Anyone know about thyroid problems?

[Psycho Doctor]

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I finally made an appointment to see an internist; it's been awhile and the area of my thyroid has hurt me recently and has made it difficult to swallow or at least it hurts when i swallow. i had a blood test last week and he called me today to question about my thyroid (hyperthyroidism). Coincidentally thyroid problems are the only permanent side effect of some treatment I just went through and is relatively rare. However the side effects of thyroid problems could easily be explained away because they are similar to the side effects from my treatment. He says he will run more tests but doing an internet search it seems like treatment includes drugs, radioactive iodine, and surgery.

Does anyone know anything about this? I've really had enough.

 

[every1blowz]

what i think you should do is feel your thyroid, which is just below the cricoid cartilage of course, with the wings of the organ wrapping around the trachea.

from what i know hyperthyroidism has a load of symptoms but the thyroid itself is generally not supposed to be painful but just enlarged (i might be wrong here).

if it is swollen and somewhat painful than i assume the most likely diagnosis will be "subacute" granulomatous thyroiditis. it's almost always caused by a viral infection. maybe it is a really freaky coincidence? i don't know.

if you don't want to wait for the doctor and have access to some basic lab stuff, then pull out the good ol' vacutainer and tourniquet, take your blood and do an erythrocte sedimentation rate. if the levels are elevated even after 60 mins that will confirm viral infection. (don't do anything i say unless you already know how)

i'm sure you'll be fine. it probably isn't anything like Graves disease or worse.

if what i say is correct, you won't need surgery or antithyroid medications. best thing is just to listen to what your doc says.

 

[Psycho Doctor]

what i think you should do is feel your thyroid, which is just below the cricoid cartilage of course, with the wings of the organ wrapping around the trachea.

from what i know hyperthyroidism has a load of symptoms but the thyroid itself is generally not supposed to be painful but just enlarged (i might be wrong here).

if it is swollen and somewhat painful than i assume the most likely diagnosis will be "subacute" granulomatous thyroiditis. it's almost always caused by a viral infection. maybe it is a really freaky coincidence? i don't know.

if you don't want to wait for the doctor and have access to some basic lab stuff, then pull out the good ol' vacutainer and tourniquet, take your blood and do an erythrocte sedimentation rate. if the levels are elevated even after 60 mins that will confirm viral infection. (don't do anything i say unless you already know how)

i'm sure you'll be fine. it probably isn't anything like Graves disease or worse.

if what i say is correct, you won't need surgery or antithyroid medications. best thing is just to listen to what your doc says.

thanks! It actually is both enlarged and painful. The only other concern is all the symptoms my MD asked if i had; I did but they could also still be side effects of my previous treatment but that ended like 6 weeks ago and I'm not sure how long side effects are supposed to last. Graves disease? Whereas I know it's a disease from hyperthyroidism, i didn't suspect that. My neck also does not look like a goiter. Yea probably just a viral infection

 

[every1blowz]

i didn't mean to scare you with Graves disease. I meant that more along the lines of "you almost certainly DON'T have it....unless you do" type of thing.

also, may i ask what your treatment was if it's fine with you? although i doubt it, i might know something.

 

[erin682]

My doc was a bit concerned about mine thyroid last year. She thought it looked enlarged and I had some of the symptoms. Anyway it turned out to be nothing, none of my labs were abnormal. I guess I just have a naturally big thyroid. Anyway don't worry too much about it. Even if there is a problem thyroid disease is very treatable.

 

[dancinjenn]

I agree with the previous posters in that you probably don't have anything major. However I do have some intimate knowledge with thyroid disorders. My grandmother has Graves disease and she went thru the I 131 (radioactive Iodine treatment) to "kill" off her thyroid and now she takes replacement hormones, but is otherwise completely fine.

I was diagnosed with thyroid cancer when I was 23...wow, it has been almost 4 years. Anyway, I ended up having surgery and a couple of rounds of radiation. But having thyroid cancer is pretty rare. I actually had masses that I could feel in my neck near and around my thyroid...I did not have any pain or swallowing difficulties.

