Resolved question:
I have Hashimoto's thyroiditis. I was diagnosed about 3 years ago, and I had an ultrasound at the time of diagnosis that showed no nodules or abnormalities. I started medication with levothyroxine 2 years ago (current dose 125). For the past two weeks I have been very tired and had persistent pain around my thyroid/throat. I have also been light headed and short of breath when trying to do simple things like taking a short walk. I am away in Ecuador and cannot see my regular endocrinologist in the US, but I did see a doctor here recently who ran several tests, but I am not sure I trust his interpretation, as he specializes more in diabetes. The ultrasound I just had done here showed normal thyroid size but with 11 small nodules, all about a half cm in size, except for one that is 8.1 mm. The ultrasound also showed three enlarged cervical lymph nodes on the right side (5.5 mm in level 2 and 7.2 and 5.6 mm in level 7 -- I don't know what this means but that's what the report says). For blood work, neutrophils are slightly elevated (67.1 %), elevated sedimentation velocity (25), and elevated TPO (110). Thyroglobulin is 52.05. Everything else normal. The dr. interpreted everything as normal and advised no follow-up, but why do I feel bad and have pain? Is it just a thyroiditis attack that will eventually die down? Any insight is appreciated, thank you.
Submitted:
4 Days
Category:
Endocrinologist
Hello,
Thank you for your query at DoctorSpring.com
The reports do suggest thyroiditis which may have a waxing and waning course. The lymph nodes and small sub-centimetric nodules are not the cause of the pain and may be a part of thyroiditis.
In such cases symptomatic treatment is important and good enough.
Please feel free to discuss further,
Regards.
What do you mean by "symptomatic treatment?" Thank you.
Hello,
In Hashimoto's both extremes, hyperthyroidism or hypothyroidism is possible.
So based on how the thyroid is reacting, treatment can be given accordingly.
Since there are 11 nodules now, the disease could be in an active state.
Did you get your thyroid profile evaluated? If so, can you send the values?
Also, do not worry about the lymph nodes, as they are not significantly enlarged. By symptomatic treatment, I also meant to imply for pain you can take Ibuprofen, and further treatment will be based on your thyroid values.
Hope this was helpful,
Regards.
I uploaded results from all of the bloodwork that was done as well as the written evaluation from the ultrasound (did you not see this attached originally?). Additionally, there are two photos of the slides from the ultrasound currently attached to the original query I posted but they are not the images I meant to select, as they are not complete; I had technical difficulties deleting them and uploading the correct attachments so I sent them to customer service in an email, but so far have not received a response.
In any case, blood results show normal thyroid function. That is the root of my original question - I am on the same dosage of levothyroxine as I have always been and my thyroid profile is coming back normal just as it has in the past when I was feeling fine. But now I have nodules that I did not have before and feeling of swelling and pain in the front of my neck/throat, and symptoms of hypothyroidism like exhuastion and dry skin.
Thyroglobulin and TPO antibodies may remain elevated forever with thyroiditis. They are just a marker of autoimmunity and not of disease activity. Treating them or deriving conclusions from their levels doesn't help.
There is nothing more than the description given by you earlier in these images.
For the nodules, as I said, it can happen in thyroiditis and it needs further observation.
If the thyroid profile is normal, then there is nothing to be worried about.
Please do not worry, the symptoms will subside soon.
Regards.