Opinions Please

[Guest guest]

Today I went to the endocrinologist, and he agrees with those of you who have

made comments on my lab tests for TSH. He said something isn't right that the

TSH would go from over 8 to under 1 on 25 mcgs of Levothyroxin. He even thinks

there could have been a mistake on the first report. He told me to stay off the

thyroid medication for a month and go back for more bloodwork. I made sure at

that time he will be checking free t3, free t4, reverse t3, and TSH.

The good news is I don't need the radioactive iodine uptake test and scan. He

cancelled them, and set me up for a needle biopsy, but it's not until January

6th. So it turns out to be a good thing that I wasn't off the thyroid meds for

three weeks, and the scan had to be rescheduled. The fact that my doctor didn't

know I had to stop the meds prevented unnecessary tests.

One of the nodules is about 3/4 of in inch, but the others are quite a bit

smaller. The endocrinologist thinks that there is about a 90% chance the

nodules are benign, but thinks the biopsy is necessary to be sure. What I don't

understand is why I have an enlarged thyroid gland. Do you think it's possible

that 25 mcg of Levothyroxin a day could have overstimulated the thyroid gland

enough to enlarge it if there was an error on the first lab report?

I have the appointment at the Mayo Clinic for 12-28, but might have to

reschedule it, since the biposy here isn't until January. I don't think the

Mayo Clinic would do blood tests and a needle biopsy the first day I go there,

but will have to call to check, since I want a second opinion. Since I just got

on Medicare, does anyone know if it pays for a second opinion?

Thanks,

Barb

[Guest guest]

I think it does, but check to be sure. I would still be interested in hearing

what the Mayo Clinic has to say. Then you'll have answers from both

perspectives. You'll be off the T4

anyway, so it should be all right. It's just possible the nodule might shrink in

that time, but you'll have to see.

<>Roni

Immortality exists!

It's called knowledge!

 

Just because something isn't seen

doesn't mean it's not there<>

From: H <macbarb0503@...>

Subject: Opinions Please

hypothyroidism

Date: Wednesday, November 17, 2010, 1:55 PM

Today I went to the endocrinologist, and he agrees with those of you who have

made comments on my lab tests for TSH.  He said something isn't right that the

TSH would go from over 8 to under 1 on 25 mcgs of Levothyroxin.  He even thinks

there could have been a mistake on the first report.  He told me to stay off the

thyroid medication for a month and go back for more bloodwork.  I made sure at

that time he will be checking free t3, free t4, reverse t3, and TSH.

The good news is I don't need the radioactive iodine uptake test and scan.  He

cancelled them, and set me up for a needle biopsy, but it's not until January

6th.  So it turns out to be a good thing that I wasn't off the thyroid meds for

three weeks, and the scan had to be rescheduled.  The fact that my doctor didn't

know I had to stop the meds prevented unnecessary tests. 

One of the nodules is about 3/4 of in inch, but the others are quite a bit

smaller.  The endocrinologist thinks that there is about a 90% chance the

nodules are benign, but thinks the biopsy is necessary to be sure.  What I don't

understand is why I have an enlarged thyroid gland.  Do you think it's possible

that 25 mcg of Levothyroxin a day could have overstimulated the thyroid gland

enough to enlarge it if there was an error on the first lab report?

I have the appointment at the Mayo Clinic for 12-28, but might have to

reschedule it, since the biposy here isn't until January.  I don't think the

Mayo Clinic would do blood tests and a needle biopsy the first day I go there,

but will have to call to check, since I want a second opinion.  Since I just got

on Medicare, does anyone know if it pays for a second opinion?

Thanks,

Barb

[Guest guest]

Thanks Roni. I agree it's wise to see what the Mayo Clinic has to say, and plan

to call them today.

Barb

Opinions Please

hypothyroidism

Date: Wednesday, November 17, 2010, 1:55 PM

Today I went to the endocrinologist, and he agrees with those of you who have

made comments on my lab tests for TSH. He said something isn't right that the

TSH would go from over 8 to under 1 on 25 mcgs of Levothyroxin. He even thinks

there could have been a mistake on the first report. He told me to stay off the

thyroid medication for a month and go back for more bloodwork. I made sure at

that time he will be checking free t3, free t4, reverse t3, and TSH.

The good news is I don't need the radioactive iodine uptake test and scan. He

cancelled them, and set me up for a needle biopsy, but it's not until January

6th. So it turns out to be a good thing that I wasn't off the thyroid meds for

three weeks, and the scan had to be rescheduled. The fact that my doctor didn't

know I had to stop the meds prevented unnecessary tests.

