# Back from ENT...



## a2bc2 (Jul 22, 2014)

Hi everyone-

Back from ENT... he told me I have 3 choices: PTU, Throidectomy or wait it out and see if it goes away. Did a thyroid and ordered blood work (which hasn't been drawn yet- FT4, FT3, TSH). My anxiety and mental health is so crappy right now that I am about to jump on the thyroidectomy. He ultrasounded my thyroid but said he doesn't do FNA bc of my hashi's the results will likely be "inconclusive" and he would recommend my thyroid come out anyways. Thoughts? I have been a crying, ugly mess all day. Also, he isn't happy that I am on Lexapro and Xanax. And said that if 5 mg of Propranolol brings my heart rate down then I likely don't need it anyways. I don't have Graves he said even though I have TSI. Just post partum thyroiditis/Hashitoxicosis.


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## Andros (Aug 26, 2009)

The criteria for Graves' is clinical. You must exhibit..........goiter, exophthalmos, pretibial myxedema and thyrotoxicosis as per Dr. Robert Graves' of the 1800 era. 3 out of the 4 qualify.
(3 chapters) http://www.thyroidmanager.org/chapter/graves-disease-and-the-manifestations-of-thyrotoxicosis/
(Copy and paste into your browser)

http://www.thyroidmanager.org/chapter/diagnosis-and-treatment-of-graves-disease/
(Copy and paste into your browser)

Otherwise you are classified as hyperthyroid either because of Hashi's, the criteria for that being high TPO Ab and a grapelike appearance of the thyroid, both of which are "suggestive" because this is commonly seen in Hashi's with FNA (fine needle aspiration) confirming those suspicions "if" there are Hurthle Cells indigenous to Hashimoto's. Or because of cancer. We don't know which comes first, the hyperthyroid or the cancer. We just know that they are often found together.

Hashi's and Graves' closely related
http://www.thyroidmanager.org/chapter/hashimotos-thyroiditis/
(Copy and paste into your browser)

(comments are my own)

I will enclose info on Graves' so you can be the judge BUT..............................based on my own experience and what I now know, I would have had my thyroid taken out immediately. As it was, I wasted 2 years on Tapazole and was really sick the whole time.

The info above is extensive but it would be to your benefit to read it all!


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## joplin1975 (Jul 21, 2011)

Again, hate to bang that surgery drum, but take the thyroidectomy and run with it. You may have a few weeks or months of struggle after surgery as they try to get your meds right, but once they do, you'll feel so, so much better.


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## a2bc2 (Jul 22, 2014)

Did either of you have anxiety or mental health issues prior to surgery that resolved after the surgery? I do not have these issues when I am hypo generally. Also, I just want to reiterate that I am 12 weeks post partum. Also, breastfeeding. Cause for concern?


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## a2bc2 (Jul 22, 2014)

I have eyelid lag (more prominent on right side) with a little sclera showing. He did give me his statistics on surgery complications, but certainly did not push it on me. He is almost 70. He has done over 7000 thyroidectomies in his career. Should I get a 2nd opinion or consult with another ENT?


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## a2bc2 (Jul 22, 2014)

Thank you for your responses by the way. Feeling pretty hopeless today. :*(


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## a2bc2 (Jul 22, 2014)

Previously post partum the hyperthyroidism went away and I was left hypo (looking at my labs, poorly managed hypo)...


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## a2bc2 (Jul 22, 2014)

Here are all my labs that I could find related to my thyroid. The most recent are at the top.

*7/7/14 (8 weeks post partum)*

FT4 1.5 (RR .8-1.8)

TSH .06

Thyroglobulin AB <1 (RR <=1)

Thyroid Microsimal AB 577 (RR <9)

TSI 477 (RR <140)

*6/16/14 (6 weeks post partum)*

FT4 1.0 (RR .8-1.8)

TSH 1.28

FT3 3.2 (RR 2.3-4.2)

TPO ab 282 (RR <9)

*5/28/14 (3 weeks post partum)*

FT4 1.5 (RR.8-1.8)

TSH .08

FT3 4.1 (RR 2.3-4.2)

TPO ab 377 (RR <35)

*5/5/14 (day before delivery)*

TSH 1.2

*12/27/13*

FT4 1.4 (RR .8-1.8)

TSH .79

*8/19/13 (about 4 weeks pregnant)*

FT4 1.4 (RR .8-1.8)

TSH 2.12

TPO ab >1000 (RR <35)

*6/27/13*
TSH 1.47
FT4 1.3 (RR .8-1.8)
TPO ab >1000

*3/31/13*
TSH 2.53

*9/26/12*
TSH 3.67

*9/21/11*
TSH 3.77

*4/22/11*
TSH 1.290
FT4 .83 (RR .8-1.8)

*5/12/10*

TPO ab >600 (RR 0-34)

Thyrotropin Receptor ab 1.07 (RR 0.00-1.75)

TSH 3.77

FT4 1.04 (RR 0.82-1.77)

*1/18/10 (3 months post partum)*

FT4 1.3 (RR 0.8-1.8)

TSH .02

T3 444 (RR 230-420)

*11/11/09 (1 month post partum)*

TSH .153

FT4 1.38 (RR 0.82-1.77)

*10/5/09*

TSH 2.1

FT4 0.87 (RR 0.93-1.71)

*7/30/09*

TSH 1.53

*4/28/09*

TSH 1.092

*2/20/08*

TSH 4.0

*6/5/2006*

TSH 2.291 (.350-5.5)
Thyroxine (T4) 15.4 (4.5-12.0)
T3 Uptake 18 (24-39)
TPO ab's 1320 (0-34)

*4/11/2005 (first diagnosed)*

TSH 5.5


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## Octavia (Aug 1, 2011)

The fact that you are postpartum changes things a bit...I might be inclined to wait a bit longer to see if it resolves, but you know your body better than anyone.

And a second opinion is always a good idea.


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## joplin1975 (Jul 21, 2011)

I think (and someone correct me if I'm wrong) you might get some relief as your hormones settle down post-delivery, but the fact that you have both TPO and TSI is what is making me advise surgery. Those might settle down a bit, wax and wane over the years, but (again, correct me if I'm wrong) I don't think you'll seet hose antibodies ever disappear and that will continue to cause problems.


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