I would ask about how long the side effects are from your previous treatment and have them pull a full thyroid panel. T3, T4, Thyroglobulin, and TSH. That will give you baseline function of your thyroid, if it is converting correctly, and how your pituitary is responding as well.

If you have any questions feel free to PM me.

 

[vigils]

Well, first off, don't listen to whoever told you that an ESR will tell you you have a viral thyroid infection, that's just crazy, ESR doesn't tell you much of anything specific unless its over 100, and all the things in that range are not good and don't include hyperthyroidism. Sedimentaion rate is really non-specific, they just let your blood sit there and see how long it takes for it to settle. It just generally indicates an inflammatory process.

The only way you can get some really precise information about your thryoid function is with tests. The main test is a TSH and a T4 test, that should be enough to get an idea of what is goin on. You can also get a radionucletide uptake scan that shows you a litter more about function of your thyroid and if you have any increased acitivity in your thyroid gland. You'll get an image that you can actually look at. Treatment option generally include a pill that will radioablate the thyroid. It is hard to give only a dose that will kill off enough thyroid to make you euthyroid, or normal thyroid function. Generally enough ablation is acheived so you are actually a littler hypothyroid. You are not likely to regain any of the thyroid function you loose with the ablation. Once hypothyroid, your doctor will give you hypothyroid medication to acheive a normal thyroid state. This is preferable because the medication for hypothyroidism are much safer and have less side effects then the ones they give for hyperthyroidism. Surgery is generally not helpfull as the thyroid just grows back and you are once again hyperthyroid. The specific symptoms you should monitor are your energy level, are you overactive, gittery or up all the time, generally overstimulated, do you feel hot all the time, this would indicate you're probably hyperthyroid. You may also have myxedema, nonpitting edema that is sometimes yellow or proptosis, where you're eyes bulge out a bit, but these symptoms are usually only present in Graves diseas, a type of hyperthyroidsim. If you are hypothyroid, you will be tired, lethargic, feel cold more often and generally fatigued. This is typical of many pregnant women either during or after pregnancy. You should probably just ask to get a TSH and T4 test done and go from there. It's nearly impossible to tell by physical palpation of the thyroid gland what is going on. You should consider other possibilities as to why you have difficulty swallowing. This could be the result of many other pathologies. Good luck!
😉

PS here's an interesting tid bid of information, milk maids often had goiters or enlarged thyroids in the dark ages due to iodine deficiency and its actually still seen or considered atractive in some areas of the world such as parts of India where some people consider it a sign of fertility!

 

[Psycho Doctor]

Well, first off, don't listen to whoever told you that an ESR will tell you you have a viral thyroid infection, that's just crazy, ESR doesn't tell you much of anything specific unless its over 100, and all the things in that range are not good and don't include hyperthyroidism. Sedimentaion rate is really non-specific, they just let your blood sit there and see how long it takes for it to settle. It just generally indicates an inflammatory process.

The only way you can get some really precise information about your thryoid function is with tests. The main test is a TSH and a T4 test, that should be enough to get an idea of what is goin on. You can also get a radionucletide uptake scan that shows you a litter more about function of your thyroid and if you have any increased acitivity in your thyroid gland. You'll get an image that you can actually look at. Treatment option generally include a pill that will radioablate the thyroid. It is hard to give only a dose that will kill off enough thyroid to make you euthyroid, or normal thyroid function. Generally enough ablation is acheived so you are actually a littler hypothyroid. You are not likely to regain any of the thyroid function you loose with the ablation. Once hypothyroid, your doctor will give you hypothyroid medication to acheive a normal thyroid state. This is preferable because the medication for hypothyroidism are much safer and have less side effects then the ones they give for hyperthyroidism. Surgery is generally not helpfull as the thyroid just grows back and you are once again hyperthyroid. The specific symptoms you should monitor are your energy level, are you overactive, gittery or up all the time, generally overstimulated, do you feel hot all the time, this would indicate you're probably hyperthyroid. You may also have myxedema, nonpitting edema that is sometimes yellow or proptosis, where you're eyes bulge out a bit, but these symptoms are usually only present in Graves diseas, a type of hyperthyroidsim. If you are hypothyroid, you will be tired, lethargic, feel cold more often and generally fatigued. This is typical of many pregnant women either during or after pregnancy. You should probably just ask to get a TSH and T4 test done and go from there. It's nearly impossible to tell by physical palpation of the thyroid gland what is going on. You should consider other possibilities as to why you have difficulty swallowing. This could be the result of many other pathologies. Good luck!
😉

PS here's an interesting tid bid of information, milk maids often had goiters or enlarged thyroids in the dark ages due to iodine deficiency and its actually still seen or considered atractive in some areas of the world such as parts of India where some people consider it a sign of fertility!

