# Lab/Ultrasound Result Help



## gbarr (Feb 11, 2016)

Hi Everyone,

I'm very new to this so I'm looking for a bit of advice so I know what to ask my doctor.

In December 2010, I had an ultrasound done on my thyroid because my doctor thought it felt large.

*The results were as follows:*

The right thyroid lobe measures 4.8 x 1.6 x 1.8 cm and the left thyroid lobe measures 4.4 x 1.4 x 1.9 cm. The thyroid isthmus measures 4 mm AP. The thyroid demonstrates heterogeneous echogeneicity and normal vascularity.

No cysts or nodules are present.

Impression:

Heterogeneous thyroid gland which raises the question of thyroiditis. No discrete cyst or nodule present.

Last week, I had my annual check up and the doctor (I now have a new doctor) wanted to do a thyroid ultrasound and some lab work.

*The results from the ultrasound from last week are as follows:*

Right lobe:

Size: 5.4 x 1.9 x 1.4 cm

Echotexture: Heterogeneous

Cysts: None

Nodules: None

Left Lobe:

Size: 4.3 x 2.3 x 1.6 cm

Echotexture: Heterogeneous

Cysts: None

Nodules: None

Isthmus:

Size: 0.4 cm

Echotexture: Heterogeneous

Cysts: None

Nodules: None

Impression:

Heterogeneous echotexture to the thyroid gland. No solid masses are identified.

Blood work from 2/6/2016:

TSH, High Sensitivity - 1.69 (Range - 0.45 - 4.50 mU/L)

T4 Free Non-Dialysis - 1.1 (Range - 0.8 - 1.7 ng/dL)

T3 Free Non-Dialysis - 3.3 (Range - 2.0 - 4.8 pg/mL)

Vitamin D, 25-Hydroxy, Total - 19.5 (Range - 30.1 - 100.0 ng/mL)

Full disclosure to the group, I was told to follow up on after my 2010 ultrasound and I did not (stupid, I know, but I'm moving past that now). When I compare my two ultrasounds, it seems like they are basically the exact same, the only difference being that on my 2016 ultrasound the doctor did not include thyroiditis under the impressions. However, when I google heterogeneous echotexture, it seems to indicate hashimoto. My mother was diagnosed with hashimoto and hypothyroid, so my guess is there could be some genetic aspect to all of this.

My current doctor looked at the labs and ultrasound and said that everything was fine. I'm just concerned that one doctor told me to follow up and this one seems to think I'm ok but the results look very similar to me. I provided my current doctor with the results from my 2010 ultrasound so I am waiting to see if she changes her opinion at all. I do not have any blood work from 2010 to compare the 2016 numbers to.

Do any of you have any thoughts on this or any questions I should be asking my doctor? I know my lab work is all within range, with the exception of the vitamin D which I will be taking 50,000 iu a week for the next 4 weeks and then re-testing the blood.

I appreciate any advice you all have!


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## joplin1975 (Jul 21, 2011)

Thyroiditis and Hashi's are often used interchangeably. There are a few, rare instances when thyroiditis is not caused by an autoimmune process, but te vast majority of the time, they are one in the same. Technically, it's called Hashimoto's thyroiditis.

The ultrasound is used to find out if you have any nodules, which you don't -- which is good! You should now have additional blood tests run that will look for the presence of antibodies, which are associated with autoimmune disease. Mainly TPO, TSI, and Tg/TgAB.

While your thyroid labs are within range, you are a smidge hypo. Usually, we look to see that your free t4 and free t3 are at least at 50% of the range, but usually prefer if those numbers hit the 75% mark.

There's lots of research that shows starting low dose thyroid medication during the beginning stages of an autoimmune disease can slow the disease process. You might want to see if your doctor is open to a trial of low dose synthroid/levothyoxrine.


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## gbarr (Feb 11, 2016)

Thanks so much for your response!! I was very glad there were no nodules present!

I will definitely ask to get the additional blood tests done. If I were to start on a low dose of a thyroid medicine, is that something you typically can't stop after you start? I am planning on getting pregnant soon (hopefully) but I'd like to resolve all of this first. I read a lot about the complications it can cause in a pregnancy and of course that made me nervous!


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## Octavia (Aug 1, 2011)

Planning to get pregnant soon REALLLLLLYYYY emphasizes the need to get your Free T3 and Free T4 at good levels. Yours aren't terrible, but could benefit by being in the upper part of the range.


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## joplin1975 (Jul 21, 2011)

Agreed with Octavia! If you want to get pregnant, you'll want those tests asap. And you'll want to be monitored through out your pregnancy. There should not be any adverse effects on your baby. In fact, it's more likely you'll need the thyroxine to have a viable pregnancy.


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## gbarr (Feb 11, 2016)

Thank you for the input. I'm all over the doctors about this and will see as many as I have to until I can get to the bottom of this.

I definitely am nervous about the pregnancy and if I would even be able to get pregnant if I do in fact have Hashimotos. I still haven't been diagnosed, I've been told I am all good and that my thyroid levels are fine. The doctor so far was concerned only about my vitamin D.

I'm making an appointment with an endo ASAP.

Thank you all again! This definitely helped me at least know what to ask for.


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