Need help with Thyroid nodules with Hypothyrodism

Hello,

Thank you for your reply. The symptoms that I observe now a days are more or less like the same before I was diagnosed with Hypothyroidism(4 months back). Now after taking medication of Hypothyroidism(75mcg), though feeling better than before but can surely says not 100% fit. My concern is when my TSH range is now around 3 then also why I'm experiencing these problems again.

Hi hunny,

If these symptoms are the same as when you were out of range then it is probably that you need a slight adjustment. The lab ranges are not a one size fits all. You have to tinker and find the level that makes you feel the best. Do not just go off of tsh results. Have them check your free t3 and free t4 levels as these are better indicators on how the meds are working. Also did they check for auto immune disorder or say anything about having hashimotos As this can cause dips and spikes in your levels. Mtviewcatherine is right also that you want to know exactly what the fillers in the medication is because it can also cause your body to not respond effectively to the medication. I am not saying that is always the case with everyone but it happens to alot of us. The fillers can cause allergic symptoms sometimes and cause your body to want to get rid of it. Sadly there is going to be some bad days but there should be more good days then bad ones. It is a cycle. I always request all my labs and write on them how I am feeling at the time of the lab. It is a good reference. It will help you and your dr find a good level for you. Also mtviewcatherine is right that you could be overmedicated. I usually do best when I am toward the hypothyroid range of I was at a two then I feel I am having hyperthyroidism symptoms. It's really hard to say. I would definitely have them check all thyroid panels and that will be a good start. There is conversion issues as well. Post your labs with ranges and that will be helpful for people giving advice also. They also have inflammation diets which actually will help with decreasing auto immune attack on the thyroid.

Hi Melissa,

Thank you so much for the information. It does emotionally feel better after getting advice from community members. Let me put up the details regarding TSH results and associated timelines:-

dd/mm/yyyy

24-02-2018 - TSH was 9.7 ---- T3, Free was 2.7 ----- T4, Free was 1.1

Doctor recommended to initially start with Thyronorm 50 mcg and repeat TSH after 1 month

06-04-2018 - TSH was 7.04

Doctor increased the dosage from 50 mcg to 75 mcg

08-05-2018 - TSH was 4.69

Doctor advised to keep the same dosage i.e. 75 mcg

03-06-2018 - TSH was 2.85

Haven't consult with Doctor yet but occasionally feels breathing problem, lack of concentration, heaviness under the chin. This is worse in the morning when I wake up and gets slightly better after taking 75 mcg in the morning empty stomach.

So, based on the above history, shall I increase/decrease the dosage or keep it the same? If I need to keep it same - It makes me worry that these symptoms will not go away and I will keep feeling low in life.

Thank you again for any advice you share.

Hi Hunny,  you may want to get your T4 and T3 checked.  

The TSH tells you how your brain is responding to ypur thyroid levels. Unfortubately, TSH tells you nothing about what your actual thyroxin levels are. It used to be that TSH was the only test available, so its still used as a diagnistic and to regulate meds, but can be misleading. Best to get a full thyroid panel done with your next bloodwork.

Thyroid meds take a  full three months to level out, so you may want to see how your body reacts in a couple months. Technically your TSH is niw in range, but this doesn't guaranty you’ll feel your best. Another reason to fo a full thyroid blood panel.

The meds are not the same as your own thyroxin, so they do come with side effects. Thyronorm is a generic version if synthetic levothyroxin (T4). IT IS VERY IMPORTANT that you familiarize yourself with the side effects of this medication so that you can recognise problems when they arise. As the dose increases, your ratios of different thyroxins become more out of balance and thus can wreak havoc on your system and can result in symptons of both hypothyroid and hyperthyroid simultaneously, as your T4 levels rise in relation to the dose if the meds, but T3 levels don’t increase proportionally. When you see your thyroid  blood  panel, you’ll see that the T4 can be in the high end of normal, while T3 is below the midrange if normal. This imbalance can actually result in additional side effects. So its really important to  track your symptoms as you change your medication dose.

Since you’re finding you gee relief from your symptoms after taking the medication, you could try splitting the dose (if you have a tablet form)- cut the pill in half- and take half in the morning, half at night before bed.

Thank you for your advice. I'll get my thyroid panel test done again. I believe these are FT3/FT4/TSH, right? Now, my main concern is what if the results come out to be normal?

Doctors will give advice based on the stats/tests results only. So, if I'll visit some ENT or Endocrinologist after Thyroid panel tests, they'll just gonna say all is normal as all tests are in normal range.

Per my inner instinct, I believe this has something to do with dosage(75mcg) that I'm taking right now. May be the perfect results are just away from some tweaking of dose.

But seriously right now it looks like dead end to me and don't see any path forward specific to my problem  

Can thyroid nodule be causing any problems?

Hi hunny

No problem! We are all here to help and offer any advice we can. I would s as y that it is hard to tell based on only tsh. All labs should include free t3 and free t4. It does take time to adjust to medication increases. It can cause symptoms of hyperthyroidism sometimes. The key is you know your body best even if they try an increase I would only go with 12mcg increase that way you dont end up over medicated. Tell your dr what tests you would like to have done after all you are the one paying for it. Also have them make sure b12 and other minerals are optimal. The free t4 and free t3 that you posted are low which is why they put you on medicine. But just good to make sure those tests are always done. Keep your chin up! We are here for you and we all know what you are going through

Thank you Melissa. I'll get complete thyroid panel tests done in a day or two and will share the results here. Hope that would help us to narrow down the underlying cause.

My one question left unanswered though Does benign Thyroid nodule can cause any problems?

I wouldnt split the dosage because it may give you too little at both times. You probably need a little increase. Its the morning dose that lowers your discomfort if you half it you may not get relief. Also you want to lower your TSH because a lower TSH may help get rid of growth or stop growth. FT3\RT3. ratio will help to see if youre getting enough at the cellular level none of the other tests will show this. High total T4 and T3 could just be from pooling in your blood and doesnt show if your cells are getting enough. So docs can undermedicate if they dont know this. Free T4 doesn't reveal enough and can cause undermedicating. So go with FT3 and RT3 ratio. If they won't do RT3 and you are still cycling every month then SHBG test will help reveal if the cells are getting.enough. As long as your estrogen is in normal range.

Good hunny I hope that it all goes well! And about your question nodules depending on size can cause discomfort. Even if they are benign. Mar is right though you do need optimal levels to prevent them from growing any further. After thyroid cancer they do suppression therapy which is basically keeping you more toward the low side of the thyroid panels and that is to prevent cancer from returning. That was a very uncomfortable time for me. Like I said before we are not all one size fits all. I have been hypothyroid since I was 16 and I am now 39. Do lots of research so you understand what all these tests are checking for and why they should be run. I have read so many books that have so many different opinions but when I look at my symptoms based off what they list I am not text book.