Thanks for the really informative post. 👍 My TSH was low; that's what prompted my MD's phone call. He said he still has some more of my blood so he'll have some more tests run, maybe the T3 and T4???? I do have all the symptoms of hyperthyroidism: weight loss, overstimulation, inability to sleep, feeling hot, heart palpitations etc; however they are also the same side effects from my treatment, so how would I know?? I've been off txt more 6 weeks now and I have no idea how long the side effects are supposed to remain (how long the drugs stay in my body), so it's hard to tell whether they are side effects from previous treatment or symptoms of a new condition.

Also is there any danger in NOT getting treatment for it?? I'd rather have hyperthyroidism, than hypothyroidism. I don't want to be overweight or lethargic! 👎

 

[Psycho Doctor]

I agree with the previous posters in that you probably don't have anything major. However I do have some intimate knowledge with thyroid disorders. My grandmother has Graves disease and she went thru the I 131 (radioactive Iodine treatment) to "kill" off her thyroid and now she takes replacement hormones, but is otherwise completely fine.

I was diagnosed with thyroid cancer when I was 23...wow, it has been almost 4 years. Anyway, I ended up having surgery and a couple of rounds of radiation. But having thyroid cancer is pretty rare. I actually had masses that I could feel in my neck near and around my thyroid...I did not have any pain or swallowing difficulties.

I would ask about how long the side effects are from your previous treatment and have them pull a full thyroid panel. T3, T4, Thyroglobulin, and TSH. That will give you baseline function of your thyroid, if it is converting correctly, and how your pituitary is responding as well.

If you have any questions feel free to PM me.

Wow, you've been through a lot already! I'm so sorry. Hopefully you're ok now. I know the thyroid cancer is very rare, and at least it's very curable. Did you have radioactive iodine treatment or some sort of external beam on a linear accelerator?

My TSH test showed abnormalities so now my MD is running other tests, perhaps those you suggested.

Oh and speaking of the pituitary, I also have a pituitary microadenoma, for which I take bromocriptine. I've been doing that for years so i doubt it now is effecting my thyroid.

 

[dancinjenn]

Wow, you've been through a lot already! I'm so sorry. Hopefully you're ok now. I know the thyroid cancer is very rare, and at least it's very curable. Did you have radioactive iodine treatment or some sort of external beam on a linear accelerator?

My TSH test showed abnormalities so now my MD is running other tests, perhaps those you suggested.

Oh and speaking of the pituitary, I also have a pituitary microadenoma, for which I take bromocriptine. I've been doing that for years so i doubt it now is effecting my thyroid.

I had the Radioactive Iodine. I had a couple of really high doses. The first to kill off any left over thyroid tissue so that it wouldn't stand the chance of becoming malignant, and the second to try and tamp down a recurrence. The iodine is just in gel caps, so it seems like you are taking a big dose of aspirin...except that you are radioactive and have to be in isolation for 7 days. Being hypo isn't too bad. I take a replacement horemone every morning and I feel fine. I am overweight...but that is a byproduct of sitting and studying and munching with too little exercise...not because of my condition. Keep us posted and good luck.

 

[erin682]

Also is there any danger in NOT getting treatment for it?? I'd rather have hyperthyroidism, than hypothyroidism. I don't want to be overweight or lethargic!

Yes. If you truly did have hypothyroidism then your thyroid can basically cause your body metabolism to burn out of control. One of our profs told us of a friend he had that would literaly wake up in the morning weighing less than he did the night before. Even more dangerous is whats called a thyroid storm which can be brought on by a stressor. Basically your thryoid just goes absolutely manic and creates a life threatening situation.

