Thread: thyroid

were you told you had graves disease or toxic multinodular thyroid? it makes a big difference, the former can sometimes burn itself out without any treatment, how high was your tsh and free t4?

TSH 0.010
free throxine 1.9

This is not ragingly high, the next step is to find out if this is graves disease or toxic nodular goiter, I suspect it is the latter. The former, many times you can be given PTU or similar drugs to supress it for a while and then come off within a year and the thyroid normalizes itself again, all without the need for radioactive iodine ablation. You need to have a nuclear thyroid scan to sort this out. The latter may need surgery or radioactive ablation or just monitored if you have subclilnical hyperthyroidism ( which sounds like that might be the case) . WHen it stays high for a long time it can cause osteoporosis, cardiomyopathy etc. but it sounds like you need to get a second opinion or have further studies.

see link regarding toxic nodular goiter, treatment is not black and white as the first line states:

The optimal therapy for treatment of toxic nodular goiter (TNG) remains controversial

http://emedicine.medscape.com/article/120497-treatment

I have seen pictures of goiter before. My neck is not like that. Is there a diet change or suppliments to take to help?

I am most worried about is "will I get fat" cause thyroid helps you lose weight

toxic nodular goiters many times are small enough you don't feel them. I usually find them with ultrasounds and thyroid scans due to abnormal blood work. Unless you have severe iodine deficiency many toxic nodules are actually quite small and not easily visualized so don't go by the fact that you can visualize your thyroid or not.

I honestly don't keep up with the literature for supplements, I do know some people's thyroid levels that are slightly high like yours I tell them to stop all supplements and it sometimes returns to normal so I know some herbs etc can raise the levels.

Originally Posted by dirtwarrior

I am most worried about is "will I get fat" cause thyroid helps you lose weight

that is why its best to clarify what type of high thyroid it is, you may not need to "ablate" your thyroid. But leaving it high, even slightly , in some people can eat up the bones and induce thyrotoxic heart failure or cardiac arrythmias...

Will I get fat if they do this?

Originally Posted by dirtwarrior

Will I get fat if they do this?

not necessarily, if your thyroid is ablated then it needs to be replaced with exogenous ( outside) thyroid hormone. If your doc tightly regulates the t3 and t4 right away you probably should not gain weight. However, if you were very thyrotoxic, the initial weight gain is just the metabolism returning to normal. The studies are actually all over the place, defninately talk with an endocrinologist about this. the interesting thing in my experience is that i have had super low thyroid get thyroid medicines and actually start gaining weight after i correct their low thyroid and i have high thyroid patietns that when i get their levels down, they start losing weight, so it is really a very individual thing.

Thanks you helped me more than you will ever know.
I have been healthy all my 54 years and distrust (at first) the unknown.
It has got me this far.
I will consider my options

I had a blood test last week as part of my yearly physical. Same as last year my thyroid is overactive but a little more than last year.
I went to the VA clinic (yes I am a vet) for a consult.
They want to give me a liquid to burn off part of my thyroid and then put me on thyroid meds to normalize me.
That sounds weerd cause I feel fine.
They said elevated thyroid can cause anxiety and other problems.
I asked the problems of depressed thyroid and they were very vague.

I need the straight scoop. Is it bad to have elevated thyroid vs depressed thyroid

ok well to determine whether radioactive iodine is indicated for your case or not i need to ask some questions

1- how old are you ? radioactive iodine isn't indicated below the age of 45
2- did you do Thyroid Ultrasound scan ? radioactive iodine is very effective in solitary nodules
less effective in multinodular goiter (and now having a swelling in your neck is suggesting a nodule
3- are you refusing surgery? radioactive iodine is indicated mainly to those unfit for surgery and those refusing it ,,, but it has side effects that should be considered

let me know what you did and the answer of these questions .

Originally Posted by solo_builder

ok well to determine whether radioactive iodine is indicated for your case or not i need to ask some questions

1- how old are you ? radioactive iodine isn't indicated below the age of 45
2- did you do Thyroid Ultrasound scan ? radioactive iodine is very effective in solitary nodules
less effective in multinodular goiter (and now having a swelling in your neck is suggesting a nodule
3- are you refusing surgery? radioactive iodine is indicated mainly to those unfit for surgery and those refusing it ,,, but it has side effects that should be considered

let me know what you did and the answer of these questions .

1. 54
2. not yet-no swelling
3. not refusing surgery but want the dr. to give me more info

ok so it's very unlikely to be grave's disease
and you're a candidate for radioactive iodine if you've a solitary active nodule
diagnosis now depends primarily on Ultrasound
as far as I know , in multinodular goitre surgery is a better option cause fibrosis in the nodular goiter make the radioactive iodine less effective

solo what will happen to me physically and mentally if I have the radioactive iodine> I feel fine now and everything even bp is in check

Originally Posted by solo_builder

, in multinodular goitre surgery is a better option cause fibrosis in the nodular goiter make the radioactive iodine less effective

surgery is by far the better option since the high dosese of radioactivity necessary to ablate toxic multinodular goiter or Plummers disease confers higher risk of neck cancer in the future. ( unlike lower doses for grave's disease although in graves disease thyroidectomy has less chance of opthalmopathy or eye changes) The USA is backwards in this sense compared to europe, over there, the standard of care is goiter surgery for plummers diease,here, it is radioactive ablation. Unfortunately, legally, in this country standard of care trumps evidence based medicine.

Originally Posted by dirtwarrior

solo what will happen to me physically and mentally if I have the radioactive iodine> I feel fine now and everything even bp is in check

nothing that you will notice
the main risk is cervical cancer, that's why they give it only if you're older than 45 ,,, cause the risk of carcinoma caused by this radioactive iodine is expected after 30 -40 years

anyway, the main cause i'm advising you against radioactive iodine is that it'll destroy both normal and hyperactive cells , and you'll have to take thyroxine pills ,,, this wouldn't happen insurgery when you remove the diseased part only

you don't wanna take a pill everyday for the rest of your life when you don't have to ,right ?

No risk of cervical cancer here

Originally Posted by dirtwarrior

No risk of cervical cancer here

I mean cancer in your NECK
I know you can't have cervical cancer

Dirtwarrior,

Sorry brother, I would go see a doc outside the VA. I had to use the VA years ago before I had private insurance. Simply had too many bad experiences with the VA system In fact, my wife has standing orders that if I am hurt on the doorstep of the VA Hospital, I will take the chance of bleeding out, take me somewhere else.

Ask them send you to an endocrinologist in private practice that specializes in thyroid diseases for a second opinion. You do have that right.