual medication combination of T4 with dessiccated thyroid, leads me to believe you are likely still hyper. I would be asking for full labs now, instead of 3 weeks from now.


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## shomols (Feb 16, 2011)

I haven't had any tests since starting this regime. I actually do feel better than when on the 90 of Armour. Could be it is not winter anymore. I have an appointment with her after the next round of tests. She wasn't the one who ordered the ultrasound but I will forward her the report. I have read the book she suggested "why do I still have thyroid symptons" and really need to move on it. I am seriously thinking of going gluten free but haven't done it yet. I have a special needs child and one other. I feel so overwhelmed with work and my husband is unemployed now so it just gets pushed back. I need to pick a date and just do it. I am really curious on how long it will take to actually feel a difference. 
Thanks for your imput.
Laurie


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