I'm not saying this will happen to you but in the off chance that you do have hyperthyroidsim you need to get it treated.

Also once the thyroid is destroyed and you become hypothyroid you are treated to replace the thyroid hormones that you lost. Therefore you wouldn't become overweight and lethargic you would just return to normal.

 

[SarahGM]

Hey -- I had the right lobe of my thyroid removed because several biopsies came back inconclusive. I also had some side complications from the mass... symptoms of hyperPARAthyroidism, to be specific.

The nodule turned out to be benign, but it was scary for a while. Feel free to PM me with any questions regarding procedures, surgery, etc.

 

[Doggie]

I had the Radioactive Iodine. I had a couple of really high doses. The first to kill off any left over thyroid tissue so that it wouldn't stand the chance of becoming malignant, and the second to try and tamp down a recurrence. The iodine is just in gel caps, so it seems like you are taking a big dose of aspirin...except that you are radioactive and have to be in isolation for 7 days. Being hypo isn't too bad. I take a replacement horemone every morning and I feel fine. I am overweight...but that is a byproduct of sitting and studying and munching with too little exercise...not because of my condition. Keep us posted and good luck.

I did some salivary gland studies before and a lot of our cases came from young women who recently had radiation treatment of thyroid cancer. These women typically complain of dry mouth and sometimes swollen parotid (and much more rare, the submandibular glands). We encouraged all the patients to seek dental consults to see if they have rampant caries due to lack of saliva.

 

[beanbean]

Psycho Doctor...you know it is against the rules to ask for medical advice here on SDN!

There is a ton of misleading and incorrect info in some of the preceeding posts which is mixed in with some good advice. No one can answer your questions better than your own physician who has examined you and reviewed your lab tests.

It is one thing to ask people on here "Hey has anyone ever had hypothyroidism? Tell me about your experience". It is completely different to say "Hey my TSH is low and my thyroid is enlarged, tell me what you think might be wrong and how to treat it".

 

[vigils]

I did some salivary gland studies before and a lot of our cases came from young women who recently had radiation treatment of thyroid cancer. These women typically complain of dry mouth and sometimes swollen parotid (and much more rare, the submandibular glands). We encouraged all the patients to seek dental consults to see if they have rampant caries due to lack of saliva.

I think these cases are probably Sjogren's Syndrome, its not the same as isolated hyperthyroidism at all, but a constelation of symptoms that mainly revolves around parotid gland enlargement and has a strong tie to some cancers, I thinks its has to do with one of those MEN syndromes, MEN I or MEN II, I can't remember.

As for the question earlier about whether you should just do nothing, well that ultimately your choice. I have to agree that taking something that kills off your thyroid gland and has the potential to leave you fat and tired doesn't sound inviting. The good thing is that you wouldn't feel hot and wired all the time and with good management of your thyroid medication you would be feeling exactly as you're supposed too. Just be sure your committed to your decision, after all, you're the one that went to the doctor in the first place because you felt something was wrong, don't you deserve to at least feel normal?

I can't say much about the previous treatment without more specifics. It sounds a bit personal so if you want to send me a personal message I'd be glad to give my two cents. But my gut impression is that since it was six weeks ago the chances are slim that the treatment is causing your problems. Most drugs are largely excreted in a day or so, although other things like monoclonal antibodies can stay in your system for much longer. If you go the bathroom everyday and you have normal liver function, you should of excreted whatever drug you were taking a while ago (impossible to say for sure without knowing what it was).

Good Luck

 

[dancinjenn]

I did some salivary gland studies before and a lot of our cases came from young women who recently had radiation treatment of thyroid cancer. These women typically complain of dry mouth and sometimes swollen parotid (and much more rare, the submandibular glands). We encouraged all the patients to seek dental consults to see if they have rampant caries due to lack of saliva.

Yeah they told me to keep sucking on sour candies to make sure that I moved fluid thru my saliva glands to reduce the chance of the radioactivity collecting there and doing damage. I don't have any issues.

