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Suggest Treatment For Thyroid Problems

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Posted on Mon, 18 Aug 2014
Question: For the last 6 months I have been feeling very fatigued, joint pain, loosing my hair, a little puffy, resting heart rate of 45-50bpm. My thyroid blood work came back fine in May. Since then my symptoms have gotten worse. At the end of my dr. appointment in XXXXXXX I mentioned every now and then when I cough I feel pressure in my throat and it sometimes is tender. The Dr. said it felt lumpy; he sent me in for an Ultra sound, which came back that I have a dominant nodule. The doctors decided that I needed a biopsy on my left thyroid. The morning of my biopsy I woke up with excruciating pain and swelling on my right thyroid, painful to the touch. They decided to do biopsies on both side, both came back benign. They redid my blood work and my TS levels are .13, which indicates hyperthyroid. I have no symptoms of hyperthyroid. I am going in for an Ultrasound on Monday for my right thyroid. I am a little worried that one hand may not know what the other is doing. they put me on 25mg of levothyroxine, but then called 2 days later and said to stop taking it because my blood work came back hyper not hypo. What are your thoughts..
doctor
Answered by Dr. Suresh Heijebu (2 hours later)
Brief Answer:
Further evaluation depends on ultrasound report

Detailed Answer:
Hi Madam,

I have gone through your query,would like to address the same.

As per your clinical history ,initially you were hypothyroid,as evident by your clinical symptoms.Later due to the development of hyperfunctioning nodules ,the hypothyroid state was converted to hyperthyroid state,which was evident by the lab values of suppresed TSH levels of 0.13.this hyperthyroid state in you ,which are unaccompanied by clinical symptoms is known as "subclinical hyperthyroidism"..

This state can soon convert into overt/clinical hyperthyroidism which then presents with symptoms.I hope by now you are clear with your diseased thyroid events.Hence your levothyroxine was asked to be stopped.

Since both the thyroid nodules have shown benign changes on biopsy,you can feel rest assured that a cancerous/malignant process is ruled out.

Now further evaluation will depend on the results of ultrasound scan of the thyroid lobes.whether you will be treated medically or surgically will be decided on the outcome of ultrasound scan reports.

i hope my feedback is quite helpful to you.
in case of any further doubts kindly post your queries as follow up.
thank you.
wish you a good health.
Dr.Suresh
Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.

Above answer was peer-reviewed by : Dr. Raju A.T
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Answered by
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Dr. Suresh Heijebu

Psychiatrist

Practicing since :2010

Answered : 3646 Questions

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Suggest Treatment For Thyroid Problems

Brief Answer: Further evaluation depends on ultrasound report Detailed Answer: Hi Madam, I have gone through your query,would like to address the same. As per your clinical history ,initially you were hypothyroid,as evident by your clinical symptoms.Later due to the development of hyperfunctioning nodules ,the hypothyroid state was converted to hyperthyroid state,which was evident by the lab values of suppresed TSH levels of 0.13.this hyperthyroid state in you ,which are unaccompanied by clinical symptoms is known as "subclinical hyperthyroidism".. This state can soon convert into overt/clinical hyperthyroidism which then presents with symptoms.I hope by now you are clear with your diseased thyroid events.Hence your levothyroxine was asked to be stopped. Since both the thyroid nodules have shown benign changes on biopsy,you can feel rest assured that a cancerous/malignant process is ruled out. Now further evaluation will depend on the results of ultrasound scan of the thyroid lobes.whether you will be treated medically or surgically will be decided on the outcome of ultrasound scan reports. i hope my feedback is quite helpful to you. in case of any further doubts kindly post your queries as follow up. thank you. wish you a good health. Dr.Suresh