if my tsh low, t3 (liothyronine) and t4 is normal, is it hypo or hyper thyroidism? should i take iodine? ultra sound is normal, without pathology.

Question

Tsh low but normal T3 (liothyronine) n T4 my endo still suggest ultrasound and iodine 123 is that necessary ?

Answer 1

Hypothyroid: The answer to this question depends on what your exact levels are and what type of symptoms you have. "Subclinical Hypothyroidsim" sometimes presents in the manner you describe.

Answer 2

Low TSH: A low TSH with normal T3 and free T4 is c/w subclinical hyperthyroidism. In a young person (esp a woman), it could be subclinical Graves disease. Suggest seeing an Endocrinologist. Check antithyroid antibodies (thyroid receptor AB, TPO). If no symptoms, it may not need treatment now. Iodine may only make it worse (it will "feed the beast").

Answer 3

Cancer risk: Risk of cancer is higher in patients < 20 and > 70, and in males. Concern for cancer higher if fixed (non-mobile), fast growing, lymph nodes in the neck, firm/hard, history of neck radiation, problems swallowing/talking/breathing. A TSH that is normal is actually more concerning as well. Typically if > 1cm and normal tsh, biopsy is performed. Especially if any other risk factors present.

Answer 4

Risk: Agree with dr. Wagner's answer. Thyroid nodules are common, however, personal history of excess radiation to the neck or family history of thyroid cancer are two strong risk factors. Depending on the original size, rapidly growing solid nodule need to be evaluated with a biopsy. Tsh can be normal in thyroid cancer. When in doubt, biopsy it.

Answer 5

Fast growing nodule: Most people with thyroid nodules have normal tsh. Less than 1% of nodules cause hyperthyroidism or thyrotoxicosis. Five percent (5%) of all palpable thyroid nodules are cancerous. Therefore, a fast growing solid nodule with a normal TSH should be biopsied to rule out malignancy. Risks : male, extreme age (<20 or >65), fast growing nodule, symptoms, history of radiation to head/neck, family history.

Answer 6

Yes: After the radioactive iodine is out of your system you can get pregnant.

Answer 7

Sounds like your: Thyroid is under active. Treatments available . Follow up with your doctor. Very easy to treat if indicated.

Answer 8

Just for the record.: After the surgical specimen goes to pathology, the pathologists create slides of the tissue and generate a report summarizing their findings. The cancer type, whether margins were negative, and if lymph node are involved are pathologic findings that impact prognosis. If there is a question or discrepancy, you can seek a second pathologist opinion on these slides or new slides if necessary.

Answer 9

Expert review: Having your slides allows you to get slides reviewed by other expert patho, ogist as needed. Second opinions are always helpful.

Answer 10

Screening/prognosis: Having your slides with you are always helpful. You are young, and rcc is rare in young people except those with familial predispositions, such as von hippel lindau, polycystic kidney disease or tuberous sclerosis. In terms of screening, your slides can be used by pathologists to compare your prior tumor to anything new that arises or assess the grade of your tumor to prognosticate behavior.

Answer 11

Yes: It would be a good idea to get it checked as levels and dosage requirements often change with pregnancy.

if my tsh low, t3 (liothyronine) and t4 is normal, is it hypo or hyper thyroidism? should i take iodine? ultra sound is normal, without pathology.

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