# Plummers, Hypo, Hyper don't know but here's some drugs?



## aallen07 (Aug 8, 2014)

T3 3.18

TSH .093

T3 1.12

Mild elevation at 24 hours of 33.7% (10-30 normal range) after radioactive iodine test

The Dr says hyperthyroid/Plummers disease. and rx'd 5mg of methimazole daily. I took it two days felt like I had strep and stopped taking it, called the office and never received a return call.

Multinodular "hot" nodules, one fairly large one. I feel like it's not a valid diagnosis, experiencing hypo issues, hair loss, weight gain, exhaustion and crap for memory. Any insight would be great. I have no idea what to do next. Not something I thought 35yr olds would have to worry about - goiter??? really???


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## Lovlkn (Dec 20, 2009)

Can you please review your lab posted and add ranges.

TSH shows hyper but your labs look to be more low range which is hypo. Without ranges I can't be sure.


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## Andros (Aug 26, 2009)

This medication may rarely cause very serious blood disorders (such as a low number of red cells, white cells, and platelets), especially during the first few months of treatment. Tell your doctor immediately if you develop any of the following symptoms: signs of infection (such as fever, persistent sore throat), easy bruising/bleeding, unusual tiredness.

http://www.rxlist.com/tapazole-side-effects-drug-center.htm

Tell your doctor immediately if you develop any of the following symptoms: signs of infection (such as fever, persistent sore throat), easy bruising/bleeding, unusual tiredness.A very serious allergic reaction to this drug is rare. However, seek immediate

Finish reading here
http://www.medicinenet.com/methimazole-oral/page2.htm

If you got a sore throat in 2 days, you were wise to stop your med. If your doctor does not call you back about this, I would go doctor shopping.

And may I point out that you do seriously need competent medical intervention. Untreated, hyperthyroid can cause much damage including death.

Welcome to the board!


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## aallen07 (Aug 8, 2014)

Lovlkn said:


> Can you please review your lab posted and add ranges.
> 
> TSH shows hyper but your labs look to be more low range which is hypo. Without ranges I can't be sure.


T3 3.18 Range 2.18-3.98 Normal

T4 1.12 Range .70-1.90 Normal

Vitamin D 23 Range 30-100 Low

TSH .093 Range 0.300-5.000 Low


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## aallen07 (Aug 8, 2014)

FINDINGS: The right lobe of the thyroid is enlarged, predominantly by the dominant cystic nodule in this lobe. The left lobe of the thyroid more normal in configuration but at the upper limits of normal in size. There is a large area of

Nuclear Medicine

absent tracer deposition in the midportion of the right lobe of the thyroid, corresponding to the dominant cystic lesion in this location as seen on ultrasound. Along the medial aspect of this photopenic area, there is a small but very hot nodule identified. This nodule is not really appreciated on ultrasound. There is another slightly hot nodule along the inferolateral margin of the cystic nodule. In the left lobe, a slightly hot nodule noted in the midportion of the left lobe corresponding to a nodule on ultrasound. Suggestion for an additional slightly hot nodule in the superior pole of the left lobe of the thyroid.

The 6 hour I-131 uptake is 16.6%.. The 24 hour I-131 uptake is 33.7%.

IMPRESSION:

1. Multinodular goiter with several slightly hot nodules in the thyroid and one nodule which is very hot medially in the midpole of the right lobe of the thyroid.

2. Large photopenic area in the midpole of the right lobe of the thyroid corresponding to the dominant cystic lesion noted on thyroid ultrasound. Although the area of photopenia correlates to the cystic portion of this lesion, the size of the lesion does make it difficult to determine if there are any components which are solid and photopenic and therefore concerning for malignancy. Therefore, I would consider further evaluation with diagnostic aspiration with cytology of the dominant cystic lesion in the right lobe as well as clinical and sonographic follow-up of the thyroid.

Nuclear Medicine

3. Mildly elevated 24 hour I-131 uptake of 33.7% consistent with mild hyperthyroidism secondary to a multinodular goiter. The status of the dominant cystic lesion in the right lobe of the thyroid should be determined prior to any contemplated radioiodine therapy.

Normal range for 6 hour I-131 thyroid uptake is 7-20%.
Normal range for 24 hour I-131 thyroid uptake is 10-30%.


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## Sadface (May 12, 2014)

When my roller coaster started in April, I noticed symptoms right away. It was the very hard and rapid heart beat and anxiety. My neck started to hurt, I woke up every night with pain, then I felt a little lump in my thyroid. That's when I drove to a lab for testing.

My Frees were still within their range even though the FT3 was very near the top. But nevertheless within the range. My TSH was however too low, at 0.12. So I decided it's time to see a doctor.

It's funny how we know ourself so much better that something is off rather than what the lab numbers are telling us. That TSH can be a pretty good indicator anyways something is wrong. I think it has "memory" of our personal body equilibrium, when we feel optimal. And in the beginning of thyroid failure, the Frees can be in range because the pituitary gland works hard to even them out. Until that doesn't hold up anymore.

Hot nodules doesn't respond to TSH, but the rest of the thyroid does, that's why it can still be in range for starters.

If you have hot nodules, they will most likely take them out surgically. That's what they told me before they knew what was wrong. They might do a biopsy first. I could be wrong here but you don't treat hot nodules with anti thyroid meds.

And yes, if you get a sore throat and/or fever while on them you need to go and have a blood test. My sister who has Graves and are on them is told to go to the nearest ER in such case and she will go in front of the line without any waiting time. So I guess it could turn out to be serious, but it stops and goes back to normal if you stop the meds at once.

I hope you'll get to feel better soon.


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## aallen07 (Aug 8, 2014)

Sadface said:


> When my roller coaster started in April, I noticed symptoms right away. It was the very hard and rapid heart beat and anxiety. My neck started to hurt, I woke up every night with pain, then I felt a little lump in my thyroid. That's when I drove to a lab for testing.
> 
> My Frees were still within their range even though the FT3 was very near the top. But nevertheless within the range. My TSH was however too low, at 0.12. So I decided it's time to see a doctor.
> 
> ...


What was your diagnosis and treatment plan?


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## Andros (Aug 26, 2009)

Do you have an appt. for that FNA. Absence of tracer deposition does indicate that cancer could be present. We all hope not but I am sure you would rather know for sure.

Let us know when you are scheduled for that.


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## Sadface (May 12, 2014)

aallen07; it turned out I had Subacute Thyroiditis. I've never heard of it before. The weirdest thing.


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## aallen07 (Aug 8, 2014)

Andros said:


> Do you have an appt. for that FNA. Absence of tracer deposition does indicate that cancer could be present. We all hope not but I am sure you would rather know for sure.
> 
> Let us know when you are scheduled for that.


Andros, the endo said not necessary, hot nodules = no cancer. Nothing in blood workup to indicate it.


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