# Finally got copies of all my previous labs. I'm so confused.



## Phayah (Nov 4, 2011)

October 2010
TSH 0.25 *Low *(0.34-4.82)​
November 2010
Free T4 0.96 (0.59-1.17)​Free T3 3.6 (2.0-4.4)​
November 3, 2011
TSH 0.867 (0.340-4.82)​
November 9, 2011
TSH 1.35 (0.49-4.67)​Free T4 0.64 *Low *(0.71-1.85)​T3 141 (80-200)​
November 10, 2011
Thyroid Ultrasound

Findings:
In the right lobe of the thyroid there is a round hypoechoic nodule. This measures 11 x 15 x 9 mm. There appears to be a hypoechogenic halo. Calcifications are not seen. A nodule is not identified in the isthmus or the left lobe. The gland size appears to be normal.

Impression:
Solitary hypoechoic nodule in the right lobe of the thyroid. There are no suspicious features but because of the size of the nodule, fine needle aspiration is recommended.​
I don't seem to fit the profile of hypo or hyper. I have symptoms of both which I wrote about in a previous post. I'm getting a biopsy on the nodule in about a week. Anyone have a clue what might be going on here? Thyroid? Pituitary? Adrenals? It seems like its all over the place.

Also, I find it a little annoying that the doctor told me my levels were normal on that last test. I got the copies today and he wrote on the paper "basically normal" and signed it. What the hell is "basically" normal?! Particularly, when I'm developing bald spots on my head at the ripe old age of 27! Ugh...


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## lainey (Aug 26, 2010)

Have you had any antibodies tests? These can affect your results.

If you are not on replacement medication, an uptake scan might tell more about how your thyroid is actually functioning.

The combination of low TSH and low free T4 can indicate a pituitary problem called central hypothyroidism. This would need to be investigated by an endo. What type of doctor are you seeing?


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## Andros (Aug 26, 2009)

Phayah said:


> October 2010
> TSH 0.25 *Low *(0.34-4.82)​
> November 2010
> Free T4 0.96 (0.59-1.17)​Free T3 3.6 (2.0-4.4)​
> ...


I think you are leaning toward hyper. It would be good to get antibodies' tests.

TSI (thyroid stimulating immunoglobulin)http://www.medicineonline.com/topics/t/2/Thyroid-Stimulating-Immunoglobulin/TSI.html,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/

TSI and the eyes
http://www.ncbi.nlm.nih.gov/pubmed/1677484

TBII (Thyrotrophin Binding Inhibiting Immunoglobulin)
http://www.ncbi.nlm.nih.gov/pubmed/1969138

Do you have the appt. for FNA set up?


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## Phayah (Nov 4, 2011)

Andros said:


> I think you are leaning toward hyper. It would be good to get antibodies' tests.
> 
> TSI (thyroid stimulating immunoglobulin)http://www.medicineonline.com/topics/t/2/Thyroid-Stimulating-Immunoglobulin/TSI.html,TPO (antimicrosomal antibodies) TBII (thyrotropin-binding inhibitory immunoglobulin), Thyroglobulin Ab, ANA (antinuclear antibodies), (thyroid hormone panel) TSH, Free T3, Free T4.
> 
> ...


I have some annoying eye issues. They are dry, red, irritated, and I have blurry vision at times. When I wake up in the morning the eyelids are literally stuck to my eyeballs and it takes a long time to get my normal vision back. They feel strained all the time. I've had 2 or 3 eye infections in the last several months. The eye doc gave me some tears but it only feels better for about 60 secs.

There is no bulging that I can see but the eyelids intermittently swell. This might sound crazy but it really looks like my eyes have gotten bigger. I've always been self concious about my eyes being too small but not anymore. I have old pics to compare with also which was pretty interesting.


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## Phayah (Nov 4, 2011)

lainey said:


> Have you had any antibodies tests? These can affect your results.
> 
> If you are not on replacement medication, an uptake scan might tell more about how your thyroid is actually functioning.
> 
> The combination of low TSH and low free T4 can indicate a pituitary problem called central hypothyroidism. This would need to be investigated by an endo. What type of doctor are you seeing?


