# New and looking for help



## Alexandra8011 (Oct 14, 2011)

Hi everyone - I am new and eagerly reading all the posts on here! I am a 30-year-old female and recently went to my PCP for an enlarged thyroid gland. She ordered some blood tests and an ultrasound and results were as follows:

Free T4: 0.95 (0.80-1.80)
Thyroid Peroxidase AB: >1,000 (<35)
Thyroglobulin AB: 329 (<20)

The ultrasound revealed a multinodular goiter.

She thought I had Hashimoto's (my mother also had this) and recommended I follow up with an endocrinologist. The endocrinologist wanted to run her own tests, which came back as follows:

Free T4: 0.84 (0.53-1.80)
Total T3: 0.9 (0.7-1.7)
TSH: 2.35 (0.5-6.0)

When I called to get the results and find out what treatment I should have, she told me my labs were fine and they just wanted to watch and wait for three months. I am pretty upset, because I don't want this to get worse and I do have times when I have pretty severe symptoms, although they come and go (depression, anxiety, fatigue, weight gain).

I got some recommendations for another endocrinologist who will hopefully run a free T3 test and be more willing to listen to my concerns and offer treatment, but am I just being a drama queen? Does my diagnosis look concerning to any of you?

Thank you in advance for any comments or suggestions you have.


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## Andros (Aug 26, 2009)

Alexandra8011 said:


> Hi everyone - I am new and eagerly reading all the posts on here! I am a 30-year-old female and recently went to my PCP for an enlarged thyroid gland. She ordered some blood tests and an ultrasound and results were as follows:
> 
> Free T4: 0.95 (0.80-1.80)
> Thyroid Peroxidase AB: >1,000 (<35)
> ...


Very very concerning to me. With the high TPO Ab and Thyroglobulin Ab, it would be a good idea for you to pursue this. Were any nodules noted on the ultra-sound? Do you have any swollen lymph nodes in the neck/clavicle area?

Symptoms that you would care to point out?

Your FT4 and Total 3 are in the basement. There is definitely something going on here!

TPO Ab
http://www.nlm.nih.gov/medlineplus/ency/article/003556.htm

TPO Ab should be negative, 0
http://www.medlabs.com.jo/docs/Leaflet-17.pdf
(The normal thyroid has TPO but should not have antibodies to TPO)

Thyroglobulin Ab
A negative test is normal. A negative test means no antibodies to thyroglobulin are found in your blood.
http://www.nlm.nih.gov/medlineplus/ency/article/003557.htm
(The normal thyroid has Thyroglobulin in low titers but should not have Thyroglobulin Ab)

Thyroglobulin Ab and cancer
http://qjmed.oxfordjournals.org/content/59/2/429.full.pdf

Another Thyroglobulin and cancer
http://www.mdlinx.com/endocrinology...963/?news_id=811&newsdt=092010&subspec_id=419

Please do not allow yourself to be dismissed.

Welcome to the board; everyone here is really really nice and very helpful.


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## Negative101 (May 23, 2011)

Andros said:


> TPO Ab should be negative, 0
> http://www.medlabs.com.jo/docs/Leaflet-17.pdf
> (The normal thyroid has TPO but should not have antibodies to TPO)


The above link doesnt seem to work -- would you happen to have it saved anywhere or know where else I can find it?

TPO Antibodies, from my research, can certainly exist in the normal healthy population. This is not to suggest that they dont warrant attention, because they certainly do. But low levels may very well be something found in normal people.


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## Alexandra8011 (Oct 14, 2011)

Thank you so much for the replies. I don't see any mention of nodules on the ultrasound report - there's just one sentence that says the scan revealed a multi-nodular goiter, which sticks out because my PCP's office told me my whole thyroid gland was enlarged, but there were no nodules. So what's up with the goiter?

I don't have any swollen lymph nodes - one was swollen probably a month ago, but has gone down.

As far as symptoms, I have major fatigue, where I can barely get up in the morning, feel tired all day at work, go home and sleep, get up to make dinner, and go back to sleep. Lather, rinse, repeat. There are times where I feel better though. I would say it's probably half and half. I also gained a lot of weight very quickly about four years ago and have never been able to take it off since. I was always very skinny before. I have anxiety and depression, despite taking antidepressants.

For purposes of full disclosure, I also am a breast cancer survivor. I was diagnosed in December of '09 with stage IIA and completed chemo and radiation last year. I thought initially the fatigue was residual from the treatments, but it's been a year and it hasn't gotten better.


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## joplin1975 (Jul 21, 2011)

Goiter means a swollen gland, but multi-nodule goiter would indicate that the gland is enlarged with a number of nodules. It would be nice to know the size and characteristcs of the nodules (solid, cystic etc)...but I agree with Andros that your bloodwork is concerning and I would, particularly with tour history, be pressing for 1) more info on the nodules and 2) additional testing, perhaps a RAIU or FNA.

Thinking of you!


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## Alexandra8011 (Oct 14, 2011)

Thank you - that explains more about the goiter to me (which I was confused about) and those are great suggestions. I really appreciate the help!


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## Andros (Aug 26, 2009)

Negative101 said:


> The above link doesnt seem to work -- would you happen to have it saved anywhere or know where else I can find it?
> 
> TPO Antibodies, from my research, can certainly exist in the normal healthy population. This is not to suggest that they dont warrant attention, because they certainly do. But low levels may very well be something found in normal people.


Yes; that happens to be true. Low levels of TPO Ab are found in those that appear to have no health issues.

I am so upset about that link. I hope to find another credible source. I "am" looking. LOL!

Antimicrosomal Antibody (alternative name, Thyroperoxidase Antibody)

Anti-microsomal Antibodies
Negative test is normal; you should not have any of these antibodies.
http://www.nlm.nih.gov/medlineplus/ency/article/003556.htm

Alternative NamesThyroid antimicrosomal antibody; Antimicrosomal antibody; Microsomal antibody; Thyroid peroxidase antibody; TPOAb


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