One of the nodules is about 3/4 of in inch, but the others are quite a bit

smaller. The endocrinologist thinks that there is about a 90% chance the

nodules are benign, but thinks the biopsy is necessary to be sure. What I don't

understand is why I have an enlarged thyroid gland. Do you think it's possible

that 25 mcg of Levothyroxin a day could have overstimulated the thyroid gland

enough to enlarge it if there was an error on the first lab report?

I have the appointment at the Mayo Clinic for 12-28, but might have to

reschedule it, since the biposy here isn't until January. I don't think the

Mayo Clinic would do blood tests and a needle biopsy the first day I go there,

but will have to call to check, since I want a second opinion. Since I just got

on Medicare, does anyone know if it pays for a second opinion?

Thanks,

Barb

[Guest guest]

Barb,

Sounds like you finally found a winner.

You wrote:

>

> ... Do you think it's possible that 25 mcg of Levothyroxin a day could have

> overstimulated the thyroid gland enough to enlarge it if there was an

> error on the first lab report? ...

No. Levothyroxine does not stimulate the thyroid; it replaces it. If

anything, too much T4 would have suppressed the activity of the nodules

and perhaps caused them to shrink. Giving a large, " suppression " dose of

T4 or T3 is a common deliberate way to hold nodules in check.

Swelling is one of the possible responses to an antibody attack in the

progression of Hashimoto's thyroiditis. Thus, your goiter's growth is

likely just the progression of the condition, which happened to be

coincident to the dose, not caused by it. Plus, 25 mcg per day is a

truly tiny dose. That is why it was surprising to us that it would

decrease your TSH from 8 to 1.

Chuck

[Guest guest]

Thanks to Roni, , Chuck, and everyone else for your replys.

Since only 25 mcg of Levothyroxin caused my resting heart rate to hover around

100, and my hair to fall out every time I touch it, it's doubtful I could

tolerate a larger dose. Before going on that medication, I had some gradual

hair thinning through the years, but have never had hair loss like I am

experiencing now. When the endo checked it earlier this week, my pulse was down

to 82.

I'm a person who has gone line dancing twice a week and to Curves for over 600

workouts over the past few years, so the rapid pulse shouldn't be from lack of

activity. I also walk my dogs almost every day.

It will be interesting to see what the lab report for thyroid levels shows after

about a month.

Thanks to everyone for your feedback and the information you share. I have

learned so much more from you than from the doctors, who don't seem to have time

for questions, and can't wait to move on to the next patient.

Oh by the way, I found out why the doctors in this medical group have seemed to

be blowing everying off, and not ordering some tests, unless the patient

insists. My daughter-in-law who works with doctors told me a couple of days

ago, that one of the surgeons has been ordering, and being reimbursed for

services that haven't been rendered, and tests that have not been done. They

weren't allowed to talk about it, but it was okay when they knew it would be in

the news. Yesterday it was in the paper that he has been fired from the medical

group and his hospital privileges have been revoked. Since all the doctors in

this group knew about the ongoing investigation, they were afraid to be accused

of ordering unnecessary tests. At least I know it wasn't my imagination.

The radioactive uptake test and scan was an exception because my doctor hadn't

done further testing as I requested back in August. He said he ordered it to

make sure it was okay for me to wait so long to se the endocrinologist.

Barb

Re: Opinions Please

Barb,

Sounds like you finally found a winner.

You wrote:

>

> ... Do you think it's possible that 25 mcg of Levothyroxin a day could have

> overstimulated the thyroid gland enough to enlarge it if there was an

> error on the first lab report? ...

No. Levothyroxine does not stimulate the thyroid; it replaces it. If

anything, too much T4 would have suppressed the activity of the nodules

and perhaps caused them to shrink. Giving a large, " suppression " dose of

T4 or T3 is a common deliberate way to hold nodules in check.

Swelling is one of the possible responses to an antibody attack in the

progression of Hashimoto's thyroiditis. Thus, your goiter's growth is

likely just the progression of the condition, which happened to be

coincident to the dose, not caused by it. Plus, 25 mcg per day is a

truly tiny dose. That is why it was surprising to us that it would

decrease your TSH from 8 to 1.

Chuck

=

[Guest guest]

Thanks to Roni, , Chuck, and everyone else for your replys

Oops. I meant replies.

[Guest guest]

Don't worry about it, when I'm not paying attention or I've got too much on my

mind there are plenty of oopsies in my typing. If only I could remember each

time to use the spell check.

<>Roni

Immortality exists!

It's called knowledge!

 

Just because something isn't seen

doesn't mean it's not there<>

From: H <macbarb0503@...>

Subject: Re: Opinions Please

hypothyroidism

Date: Saturday, November 20, 2010, 9:34 AM

Thanks to Roni, , Chuck, and everyone else for your replys

Oops.  I meant replies.