# Does this look like hashitoxicosis?



## mememe (Mar 18, 2010)

So far, my TSH, FT4 & FT3 has always been in normal range, but I have been positive for all antibodies that I've been tested for. Below are all labs and ultrasound reports. I am waiting on my most recent ultrasound report. Hopefully I will get it tomorrow. Appointment on Thursday as a follow up for that, as well as the labs that are from 12/5. My doctor is just "keeping an eye on things" so to speak. No meds for thyroid ever so far.

Most recent labs from 12/5:
TSH 1.590 (0.450-4.500)
FT4 1.29 (0.82-1.77)
FT3 3.3 (2.0-4.4)
TPO 340 (0-34)
TSI 39 (0-139)
TgAB <20 (0-40)
TRAB <0.51 (0.00-1.75)
Comparison of all labs:









Previous ultrasound reports (Still waiting on the most recent one from 12/5):
12/9/2010
"Indication: goiter.

Findings: Thyroid gland is slightly enlarged. Right lobe measuring 4.6 x 1.7 x 1.7cm. Left lobe measures 5.1 x 1.2 x 1.8cm. There is diffuse heterogeneity of the thyroid parenchyma. There is some lobulation of the right lobe. No dominant nodules or cysts identified.

Impression: Slightly enlarged thyroid gland with heterogeneous parenchyma. No dominant nodules or cysts."

4/12/2010
"Findings: The right lobe measures 5.2 x 1.8 x 1.6 cm and the left lobe 5.5 x 1.4 x 1.8 cm. The right and left lobes of the thyroid are diffusely heterogeneous with no discrete right or left lobe nodule identified. The isthmus measures approximately 0.3 cm.
Impression: Diffusely heterogeneous echogenicity of the thyroid likely representing multinodular goiter with no discrete dominant nodule identified."


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## angel1976 (Nov 15, 2011)

Thanks for very organized data (your post should go to Q and A section as an example)
Based on the results it rather looks like inflammatory process due to Hashimoto's disease.
Due to the fact that your T4 and T3 readings within the range, your condition cannot be considered "hashitoxicosis'.
some patients in this condition demonstrated marked decrease of TPO antibodies during the selenium supplementation trial, however it may or may not work.
The volume of your thyroid is 13 cu cm, therefore I am not sure it is considered to be a goiter (you have no nodules and its size is less the 18cu cm)


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## Andros (Aug 26, 2009)

mememe said:


> So far, my TSH, FT4 & FT3 has always been in normal range, but I have been positive for all antibodies that I've been tested for. Below are all labs and ultrasound reports. I am waiting on my most recent ultrasound report. Hopefully I will get it tomorrow. Appointment on Thursday as a follow up for that, as well as the labs that are from 12/5. My doctor is just "keeping an eye on things" so to speak. No meds for thyroid ever so far.
> 
> Most recent labs from 12/5:
> TSH 1.590 (0.450-4.500)
> ...


I would say you might be headed in that direction as per..............

http://www.mayomedicallaboratories.com/test-catalog/print.php?unit_code=8634

Please read in it's entirety.


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## mememe (Mar 18, 2010)

Andros said:


> I would say you might be headed in that direction as per..............
> 
> http://www.mayomedicallaboratories.com/test-catalog/print.php?unit_code=8634
> 
> Please read in it's entirety.


Is this TSHR the same thing as TRAB?


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## Andros (Aug 26, 2009)

mememe said:


> Is this TSHR the same thing as TRAB?


I don't believe so. TRAB is an antibody and TSHR is a receptor. Now that is my answer but I am not sure I am right. If anyone else would care to kick in; it would be appreciated.

http://en.wikipedia.org/wiki/Thyrotropin-releasing_hormone

http://www.ncbi.nlm.nih.gov/pubmed/1633635


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## mememe (Mar 18, 2010)

Gosh! I have so much to learn! Sometimes this stuff can be so confusing!
Thanks for the links!
I'm wondering if there are any other blood tests I should get done?


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## Andros (Aug 26, 2009)

mememe said:


> Gosh! I have so much to learn! Sometimes this stuff can be so confusing!
> Thanks for the links!
> I'm wondering if there are any other blood tests I should get done?


Right now, I think you have some good lab tests that should narrow the field.

When do you see this new doc?


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## mememe (Mar 18, 2010)

It's not a new doctor, but I go on Thursday for my lab and ultrasound follow up. I am planning to get a copy of the ultrasound report tomorrow, so if I do, I'll post the report.


