# Newly diagnosed Hyperthyroid with nodule. Help



## Erinc (Jul 16, 2011)

Hi, I've been lurking on here today and thought I would join to get some input from you all. I am 35yo female. I noticed having odd symptoms about 2 months ago. I was 3 months postpartum at the time. My legs felt weak, my hands were trembling, increased heartrate, hair loss(I attributed this to being post partum but it seemed like I was losing a lot more hair than usual), feeling hot all the time, dry eyes and the list goes on and on. Pretty typical for thyroid problems. My labwork showed my TSH was .006, T4 19ug/dl, Free Thyroxine Index 8.7/ TPO Ab was negative. Ultrasound report just stated that I have a single nodule on my right lobe measuring 3.6mm.

I have a very strong family history of thyroid disease, mainly hyperthyroid. What does it mean when my TPO Ab is negative and the nodule? Should I be concerned about the nodule? Could a nodule that small be hyperactive and be causing my hyperthyroid? Any info would be appreciated. I am having the RAI uptake and scan on Tuesday/Wednesday this week.


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## Andros (Aug 26, 2009)

Erinc said:


> Hi, I've been lurking on here today and thought I would join to get some input from you all. I am 35yo female. I noticed having odd symptoms about 2 months ago. I was 3 months postpartum at the time. My legs felt weak, my hands were trembling, increased heartrate, hair loss(I attributed this to being post partum but it seemed like I was losing a lot more hair than usual), feeling hot all the time, dry eyes and the list goes on and on. Pretty typical for thyroid problems. My labwork showed my TSH was .006, T4 19ug/dl, Free Thyroxine Index 8.7/ TPO Ab was negative. Ultrasound report just stated that I have a single nodule on my right lobe measuring 3.6mm.
> 
> I have a very strong family history of thyroid disease, mainly hyperthyroid. What does it mean when my TPO Ab is negative and the nodule? Should I be concerned about the nodule? Could a nodule that small be hyperactive and be causing my hyperthyroid? Any info would be appreciated. I am having the RAI uptake and scan on Tuesday/Wednesday this week.


Whoever your doctor is, he or she is right on it. I am very impressed w/ the sequence of events. Most of us have to beg to get the treatment you are getting and I am so so glad for you!

Now.....................if you would be so kind to re-post your lab results with the ranges, it would be so much appreciated. Different labs use different ranges. Mainly, I would like to see where that FREE T3 is at in the range given by your lab. Your TSH is quite low which is supiciously hyper.

The word negative leaves a lot to be desired. Does it mean TPO is within the range or does it mean you have none, zero, zilch etc.? That is the question. Can you find out?

Their mere presence means something as the healthy body should have none.
http://labtestsonline.org/understanding/analytes/thyroid-antibodies/tab/test

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

Depending on what the RAIU turns up and I would wait; you can have this test.

TSI
Normally, there is no TSI in the blood. If TSI is found in the blood, this indicates that the thyroid stimulating immunoglobulin is the cause of the of a person's hyperthyroidism. 
http://www.medicineonline.com/topics/t/2/Thyroid-Stimulating-Immunoglobulin/TSI.html

Actually, if any nodule is cancerous, it can and does cause hyper. This article says it is rare but I don't agree as I have seen a lot of it over the years.

http://www.ncbi.nlm.nih.gov/pubmed/12876418

But not always cancer; it can just simply be a nodule as you will read here.........
Thyroid cancer in patients with hyperthyroidism.
http://www.ncbi.nlm.nih.gov/pubmed/12876418

This is why I am so impressed with your medical intervention.

Welcome although I hate the reason why you are here and please let us know about the RAIU and any further developments.


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## Erinc (Jul 16, 2011)

Thanks for you input. Here are my lab results

TSH .006uILU/ml .45-4.5
Thyroxine(T4) 19.0ug/dl 4.5-12
T3 uptake 46% 24-39
Free Thyroxine Index 8.7 1.2-4.9
TPO Ab 9IU/ml 0-34

What do you think about the size of the nodule? It is not palpable and I do have a small goiter. My doctor looked at the ultrasound pictures and said he thought it was a cyst.


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## Andros (Aug 26, 2009)

Erinc said:


> Thanks for you input. Here are my lab results
> 
> TSH .006uILU/ml .45-4.5
> Thyroxine(T4) 19.0ug/dl 4.5-12
> ...


Honey bunny! Thank you for the re-post on results w/ranges added!! You are really hyper; there is no question of that and when the T3 uptake is high like that, there is no question. It happens to be one of the few times T3 uptake is handy as it is protein, not hormone.
T3 Resin Uptake (hyper if high)
http://www.nlm.nih.gov/medlineplus/ency/article/003688.htm

I will say this to you; try to put your fears at rest. You are so blessed to have this wonderful doctor. While this is no fun; you do have a medical professional who as I said previously is "on top of it" and moving fast too. Your doctor is not hedging one little bit.

It's like a breath of fresh air.

We are here for you also. I hope other comment. I am sure they will.

It could be a cyst but RAIU will show if it has calcified margins. Or any other abnormalities.


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## Erinc (Jul 16, 2011)

Can you explain the T3 Resin uptake information again? I'm not quite sure I understand the test.

Thanks,
Erin


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## Andros (Aug 26, 2009)

Erinc said:


> Can you explain the T3 Resin uptake information again? I'm not quite sure I understand the test.
> 
> Thanks,
> Erin


This test is done to check your thyroid function. Thyroid function is complex and depends on the action of many different hormones, including thyroid-stimulating hormone (TSH), T3, and T4.

This test helps estimate the availability of thyroxin binding globulin (TBG). This is the protein that carries most of the T3 and T4 in the blood. The higher the level of TBG, the lower the value of T3RU. A higher T3RU value means less TBG is available, possibly as a result of hyperthyroidism.

It's an inverse relationship. Your doctor might run your TBG just to see and I am positive your doc can explain this further to you.


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