# Ultrasounds results, need help



## Misty76 (Apr 5, 2011)

*Can anyone help me decipher this?*

STUDY: Ultrasound thyroid dated March 24, 2011, at 1423 hours, without 
any prior studies for comparison.

INDICATION: 34-year-old female with history of an outside ultrasound 
showing a 1.2-cm left thyroid nodule that was neither hot nor cold on an 
iodine scan.

FINDINGS: Ultrasound examination of the thyroid gland is performed. The 
isthmus is visualized, is homogeneous in appearance and measures 2 mm. 
The right thyroid lobe measures 4.2 x 1.3 x 1.3 cm and is homogeneous 
with regards to echogenicity.

The left thyroid lobe measures 1.6 x 4.2 x 1.2 x 1.6 cmcm. At its mid 
aspect, the left thyroid lobe has a slightly echogenic nodule measuring 
4.3 mm that is likely a benign process. Additionally, the left lower 
thyroid lobe has a 1.2 x 0.6-cm slightly complex hypoechoic nodule with a 
spongiform configuration. No abnormal blood flow is seen over this 
region.


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## Andros (Aug 26, 2009)

Lil4x4Girl said:


> *Can anyone help me decipher this?*
> 
> STUDY: Ultrasound thyroid dated March 24, 2011, at 1423 hours, without
> any prior studies for comparison.
> ...


Hi there!!









Your thryoid is not completely healthy. I would recommend an FNA (fine needle aspiration) of those nodules on the left side.

Tell us; what brought you to the doctor in the first place? Where you symptomatic? Do you have swollen lymph nodes in the neck/cervical area and/or a goiter? Just wondering what prompted the sonogram as per the doctor which is a good thing, of course.

Any other tests such as the ones listed below?

TSI (thyroid stimulating immunoglobulin),TPO (antimicrosomal antibodies) TBII (thyrotropin-binding inhibitory immunoglobulin), Thyroglobulin Ab, ANA (antinuclear antibodies), (thyroid hormone panel) TSH, Free T3, Free T4.

You can look this stuff up here and more.........
http://www.labtestsonline.org/


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## Misty76 (Apr 5, 2011)

What started all of this was some of the symptoms that I have had and started asking my doctor some questions about it. My normal weight is around 110-115 range. Now, I am at 153 and feel horrible. I could understand a couple pounds here & there but this much is ridiculous when there's no reason for it. I'm a normal person, likes outdoor activity, I like to walk and do things like that so I'm not just a couch potato who should expect some weight gain. But after the first 10 lbs, I began to worry. It just kept adding up month after month.

Finally, I talked to my ob/gyn doctor last summer about it when I had my annual visit. She said my body should not be going through any type of change yet that would cause such rapid weight gain. She suggested that I find a family doctor to handle this and have some thyroid tests run. There is a doctor that I go to for normal allergy/sinus problems a couple times a year so I figured I'd start there.  I happened to catch a multiphasic blood test at the hospital and saw they add-on thyroid panel. My numbers weren't bad (I don't have them to post right now) but I took them to the doctor and they started asking questions about why I thought I had a thyroid problem. I explained all of my symptoms and they started sending me for tests. I had the dizziness to the point that I would be walking around and have to sit down or I would just crumble to the ground, I had the fatigue to the point that I could fall asleep in my chair at work almost every afternoon. When I started reading about the thyroid, it all fit.

So, the 1st ultrasound, came back showing nodules. They sent me for the uptake test & scan. That came back showing nothing cold or hot, didn't show anything on the scan abnormal. So they referred me to an endo specialist. Had my 1st appointment with her in October. She did another round of blood work and told me that she didn't see any problems and that maybe it was just my diet. I'm tired of that, seems to be the common answer. I have been charting my weight and she didn't even want to see it. Just dismissed me as if this was just all in my head. She scheduled me for a follow-up ultrasound since the others had conflicting information. That is what I just had a couple weeks ago. I have my follow-up appointment with her on Monday to discuss the results. What I posted is from the report that I saw online on my medical chart. I don't have the scans yet to see.

The symptoms are not near what I have been having over the past 2 years but they come & go. It's more the whole weight issue now and the lack of energy that bothers me. And the fact that I can't get someone to pay attention to me when I say that something is wrong with my body!