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## Andros (Aug 26, 2009)

mememe said:


> Gosh! I have so much to learn! Sometimes this stuff can be so confusing!
> Thanks for the links!
> I'm wondering if there are any other blood tests I should get done?


I also have a lot to learn!! And that is not a joke! The more you learn, the more you need to learn.


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## mememe (Mar 18, 2010)

I just found out from my ultrasound report that there is a "solitary 2.0 cm solid nodule identified in the inferior pole of the right lobe". Will be able to pick up my report tomorrow!


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## shellebean (Oct 12, 2011)

I would imaging an FNA of that solid nodule would be next step.


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## angel1976 (Nov 15, 2011)

the 2cm nodule may form as the result of inflammatory process or in some cases inflamed tissue can be confused with the nodule


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## mememe (Mar 18, 2010)

angel1976 said:


> the 2cm nodule may form as the result of inflammatory process or in some cases inflamed tissue can be confused with the nodule


How would they differentiate?

Also, each of the 3 ultrasounds were done in 3 totally different places. Just an fyi


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## Andros (Aug 26, 2009)

mememe said:


> I just found out from my ultrasound report that there is a "solitary 2.0 cm solid nodule identified in the inferior pole of the right lobe". Will be able to pick up my report tomorrow!


Oh, dear! Do let us know. Sounds like FNA or bypass that and go to surgery.

Saying a prayer for you!


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## joplin1975 (Jul 21, 2011)

mememe said:


> How would they differentiate?
> 
> Also, each of the 3 ultrasounds were done in 3 totally different places. Just an fyi


A FNA (biopsy) of the nodule. Solid nodules are more concerning than cystic nodules.


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## angel1976 (Nov 15, 2011)

The ultrasounds should be done at the same machine and (prefered) by the same person, otherwise the data cannot be reliable; the shift in the ultrasound wave frequency can chnge the image quality. If that nodule is "palpable" then repeated ultrasond with biopsy in doctor's office must be done.


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## mememe (Mar 18, 2010)

Ok, here is my full ultrasound report:

"Right lobe measures 4.1 x 1.4 x 1.4 cm. The entire right lobe is somewhat inhomogeneous in attenuation with a 2.0 cm. solid nodule identified in the inferior pole. The left lobe of the thyroid measures 4.2 x 1.5 x 1.5 cm. and is also heterogeneous in attenuation. No discrete solid or cystic nodule can be identified in the left lobe. The thyroid isthmus measures 3 mm.

Impression: Both lobes of thyroid slightly enlarged and somewhat inhomogeneous in attenuation. A solitary, 2.0 cm. solid nodule identified in inferior pole of right lobe."


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## angel1976 (Nov 15, 2011)

can you post a link to the ultrasound image like you did the last time?


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## mememe (Mar 18, 2010)

I don't have images for this one, images were only for that last ultrasound. They may have some to give me tomorrow, but all I have is the report.


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## Andros (Aug 26, 2009)

mememe said:


> I don't have images for this one, images were only for that last ultrasound. They may have some to give me tomorrow, but all I have is the report.


I do hope you are scheduled soon for FNA. Poor thyroid; does not sound healthy at all.


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## mememe (Mar 18, 2010)

Thanks. I will update after my appointment in the morning!


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## mememe (Mar 18, 2010)

Saw the PA today and she suggests FNA so they are scheduling it for me. They are sending me to a nearby hospital in which the radiologist does it, Ultrasound guided, and I believe she said he does them twice a week there.


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## bigfoot (May 13, 2011)

Good to hear! hugs6


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## Andros (Aug 26, 2009)

mememe said:


> Saw the PA today and she suggests FNA so they are scheduling it for me. They are sending me to a nearby hospital in which the radiologist does it, Ultrasound guided, and I believe she said he does them twice a week there.


We are so glad to hear this and you must let us know when you are scheduled.


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## mememe (Mar 18, 2010)

I just got the call. FNA in the morning!


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## Andros (Aug 26, 2009)

mememe said:


> I just got the call. FNA in the morning!


That was fast! Coola loola!!! Good luck; you will be in our thoughts and prayers for this.


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## mememe (Mar 18, 2010)

Guess what? They couldn't find a solitary nodule, so no FNA!


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## angel1976 (Nov 15, 2011)

I was right
Sometimes the frequency shift during testing can produce false images as well!
I saw it myself!!!


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## mememe (Mar 18, 2010)

Yep! Well i will just wait to hear from the doc now and i'm supposing we'll do the 6 month ultrasound checks!


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