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Dr. Andrew Rynne

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Exp 50 years

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Suggest treatment for weight & hair loss during hypothryroidsm

I have symptoms of what appears to be hypothyroidism (hair loss, weight loss, heart palpitations and spikes in blood pressure, shaking, dizziness, thyroid nodules, a now-visible lump, etc. These symptoms are now getting worse. I have had several tests: thyroid sono showed nodules, nodules are palpable, and iodine uptake moderately high at both testing times. However, my blood tests were relatively normal and do not seem to match up with my symptoms and the other tests. My cortisol level was slightly elevated at 21.1 ug/dl. Thyroid Stimulating Immunoglobulin was 22, Free T4 was 1.49, Free Triiodothyronine was 3.7, and TSH was 3.84. The endocrinologist was truly stumped; she consulted with others in the practiced and they were stumped as well. She told me that they had only seen these sorts of results once or twice in several years. She said it could be thyroiditis, or thyrotoxicosis(?), but never gave me any sort of diagnosis. She prescribed propranolol for the palpitations, and that was about it. She released me back to my family doctor. Now my thyroid is much more swollen, and is visible. It has become painful, especially when swallowing or turning my head. My hair loss is getting worse, and the weight loss is becoming alarming to my family and friends. Have you ever heard of these sorts of results? And do you have any idea how I should proceed?
Mon, 1 Apr 2019
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Endocrinologist 's  Response
Hello,

Your Ft3,fT4 and TSH test results are within the range. At the other side, you have serious symptoms of hypothyroidism and High Thyroid Stimulating Immunoglobulin.

Considering your ultrasound result and all the hormone results, it is difficult to find a logical explanation for all the elements. For this reason.

If you were my patient the first thing I will suggest to you is to repeat your thyroid panel tests.

You have a multinodular goiter that will become toxic soon, considering your high TSI titre.

Personally, I have heard these sort of results but the patients in these circumstances have symptoms of Hyperthyroidism.

As I said, my advice is to repeat the TSH, fT3 and fT4 tests.

Hope I have answered your query. Let me know if I can assist you further.

Take care

Regards,
Dr Elona Xhardo, Endocrinologist
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