# NEW- Normal labs but sympotms



## Archer (Aug 29, 2010)

Hi Everyone, Sure could use some advice/input !!!

Diagnosed hypo 3 years ago. Rt lobe removed 2 years ago,diagnosed Hashimoto's TPO 911. (<35)
Currently taking .100mcg Synthroid (10 months)
June 2010 Labs TSH 1.2 (0.34 - 4.82) FT4 1.1 (0.6 -1.9)
Symtoms- periods of rapid heart rate, palpations, chest discomfort, hot, sweating, can not tolerate the heat, not sleeping, weight loss, headaches, hands shake, anxious, nervous, loose stools, mind racing,

Dr. says labs are normal not thyroid or Synthroid related must be anxiety or menopause. 24 hour holt monitor showed PCV echo ok. May have to order something for PCV'S if I feel I can not tolerate them anymore.

Started on Zolfot seemed to make things worse, switched to Lexapro still symptoms persits. After 10 months of feeling this way I could not take it anymore so I lowered my Synthorid to 50 mcg for 3 days and have been feeling much better. 
I do not understand what is going on Dr keeps telling me Synthroid can not cause these kinds of symptoms when labs are normal but when I cut back I feel better? Any help would be greatly appreicated
Thanks


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## chopper (Mar 4, 2007)

Hello and welcome.

Something doesn't make sense. No one gets HALF their thyroid removed for Hashi's because hashi's is systemic. It would only attack the other half.

You are describing hashimotos. That's what's going on and that's why your doc sees no changes in blood work.

What is most likely happening now is that your hashi's is acting up again and going after the other half...eventually that side will die off and you'll be ok but will have to adjust your meds up to compensate for the half that is no longer working.


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## Lovlkn (Dec 20, 2009)

Strange -

Insist on a FT-3 or pay out of pocket at HealthcheckUSA.com

Something is up but your labs do not reflect what it is.

ave you ever had Ferritin or B-12 done?


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## Archer (Aug 29, 2010)

nasdaqphil said:


> Hello and welcome.
> 
> Something doesn't make sense. No one gets HALF their thyroid removed for Hashi's because hashi's is systemic. It would only attack the other half.
> 
> ...


I had been on Synthroid for over a year and was still having great difficulty swallowing. Dr's kept telling me it was acid reflex, anxiety, ect. Finally had ultra sound done large nodule was found. After 2 inconclusive FNA surgery was done to rule out cancer.
Surgery pathology report diagnosis Fibrous Variant of Hashimotos Thyroiditis. 
Surgeon ordered TPO antibodies after surgery to confirm
So I did not know I had Hashimoto's before surgery.
Dr's now tell me all my symptoms are not at all related to thyroid, and give me antidepressants.


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## Archer (Aug 29, 2010)

Lovlkn said:


> Strange -
> 
> Insist on a FT-3 or pay out of pocket at HealthcheckUSA.com
> 
> ...


I have asked to have FT3 tested several times over the last 3 years and have been told it is only tested when hyper and you are hypo so it does not need to be tested. So I have never had it checked. 
I took your advice and have ordered test thru Healthcheck. 
Since I cut back on meds for 3 days do you think I should wait awhile before testing or would it be ok to test now? 
Ferritin & B-12 have never been checked. Will ask to have both tested.
Thanks so much for your time.


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## chopper (Mar 4, 2007)

So your doctor is calling you nuts basically. Fire his ass and get a new doctor. If he won't take the time or care to deal with your thyroid issues then dump him. This guys loading you up with anti depressants and anti anxiety meds instead of properly diagnosing the problem. That's bullshit.


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## Andros (Aug 26, 2009)

Archer said:


> Hi Everyone, Sure could use some advice/input !!!
> 
> Diagnosed hypo 3 years ago. Rt lobe removed 2 years ago,diagnosed Hashimoto's TPO 911. (<35)
> Currently taking .100mcg Synthroid (10 months)
> ...


Hi there; a Free T3 would have been ever so helpful and the doctor would have been prudent to run the TPO just to see what is going on w/ that!

It might be a good idea to get TSI (thyroid stimulating immunoglobulin) to see if you are going into hyper or are actually in hyper state.

