# New to Hashis- Really Need Advice



## ZeldaGirl712 (Mar 19, 2015)

Hello  I will try my best to make this short without forgetting anything. So my old PCP felt nodules on my thyroid about 5 yrs. ago. I went to an ear, nose and throat specialist as they recommended and had an ulrasound. Specialist said they were small and that I would need to come back yearly to have them checked and that lots of people have them but they were fine. So I went about my life.

Fast forward a few years. My anxiety has been getting worse over the last couple years so last year I went to a new PCP and asked him to check me out to make sure nothing could be physically wrong because I found it odd that I got extreme anxiety when I was fine a couple years ago. He really wasn't interested in doing any blood work and just gave me some Xanax and reccommended that I take an antidepressant. I took the Xanax in case I needed for a panic attack but have never taken it but declined the antidepressant. He agreed to check my thyroid and vitamin d at my request but just did TSH which came back normal and vitamin d was 30 which he said was fine. So I suffered on another year. Had my yearly thyroid ulrasound done in oct 2014 and throat doctor said nodules where still there but we're fine come back in a yr. I also had him check another lump on my neck which he said is a swollen lymph node and that it was from acne and is normal.

Last couple months anxiety has been through the roof unbearable. Went back to PCP insisting on blood work. He agreed to do blood count and TSH and sent me on my way with some Ativan and an an an antidepressant (which I don't take). Blood work came back normal again. I decided to go to and endocronologist because I feel my anxiety is related to my hormones. She tested hormones and thyroid:

T3-Total: 96
T4-Free: 1.40
TSH: 1.310
Thyroid Microsomal Abs: 133 (should be under 40)
Vitamin D: 18.1

She diagnosed me with Hashimotos and said my T3 is a little low but since my T4 is so good we will just watch it. She prescribed me 50,000 iu a week vitamin d and she doesn't think any of this is related to my anxiety. I'm so stressed about the fact that I would not have even found this out if I hadn't been playing doctor. I'm so disapointed that none of these doctors were looking or even trying to help and they still aren't. Any input or advise is appreciated. Thanks for listening


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## Andros (Aug 26, 2009)

Understanding Thyroglobulin Ab.
http://www.labtestsonline.org/understanding/analytes/thyroglobulin/test.html

Histologic diagnosis of Hashimoto's
http://emedicine.medscape.com/article/120937-diagnosis
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Hashimoto's Hurthle cells
http://www.pathconsultddx.com/pathCon/diagnosis?pii=S1559-8675(06)71549-2
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http://www.thyroidmanager.org/chapter/hashimotos-thyroiditis/
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SUGGESTED TESTS
TPO (antimicrosomal antibodies) TBII (thyrotropin-binding inhibitory immunoglobulin), Thyroglobulin and 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/
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Trab
http://www.ncbi.nlm.nih.gov/pubmed/17684583
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Welcome to the board!

Has not anyone suggested biopsy of some of the nodules, I am wondering?

And there are some tests you really should have which would help get to the bottom of this.

Listed above!

I do not see how you could get a diagnosis for Hashimoto's when the only way to do that is through biopsy.

More info above. And I think you should query your doctor about how she arrived at the conclusion that you have Hashimoto's.

The presence of TPO Ab suggests many things; it is not definitive.


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## ZeldaGirl712 (Mar 19, 2015)

Thanks for your reply and for the info  I have read nearly every one of those the past few days trying to figure all this out and I still don't understand. So the presence of thyroid antibodies doesn't automatically mean Hashimotos? What else could they mean? I'm new to all this and would like to know how to approach my doctor and which tests I need or possibly find a new one :/ They said my nodules are really small and they won't mess with them unless they start getting bigger.


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## ZeldaGirl712 (Mar 19, 2015)

Also, This is some of what was in my doctors notes about my thyroid ultrasound.

Enlarged thyroid gland. There is an oval hypoechoic nodule either within or adjacent to the isthmus which measures up to 8mm in greatest diameter. Thyroid gland echo texture is moderately heterogeneous throughout.

Any input is appreciated  thanks!


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## Andros (Aug 26, 2009)

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

TPO Ab, negative is expected
http://www.medlabs.com.jo/docs/Leaflet-17.pdf

Substances not found in normal serum (scroll down to autoantibodies)
http://www.thyroidmanager.org/chapter/evaluation-of-thyroid-function-in-health-and-disease/
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Anti-microsomal Antibodies- TPO Ab
Negative test is normal; you should not have any of these antibodies. And the healthy person does have a low titer of TPO.

Mild to moderately elevated levels of thyroid antibodies may be found in a variety of thyroid and autoimmune disorders, such as thyroid cancer, Type 1 diabetes, rheumatoid arthritis, pernicious anemia, and autoimmune collagen vascular diseases. Significantly increased concentrations most frequently indicate thyroid autoimmune diseases such as Hashimoto thyroiditis and Graves disease.
http://labtestsonline.org/understanding/analytes/thyroid-antibodies/tab/test
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That is correct; if you go to the links I furnished, you will find clear cut explanations.


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