I am a little worried about it possibly being pituitary related. I've had chronic migraines since I was 10 and they are always in the same spot - behind my right eye, close to the pituitary area. I take Imitrex injections though and they work most of the time. I've had a brain/spine MRI but not a pituitary scan. I was referred to a neuro a while back and my appointment is finally coming up next week. Do you think he might do a pituitary scan?

My general/primary doctor is on a military base. There are only two doctors at this base, a male and female. My primary is the female but I have seen the male and he's an ass (lol). It would be too expensive to get a new doc off base. So, I have to find a way to deal with these guys because thats the way my insurance works. Everything goes through them unless its psychological... everything (referrals, ER, procedures, labs).

My primary doc told me if the thyroid biopsy was normal and I still had symptoms she would give me an endo referral. So, it might be a while but at least I know she will give me this option.

It seems like it might all get figured out, eventually. Its taking way too long. I feel like crap and I want to start a home daycare. I'm in the process of getting training/certification/license, but I honestly don't think I can do the job until this is all sorted out. I can barely make myself clean my house right now which is completely unacceptable. I need an immaculate house and the ability to entertain/chase children around, not to mention feeding/cleaning babies. Um, not happening. I don't even have my house set up yet. :sad0049:


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## lainey (Aug 26, 2010)

You can bring the results to the neuro and talk to him about it, if for no other reason than the appointment is sooner. He may have an idea as to whether those tests in the past would have shown a tumor on the pituitary.

There are other blood tests that can be run to check pituitary function as well--it doesn't have to be a tumor (and these are usually benign) the gland can malfunction, the same as any other.


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## Phayah (Nov 4, 2011)

lainey said:


> You can bring the results to the neuro and talk to him about it, if for no other reason than the appointment is sooner. He may have an idea as to whether those tests in the past would have shown a tumor on the pituitary.
> 
> There are other blood tests that can be run to check pituitary function as well--it doesn't have to be a tumor (and these are usually benign) the gland can malfunction, the same as any other.


Yeah, I'm going to talk to him about all my symptoms if he'll let me. I've never been to a neuro/specialist so I'm just not sure what to expect. I don't know if he will evaluate/run tests for non-neuro problems or if he'll just run neuro only tests.

I've considered the possibility because of the unusually precise location of each migraine I've ever had and also, the inconsistency of my symptoms over the years (hyper/hypo, all over the place). I read that brain scans often do not reveal pituitary tumors because they are so small. A specific pituitary MRI will reveal more "slices" of the pituitary gland itself. If there is a better lab measurement than TSH for pituitary issues I would be more than willing to get that checked out too. I just don't know if the neuro doc will go that far with "non-neuro" testing.


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## lainey (Aug 26, 2010)

To check if the pituitary is functioning properly regarding thyroid stimulating hormone, you would do a TRH stimulation test:

http://thyroid.about.com/od/gettestedanddiagnosed/a/trhtest.htm

This is probably outside of the scope of the neuro, and more likely done by an endocrinologist. It could be done before or after any MRI-type studies of the gland.


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## Phayah (Nov 4, 2011)

lainey said:


> To check if the pituitary is functioning properly regarding thyroid stimulating hormone, you would do a TRH stimulation test:
> 
> http://thyroid.about.com/od/gettestedanddiagnosed/a/trhtest.htm
> 
> This is probably outside of the scope of the neuro, and more likely done by an endocrinologist. It could be done before or after any MRI-type studies of the gland.


Thanks. When/if I get the endo referral I will ask about this. All this waiting around feeling miserable is unbearable. :sad0049:


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## Andros (Aug 26, 2009)

Phayah said:


> I have some annoying eye issues. They are dry, red, irritated, and I have blurry vision at times. When I wake up in the morning the eyelids are literally stuck to my eyeballs and it takes a long time to get my normal vision back. They feel strained all the time. I've had 2 or 3 eye infections in the last several months. The eye doc gave me some tears but it only feels better for about 60 secs.
> 
> There is no bulging that I can see but the eyelids intermittently swell. This might sound crazy but it really looks like my eyes have gotten bigger. I've always been self concious about my eyes being too small but not anymore. I have old pics to compare with also which was pretty interesting.