Ditto on getting a radioactive uptake scan. Docs do diagnose Hashi's when TPO is high but that is only conjecture supposedly based on clinical experience. There are many reasons a person can have high TPO.

Now, when you had the lobe removed, did pathology identify the Hurthle Cells indigenous to Hashimoto's? If so, then that would have been conclusive.

Do you have the pathology report?


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## prettynikki5 (Dec 9, 2009)

I agree with Phil. You have an autoimmune flare up it seems. I had the same until my thyroid was completely removed. All those 'symptoms' calmed down, went away. Your body is in 'attack' mode. The immune system does not forget or change it's mind. It has a job to do and it will not stop until mission is complete. Whilst you still have the other part of your thyroid in tact, you will continue to have these symtoms or others most likely. My personal opinion and experience is that thyroid removal is the only way to stop the symptoms completely, taking Synthroid, etc, will only delay the inevitable, which is complete desctruction of the thyroid and you will need replacement thyroid hormones. I found that alot of my symptoms were not just 'hypo'thyroid symptoms, they were from the autoimmune activity going on in my body. Nothing helped me stop feeling these horrible 'anxious' things, only complete TT. Please keep us updated, so sorry you are feeling so badly


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## CA-Lynn (Apr 29, 2010)

Agree with Phil. Fire the doctor. There are plenty others out there.

Just so you have a frame of reference: when I ask my endocrinologist to order extra tests she NEVER hesitates.


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## Archer (Aug 29, 2010)

First I would like to thank you for all for taking your time to help me. I GREATLY appreciate it. Second I hope I don't scare you away with all my questions.

I have ordered TSH, FT4 & FT3 from Healthcheck I tried to order antibodies but it said I needed approval from DR.

Yes I do have pathology report I see no mention of Hurthle cells on report so maybe I don't have Hashimoto's?
Pathology report says
Part A The specimen is labeled "right lobe thyroid". The frozen section is interpreted by Dr. Hoover as "Benign". Received fresh is a 5.2 x 2.6 x 1.8 cm thyroid lobe. The specimen is inked black in the pathology laboratory. On sectioning, there is a firm pale tan nodule present measuring 1.5 x 1.0 x up 2.5 cm. Normal thyroid tissue is not present. The remaining cut surface has a white-tan to pink-tan appearance. The firm area described appears to be well circumscribed and extends to the margin but not through it grossly. A representative section of the lesion is submitted for frozen section.
Key to sections: Block FS1, frozen section remnant resubmitted. Blocks #2 through #6, additional sections from the nodule. 
Part B. The specimen is labeled "mid line lymph node". Received fresh is a pink-tan possible lymph node measuring 0.5 x 0.3 x 0.3 cm. The specimen is entirely submitted in one block.
Microscopic exam performed for parts A and B.
Intradepartmental consulation obtained for parts A and B
Diagnosis:
A. Thyroid, right lobe, lobectomy:
Fibrous variant of Hashimoto's thyroiditis
Incidental benign parathyroid tissue (block 6)
Negative for malignancy.
B. Midline lymph node, biopsy: Benign lymph node.

Thanks so much,


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## Archer (Aug 29, 2010)

First I would like to thank you for all for taking your time to help me. I GREATLY appreciate it. Second I hope I don't scare you away with all my questions.

I have ordered TSH, FT4 & FT3 from Healthcheck I tried to order antibodies but it said I needed approval from DR.

Yes I do have pathology report I see no mention of Hurthle cells on report so maybe I don't have Hashimoto's?
Pathology report says
Part A The specimen is labeled "right lobe thyroid". The frozen section is interpreted by Dr. Hoover as "Benign". Received fresh is a 5.2 x 2.6 x 1.8 cm thyroid lobe. The specimen is inked black in the pathology laboratory. On sectioning, there is a firm pale tan nodule present measuring 1.5 x 1.0 x up 2.5 cm. Normal thyroid tissue is not present. The remaining cut surface has a white-tan to pink-tan appearance. The firm area described appears to be well circumscribed and extends to the margin but not through it grossly. A representative section of the lesion is submitted for frozen section.
Key to sections: Block FS1, frozen section remnant resubmitted. Blocks #2 through #6, additional sections from the nodule. 
Part B. The specimen is labeled "mid line lymph node". Received fresh is a pink-tan possible lymph node measuring 0.5 x 0.3 x 0.3 cm. The specimen is entirely submitted in one block.
Microscopic exam performed for parts A and B.
Intradepartmental consulation obtained for parts A and B
Diagnosis:
A. Thyroid, right lobe, lobectomy:
Fibrous variant of Hashimoto's thyroiditis
Incidental benign parathyroid tissue (block 6)
Negative for malignancy.
B. Midline lymph node, biopsy: Benign lymph node.