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## Andros (Aug 26, 2009)

Lil4x4Girl said:


> What started all of this was some of the symptoms that I have had and started asking my doctor some questions about it. My normal weight is around 110-115 range. Now, I am at 153 and feel horrible. I could understand a couple pounds here & there but this much is ridiculous when there's no reason for it. I'm a normal person, likes outdoor activity, I like to walk and do things like that so I'm not just a couch potato who should expect some weight gain. But after the first 10 lbs, I began to worry. It just kept adding up month after month.
> 
> Finally, I talked to my ob/gyn doctor last summer about it when I had my annual visit. She said my body should not be going through any type of change yet that would cause such rapid weight gain. She suggested that I find a family doctor to handle this and have some thyroid tests run. There is a doctor that I go to for normal allergy/sinus problems a couple times a year so I figured I'd start there. I happened to catch a multiphasic blood test at the hospital and saw they add-on thyroid panel. My numbers weren't bad (I don't have them to post right now) but I took them to the doctor and they started asking questions about why I thought I had a thyroid problem. I explained all of my symptoms and they started sending me for tests. I had the dizziness to the point that I would be walking around and have to sit down or I would just crumble to the ground, I had the fatigue to the point that I could fall asleep in my chair at work almost every afternoon. When I started reading about the thyroid, it all fit.
> 
> ...


Yes; the symptoms wax and wane as do your numbers for thyroid panel and antibodies.

Have you had these tests?

TSI (thyroid stimulating immunoglobulin),TPO (antimicrosomal antibodies) TBII (thyrotropin-binding inhibitory immunoglobulin), Thyroglobulin Ab, ANA (antinuclear antibodies), (thyroid hormone panel) TSH, Free T3, Free T4.

You can look this stuff up here and more.........
http://www.labtestsonline.org/

If you can get you last lab results, we need the ranges also. That would be "really" helpful.

There can be no worse experience than being female and having a female doctor be condescening to her. Boy does that rankle.

I am a big believer in listening to the "inner doctor" that we all have. You do sound like you have a thyroid issue and I validate that for you.

We are here to help you get to the bottom of this.


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## Misty76 (Apr 5, 2011)

Here's the last set of labs that I have..

Component Your Value Standard Range
TSH 4.523 0.300-5.900
Free T4 0.87 0.60-1.10
Total T4 8.89 5.0-12.5
Uptake 32.4 32.0-49.0
Free Thyroxine Index 2.9 1.4-3.1
Peroxidase AB <10 <40


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## Andros (Aug 26, 2009)

Lil4x4Girl said:


> Here's the last set of labs that I have..
> 
> Component Your Value Standard Range
> TSH 4.523 0.300-5.900
> ...


Most of us would feel terrible w/TSH where yours is. AACE recommends the range to be 0.3 to 3.0 and the truth is, the majority feel best @ 1.0 or less.

And your FT4 is just slightly above the mid-range of .85 There again, most of us would feel best if it was higher. Too bad they did not do a FREE T3 which is your active hormone. I would expect it to be quite low given what I see here.

You do have a smattering of antibodies even though they are below range, they are there.

Thank you for providing the lab results and the ranges. They are most helpful. I believe something is afoot.

Here is a place to read about the different labs. You will see that some of the labs you had are out dated.

understanding thyroid labs
http://www.amarillomed.com/howto/#Thyroid

Will be very interested when you get your scan results from a few weeks ago. The thyroid should be smooth, not nodular. As you well know.


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## Misty76 (Apr 5, 2011)

Well, had my follow-up appointment on Monday with the endo doctor and she seemed the same as the first time, didn't seem to think anything was wrong. Nodules are not growing though so that's a plus. She sent me down the hall for more bloodwork. Here's the results..

Test.....................my value........normal range
TSH.......................6.779...........0.300 - 5.900 
THYROID UPTAKE......27.0............32.0 - 49.0 
FREE T4...................0.62.......... 0.60 - 1.10

They called me on Tuesday afternoon and said that she is trying me on 0.05mg of Levothyroxine. She wants me to go for these 3 labs every 2 months til I see her again in October.


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