Please see an Opthalmologist at your earliest convenience. It is important to establish a "baseline" in the early stages and much much can be done by way of medical intervention.

Get some Lacrilube to use at night prior to lights out and get some Refresh or similar (do not use anything but lubricating drops; antihistamine makes the eyes worse) for use by day.

You do not want to have an injured cornea from the eyelids sticking. I "promise" you that.

The infections could possibly be Iritis which is a precursor to autoimmune disease most notably thyroid disease.


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## Phayah (Nov 4, 2011)

Andros said:


> Please see an Opthalmologist at your earliest convenience. It is important to establish a "baseline" in the early stages and much much can be done by way of medical intervention.
> 
> Get some Lacrilube to use at night prior to lights out and get some Refresh or similar (do not use anything but lubricating drops; antihistamine makes the eyes worse) for use by day.
> 
> ...


Wow, that is so odd. I wonder how I would go about seeing an opthalmologist? I'm pretty sure the guy I saw recently was an optometrist. I had an eye exam (20/20) and he saw "irritation" so he gave me eye drops. They are called "Refresh Tears". I can't see this guy thinking its anything more than "dry eyes" and giving me a referral. Too much to think about!

Here's some pics lols! Lighting is different so I don't know, just guessing.

Oh, I was on Skype with my bro and he asked me if I'd dyed my hair. Um, no! I guess my eyes aren't the only thing to have changed. Apparently, I am mutating.

One other thing Andros... I was on a very strict almost zero carb diet for about 6 months. I lost 55 lbs in about 5 of those months and stopped losing the last month. For the past month or maybe more, I went back to my sugary sodas all day, fast food, frozen foods, junk, etc and I have LOST weight. All this conflicting stuff is overwhelming. No wonder the docs don't want to figure it out.


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## Andros (Aug 26, 2009)

Phayah said:


> Wow, that is so odd. I wonder how I would go about seeing an opthalmologist? I'm pretty sure the guy I saw recently was an optometrist. I had an eye exam (20/20) and he saw "irritation" so he gave me eye drops. They are called "Refresh Tears". I can't see this guy thinking its anything more than "dry eyes" and giving me a referral. Too much to think about!
> 
> Here's some pics lols! Lighting is different so I don't know, just guessing.
> 
> ...


What a cutie pie you are. Yes; your left eye appears bigger. And this is typical. It usually is the left eye but "sometimes" the right eye. One is bigger than the other. Soon the other will follow suit as the eyes are "sympathetic."


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## Phayah (Nov 4, 2011)

Andros said:


> What a cutie pie you are. Yes; your left eye appears bigger. And this is typical. It usually is the left eye but "sometimes" the right eye. One is bigger than the other. Soon the other will follow suit as the eyes are "sympathetic."


I'm pretty sure it was my right eye that kept getting infected. The last few days it has been feeling a bit swollen in the morning as well. They look pretty similar in size now. Maybe I should take another picture, haha. :tongue0013:

What do you mean by sympathetic?

This seems like some pretty dangerous stuff, blindness?! Maybe I should go back to that optometrist soon. Surely he can refer me.

Ugh, too much to do when you've gotta tote a 2 year old around and your brain is malfunctioning... don't know if I can do this. :sad0049:


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## Andros (Aug 26, 2009)

Phayah said:


> I'm pretty sure it was my right eye that kept getting infected. The last few days it has been feeling a bit swollen in the morning as well. They look pretty similar in size now. Maybe I should take another picture, haha. :tongue0013:
> 
> What do you mean by sympathetic?
> 
> ...


It means the other eye will follow suit! I thought maybe in the photo the image was reversed. So,that is the right eye that appears larger?

Yes, your optometrist should be happy to refer you. If not, call around and make sure the ophthalmolgist is familiar with GED (Graves' Eye Disease) and TED (Thyroid Eye Disease.)

You will have to have drops put in your eyes so maybe someone could go w/you to help with the baby and drive you?


