Discussions By Condition: Thyroid conditions

Is it Hyper‏ Hypo?

Posted In: Thyroid conditions 0 Replies
  • Posted By: Yasser
  • November 10, 2007
  • 03:22 AM

Hello everybody :)


My name is Yasser Shaaban I am 46 years old male from Egypt.. .. I am 5'5 and weight about 128 lbs ( 65 kg.s ) lost about 23 lbs (I was 75 Kg ) in the last 10 months 6 of the were only in the last 10 days.. an Internal Doctor has asked for some Thyroid tests.. the readings are .. T3 : 191.3 NG/DL ( NORMAL : 80-200) T4 : 13.7 UG/DL ( Normal : 5.1-14.1) TSH : 0.06 (Normal 0.30-4.2) Dated 3rd October 2007 I also had a FREE T3 & T4 test done the results were : FT3 3.6 pg/ml Ref Range 1.5-4.5 Neonate 1.5-5.0 FT4 1.7 ng/dl Ref Range 0.8-1.9 Neonate 08-2.3 ( this test was dated 4th Oct 2007 Took the results to the Doc.. he said hummm I am not really sure about that .. you might need to repeat the TSH test.. So I redid the test ( In a different Lab ) and the result came out TSH 0.01 Ref Range 0.35-4.50 ( Dated 10/10/2007 ) too the result to a Diabeats and Glands specialist .. whom examined me and said you're not showing enough symptoms of a something wrong with your Thyrpid ( not enough sweating.. and not enough weight loss and no hands' shaking , but yes.. I am anxieous, and lost some some weight and my heart is pounding missing a beat every like 4-5 beats.. ) but to him I don't have enough symptoms to decide although he had all the results of the tests infront of him.. ) kinda didn't like that .. So yesss.. I called the FIRST Doctor ( who also asked for a Thyroid UltraSonic .. that came out normal ) ASked the OLD Internal Doctor.. I said hey the re-testing of the TSH came out as this 0.01 .. he said that IS Intoxication .. so that's it .. that is what is mainly responsible for your symptoms ( which are a few thousands.. Fatigue, depression,constipation, moving between high appetite and none at all.. mood swings .. tempratures intolerance lack of sleep.. LOTS os sleep .. feel Like I am onboard of a rolercoaster.. ) more though now as the 2 doctors have ( as usual ) contradict each other.... So, what do you see and what do suggest ? First thin g i am thinking of is to reredo the TSH and seek a THIRD opinion ..

One of the doctors ( the one that said I am now showing enough clicical symptoms asked for TC 99 Thyroid ssn which I did.. and the result is this :

Technique :
Spot views of the neck were acuired 20 minutes after injection of 6 MCI of the tracer



Findings:
Mild diffuse enlargement of the thyroid gland is seen with no substenrnal extension detected



Uniform, reduced tracer uptake pattern is portrayed all over the gland with no focal lesions detected .

Thyriod uptake = 0.5% ( Normal : 0.5 - 4 % )



Opinion :

Mild diffuse goitre with borderline low thyriod uptake, for correlation with thyriod hormonal profile.







That was the results report... I took it to the doctor who asked for it and he said ( as you have ) that's on the border.. not INTO yet.. hyperthyroid .. and his opinion was it's not Grave's disease.. but it's a sort of Thyrotitis.. ( Hope I spelled that right ).. So , he prescribed me Neomercazole 5 Mg.s X 2 tab.s in the morning for a month then only one tab. for another months then redo the tests.. (FT3-Ft4- Tsh ) ...
:(

Still.. I did the usual classical mistake :mad: and went for a THIRD opinion a well respected Internal doctor.. specialized in Diabetes and Glands.. I showed him all of my reports.. including the TC99 scan.. ( which I just sent you and the OTHER doctor have seen.. and agreed it needs something to be done ) .. So this THIRD doctor said " No it's not at all of any siginficance and there's nothing at all wrong with your Thyorid Mr. Shaaban.. I asked him although the report says Enlarement .. he anwsered.. only by pouting his lower lips as in.. so what ...


So.. here I am confused.. again... with too many opinios.. although 3 of all 4 are saying Mr Shaaban your Thyriod has something wrong with it.. not sever but there is...

Here are some ideas I had from contacting some distiguished specialist online:

Hi Yasser,
TSH is a pituitary hormone that helps regulate thyroid hormone levels.
As thyroid hormone levels start to rise, the pituitary secretes less TSH to keep thyroid hormone levels from rising too high. So TSH will fall, becoming quite low before thyroid hormone levels rise abnormally high.
this is where you're at and the condition is known as subclinical hyperthyroidism.
Subclinical disorders can resolve on their own or they can worsen.
Smoking is a risk factor and so are the poor diet and other things you mentioned. You can help yourself heal by taking better care of yourself.
In the meantime, your doctor may want to prescribe beta blockers like propranolol to help reduce symptoms of anxiety and nervousness and to mildly lower your thyroid hormone levels. A low TSH on its own doesn't cause symptoms but rather reflects what's going on with your hormones. Take care


THEN

Hi,
Your uptake shows a diffuse enlargment, which means that there are no nodules or lesions, just an overall enlargement of the tissue. With your uptake being borderline for hypothyroidism (low end of the range), I'd probably not do anything since the meds can move you into hypothryoidism. I'd ask for a beta blocker to reduce any symptoms and go from there

AND FINALLY

Hi,
Your thyroid hormone levels did show subclinical hyperthyroidism with a low TSH. However, your uptake should be elevated in hyperthyroidism and it's at the low end which would indicate hypothyroidism. Because these results don't support one another you're likely in a transitional stage, moving from hypothyroidism (which is the first stage of hyperthyroidism) to hyperthyroidism. Treatment with ATDs would lower levels that are already normal and likely move you into hypothyroidism. Hope that clarifies things. Best


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