Thanks so much,


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## Archer (Aug 29, 2010)

nasdaqphil said:


> So your doctor is calling you nuts basically. Fire his ass and get a new doctor. If he won't take the time or care to deal with your thyroid issues then dump him. This guys loading you up with anti depressants and anti anxiety meds instead of properly diagnosing the problem. That's bullshit.


You got it!! At times I think it would be easier to just take the drugs and keep my mouth shut (even though they don't seem to be doing much for me) because none of them seem to be listening to anything I am saying.

I am looking for a new DR. my Endo seems to be pretty much worthless he says TSH & FT4 are normal so no need for any other tests, see ya in 6 months. GP says if Endo says your good YOUR GOOD so he refuses to order any tests. I guess I am on my own for now. Since lower Synthroid things have improved so I guess I have that to be thankful for. 
Thanks for your time.


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## Andros (Aug 26, 2009)

Archer said:


> First I would like to thank you for all for taking your time to help me. I GREATLY appreciate it. Second I hope I don't scare you away with all my questions.
> 
> I have ordered TSH, FT4 & FT3 from Healthcheck I tried to order antibodies but it said I needed approval from DR.
> 
> ...


Under Diagnosis.........it says this {Fibrous variant of Hashimoto's thyroiditis} so it sounds to me like it's a close cousin or something. And it also sounds lie the pathologist could not make up his/her mind. Unfortunately there are Hurthle cells indigenous to cancer also and the pathologist really had to know his/her stuff.

Thank God there was no malinancy; that's the good news. Which getting back to the Hurthle cell, clearly you did not have the ones for cancer. I am sooooooooooooo glad.

http://www.histopathology-india.net/fibrous_variant_hashimoto's.htm (note the use of the word "probably)

The fibrous variant of Hashimoto's thyroiditis is probably a genuine variant rather than just a late stage of Hashimoto's thyroiditis since these patients appear to have pronounced fibrosis from an early stage.

The fibrosis is in broad hyaline bands and does not extend into other tissues. Hurthle cells may be present.

Obliterative vascular changes are not seen. The plasma cells present express IgG. Lymphoid aggregates may be present.

The patients may have other organ-specific autoimmune diseases as with regular Hashimoto's thyroiditis, and the condition is not associated with fibromatoses.

more.................

http://www.ncbi.nlm.nih.gov/pubmed/12906372

http://www.ncbi.nlm.nih.gov/pubmed/7865983

It looks like you could (note that tricky little word) have Riedel's

http://jmedicalcasereports.com/content/4/1/15

I think it would be good to discuss this with a very "qualified" and "knowledgable" doctor. That is what I think.


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## Archer (Aug 29, 2010)

Andros said:


> Under Diagnosis.........it says this {Fibrous variant of Hashimoto's thyroiditis} so it sounds to me like it's a close cousin or something. And it also sounds lie the pathologist could not make up his/her mind. Unfortunately there are Hurthle cells indigenous to cancer also and the pathologist really had to know his/her stuff.
> 
> Thank God there was no malinancy; that's the good news. Which getting back to the Hurthle cell, clearly you did not have the ones for cancer. I am sooooooooooooo glad.
> 
> ...


Thanks so much for the links you provided. Lots of great info.

Yes I was VERY thankfull no cancer was found.

Funny you should bring up Riedel's that is what my surgeon thought I had at first. He said the lobe he removed was very hard and was very difficult to remove. He said that was why they couldn't get anything with the FNA it was to hard, and that I had had this for quite some time. That is why he tested for TPO anitbodies he said if they came back high he would feel better about the Hashimoto's diagnosis. I still have problems swallowing but Dr's tell me that is because of the surgery- scar tissue and such. I truely dont know what to believe anymore.

I am currently looking for a new Dr and hope to find one who is both qualifed & knowledgable if thats possible.:rolleyes:
Thanks again for your time


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