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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest treatment for elevated TSH levels

Answered by
Dr.
Dr. Shehzad Topiwala

Endocrinologist

Practicing since :2001

Answered : 1663 Questions

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Posted on Thu, 1 Sep 2016 in Thyroid Problem and Hormonal Problems
Question: I have been diagonsed with 3 nodules in the thyroid
-RY lobe 2 nodules siza are (1.19 and 0.79) and (0.52 * 0.42)
-RT lobe one nodule size 1.28* 0.62
There is mild increase in the internal vasculaity of both lobes
No soft tissue

My TSH is 15.3
T4 is 7.5
What is the correct diagnose and treatement required
doctor
Answered by Dr. Shehzad Topiwala 47 minutes later
Brief Answer:
Thyroid

Detailed Answer:
I have noted your thyroid nodules and lab results.

The elevated TSH requires further assessment in the form of thyroid auto-antibody testing to see if you have a permanently underactive thyroid condition called hypothyroidism ,necessitating treatment with thyroid medication.

Next you need to be examined comprehensively regarding the thyroid nodules. A fine needle aspiration biopsy can be considered.

You need a thorough in-person consultation with a qualified endocrinologist. When I see someone like you in my practice, I typically order the following blood tests in addition to a detailed physical examination:

CBC (Complete Blood Count, also known as Hemogram; includes Hemoglobin, WBC and Platelet counts)
Electrolytes (Sodium and Potassium in particular)
HbA1c (Glycosylated Hemoglobin = your last 3 months' glucose average). Also known by other names such as GlycoHemoglobin or Glycated Hemoglobin or A1c
Liver function tests (SGOT , SGPT, Albumin, Bilirubin, Alkaline Phosphatase)
Kidney function tests (BUN, Creatinine)
Thyroid autoantibodies : Anti Thyroid Peroxidase (TPO) antibodies and Anti Thyroglobulin antibodies
25 hydroxy Vitamin D levels (ideal range 40 to 60 ng/ml = 100 to 150 nmol/liter)

None of these tests require any fasting and can be done at any time of the day
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shehzad Topiwala 11 minutes later
Dose these primary result indicate csncerous nodules
doctor
Answered by Dr. Shehzad Topiwala 1 hour later
Brief Answer:
Follow up

Detailed Answer:
Based on the information you have provided , it is not possible to tell if it is cancerous. That is why I recommended further testing
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shehzad Topiwala 2 days later
Dear dr
I did the antibodies for the thyroid
And the result was vey high
doctor
Answered by Dr. Shehzad Topiwala 1 hour later
Brief Answer:
Second follow up

Detailed Answer:
In this case it is quite likely you have a permanently underactive thyroid condition and that you will likely benefit from a medication called levo thyroxine.
However the final decision will be made by the endocrinologist you see in-person. Sometimes 'pseudo-nodules' are seen in this condition on ultrasound. This determination is also possible by following up regularly with an endocrinologist
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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