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## Phayah (Nov 4, 2011)

Andros said:


> It means the other eye will follow suit! I thought maybe in the photo the image was reversed. So,that is the right eye that appears larger?
> 
> Yes, your optometrist should be happy to refer you. If not, call around and make sure the ophthalmolgist is familiar with GED (Graves' Eye Disease) and TED (Thyroid Eye Disease.)
> 
> You will have to have drops put in your eyes so maybe someone could go w/you to help with the baby and drive you?


No, the image isn't reversed. The left eye does appear larger but the recent infections/swelling were actually in my right eye.

Side note, my migraines are also behind my right eye, close to the bridge of my nose in the upper eyelid area.

My husband would have to take off work and he's had to do that so much lately. I wonder if I can find a babysitter. No one wants to do part time care! Blah, I will see if I can get it done somehow.


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## Phayah (Nov 4, 2011)

The FNA was today. It wasn't bad at all. The anesthetic hurt more than anything. The area is a little swollen. I hope thats normal? All she said was it might be tender for a couple of days.

I found out that its a solid nodule. Any idea what that could mean?

They said they'd have the results by Monday but it has to go through my doctor. It could be another week before I find out anything. Maybe if I call they will tell me.


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## webster2 (May 19, 2011)

Call, it will make you feel better. If they have the results, then maybe you will know something. It never hurts to try.  Best wishes, and I will say a prayer for great results.


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## Andros (Aug 26, 2009)

Phayah said:


> The FNA was today. It wasn't bad at all. The anesthetic hurt more than anything. The area is a little swollen. I hope thats normal? All she said was it might be tender for a couple of days.
> 
> I found out that its a solid nodule. Any idea what that could mean?
> 
> They said they'd have the results by Monday but it has to go through my doctor. It could be another week before I find out anything. Maybe if I call they will tell me.


Oh, dear...................well, solid is usually not good.

Nodules http://www.aafp.org/afp/2003/0201/p559.html

Nodules http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1665239/

Will be waiting w/you for the results on Monday or whenever that happens.


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## Phayah (Nov 4, 2011)

Andros said:


> Oh, dear...................well, solid is usually not good.
> 
> Nodules http://www.aafp.org/afp/2003/0201/p559.html
> 
> ...


Yeah I'm starting to get really worried. I'm only 27! They didn't seem to think much about it, though. I was told by the technologist it was highly unlikely to be cancer but then I came home and read that 1 in 4 or 5 hypoechoic solid nodules are malignant, regardless of other factors. Why would they not know this?! They are supposed to be experts in radiology.

Also, I just spoke to a cousin of mine that I haven't seen in about 10 years. He told me that his sister had to have half her thyroid removed not long ago. A week later she was back to normal. She is 24.

I am in fact losing weight regardless of the fact that I'm eating/drinking junk daily. I have lost at least 10 lbs or so in the last couple of weeks. It is highly unusual. My weight/appetite has always been unstable but sodas + junk usually make me gain weight no matter what. I also went from having to take laxatives a week or so ago to the big "D". Ugh.

I hate this. I guess the thing that scares me the most is that it could be lung cancer. I had a chest x ray about a year ago and they came back and asked me if I was wearing some kind of zipper/jewelry near my collarbone. I was completely naked under a scrub shirt so no I wasn't. They didn't see it on the side view so they wrote it off as nothing. I hope they were right. I have smoked since I was 12! Then again, it could have been the thyroid nodule they saw. I can't remember the exact location.

I don't know. I just know I feel like I'm falling apart... everywhere.


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## Andros (Aug 26, 2009)

Phayah said:


> Yeah I'm starting to get really worried. I'm only 27! They didn't seem to think much about it, though. I was told by the technologist it was highly unlikely to be cancer but then I came home and read that 1 in 4 or 5 hypoechoic solid nodules are malignant, regardless of other factors. Why would they not know this?! They are supposed to be experts in radiology.
> 
> Also, I just spoke to a cousin of mine that I haven't seen in about 10 years. He told me that his sister had to have half her thyroid removed not long ago. A week later she was back to normal. She is 24.
> 
> ...


Given the fact that you had FNA, it's possible you will have your answer to a lot of health problems soon. You would be surprised at how much of our bodies the thyroid regulates.

Take it a day at a time and do know we are traveling the road with you as best we can from afar.


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