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symptoms are a little worse, tests are very inconclusive!

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I am a 35 year old male. I had a blood test about 6 months ago which showed slighlty elevated T4, and normal TSH, pathologist suggested repeating blood test 4 - 6 weeks later.

Second blood test showed slightly high T4 almost insignificant 19.2 pmol/L - Range (10.0 - 19.0)
And Low TSH: 0.16 mIU/L - Range (0.50 - 4.00). This blood test was done in April this year. (2011)

However not many symptoms apart from not sleeping well, and shaky hands (Have had shaky hands for years though, so not sure if its because of this).
Feeling unusually hot and moody. Doctor did not prescribe any meds, didnt think i needed them. (I didnt either, sysmptoms were not too bad). He did give me a form to get blood test done around end of may. (symptoms still the same in may, not too bad, so didnt do blood test)

Went to see other doctor, around early August, because my symptoms were getting a little worse. (By the way both docs are not endocrinologists). I told him the story so far, and he thought I should take meds for a week and see how i felt. He prescribed Neo-Mercazole - 5mg twice daily. ( I didn't buy them, so still taking no meds at this time) He asked me to show him my blood test request i got from the first doctor, and he added a test to check for thyroid antibodies.

Still I thought I would wait and see if everything went back to normal, so left it till the 17th of this month (Oct - 2011) Yesterday to do third blood test. My symptoms have progressively got worsew.
Feeling hot almost every day, trouble concentrating sometimes, sleep is crap, more moody than before, still shaky hands (not very bad though), eys sometimes feel irritated and sting a little (havnt noticed any swelling, just irritated eyes), just an overall feeling of disconfort)

Got my results today:
TSH normal - 0.66 Range (0.50-4.00) Previous test in april was 0.16
Doc didnt check for T4, or T3 levels this time though???? Dnt know why??? Would ve thought he would want tpo check them again to compare.

Antibodies:

Anti-Thyroid Peroxidase: Little high - 88 kIU/L - Range (<60)
Anti-Thyroidglobulin: Normal - 37 kIU/L - Range (<60)

Pathologist said these are markers for autoimmune diseases like Hashimotos and Graves disease. However they are also detected in healthy people.

So my symptoms are getting a little worse, tests are very inconclusive!! and no T4 or T3 levels tested this time.

I also had an ultrasound of my thyroid, and they have found one nodule. Worried that it might be cancer

This is what they found:
Within the Right mid pole is a hypo echoic nodule measuring 6X5X4 mm in diameter with internal vascularity. Vascularity elsewhere is normal, no retrosternal extension is seen.

Conclusion: Solitary nodule in the right mid pole. Suggest nuclear medicine to exclude toxic nodule

Still not clear, will have to do the FNA i think, only way to be completely sure.
The nodule has no calcification, or irregular margins and its less than 1cm in size. As i stated in previous question i have a history of overactive thyroid, then normal TSH with he latest blood work being positive for thyroid peroxidase antibodies


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replied October 31st, 2011
Thyroid Cancer Answer A28080
Hello and welcome to e health forum.

Based on the history given, it seems that you have a hyperthyroid status, due to overactive tissue in the solitary nodule.

Since the symptoms are getting worse over time, it is very essential for you to initiate the treatment at the earliest.

Based on the ultrasound findings, the nodule does not appear to be cancer related.

The best way to proceed further, is to get a Radio active Iodine Uptake scan (Nuclear imaging scan).

The need for surgery may be decided on the findings of this test.

In the mean time, medications to reduce the symptoms are very essential, to achieve the Euthyroid status (Normal).

You might consult with a endocrinologist for a proper and complete examination and advice.


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