 

[Psycho Doctor]

Thanks so much everyone who offered me advice, personal experiences and links. They were all helpful. I'll respond more to this tomorrow...right now i fgeel like crap and am overwhelmed with how much work i have to get thru tonight. 🙁

 

[Doggie]

I think these cases are probably Sjogren's Syndrome, its not the same as isolated hyperthyroidism at all, but a constelation of symptoms that mainly revolves around parotid gland enlargement and has a strong tie to some cancers, I thinks its has to do with one of those MEN syndromes, MEN I or MEN II, I can't remember.

Actually, sjogren's is more of an autoimmune disorder. The cases with the ladies presenting with a history of thyroid cancer is completely different. The radioactive iodine that selectively kills any thyroid cells also sometimes selectively kills parotid (and rarely submandibular) serous cells.

 

[stoic]

Thanks so much everyone who offered me advice, personal experiences and links. They were all helpful. I'll respond more to this tomorrow...right now i fgeel like crap and am overwhelmed with how much work i have to get thru tonight. 🙁

dude, you're in med school right?

cross posting is not cool. seeking med advice is not cool. if you want specific info, then PM one of the posters you have a good relationship with and see what they know.

but i don't understand why you're not looking this stuff up for yourself? presumably you have access to up-to-date as well as countless journals through your school. that's where the posters here would get any advice they're giving you. you know what meds you took, you know your symptoms. no one here does.

we all wish you the best man. but you're a big boy now... you should be able to look up these things in no time flat. here's a list of resources that you could use:

up to date
emedicine
harrisons
pubmed
google (just make sure to sift through the crappy info)
pdr
your physiology book
clinical laboratory interp. text
any of the millions of endocrin books in your schools library
your professors


and those are just the ones i came up with off of the top of my head. the point is that in the resources listed above, there is approximately 1000 times more information about thyroid disorders than is contained in the minds off all the sdn posters combined.

keep on trucking dude.
stoic

 

[Psycho Doctor]

dude, you're in med school right?

cross posting is not cool. seeking med advice is not cool. if you want specific info, then PM one of the posters you have a good relationship with and see what they know.

but i don't understand why you're not looking this stuff up for yourself? presumably you have access to up-to-date as well as countless journals through your school. that's where the posters here would get any advice they're giving you. you know what meds you took, you know your symptoms. no one here does.

we all wish you the best man. but you're a big boy now... you should be able to look up these things in no time flat. here's a list of resources that you could use:

up to date
emedicine
harrisons
pubmed
google (just make sure to sift through the crappy info)
pdr
your physiology book
clinical laboratory interp. text
any of the millions of endocrin books in your schools library
your professors


and those are just the ones i came up with off of the top of my head. the point is that in the resources listed above, there is approximately 1000 times more information about thyroid disorders than is contained in the minds off all the sdn posters combined.

keep on trucking dude.
stoic

uh thanks. and i did look things up. however sometimes personal experiences are also helpful and people could be posting about them as i decipher through resources on the internet 😳

 

[vigils]

Actually, sjogren's is more of an autoimmune disorder. The cases with the ladies presenting with a history of thyroid cancer is completely different. The radioactive iodine that selectively kills any thyroid cells also sometimes selectively kills parotid (and rarely submandibular) serous cells.

Dude, I obviously realize Sjogrens is autoimmune, and if you actually read my post you would realize I was responding to the comments about it. I said hypothyroidsim wasn't the same as Sjogrens. You are so lost. Just read the quoted caption above the post, I hope it makes sense to you then.

 

[Doggie]

Dude, I obviously realize Sjogrens is autoimmune, and if you actually read my post you would realize I was responding to the comments about it. I said hypothyroidsim wasn't the same as Sjogrens. You are so lost. Just read the quoted caption above the post, I hope it makes sense to you then.

I think you are mistaken. I clearly stated the CC and history of the patient and out of the blue, you came out with a dx that doesnt even fit into the picture.
If I have corrected you in an open forum in front of millions of people, I sincerely apologize.

 

[vigils]

I think you are mistaken. I clearly stated the CC and history of the patient and out of the blue, you came out with a dx that doesnt even fit into the picture.
If I have corrected you in an open forum in front of millions of people, I sincerely apologize.

Well if you actually read your own post you would see you didn't provide a clear cheif complain and history, you just started spouting off your own experience with parotid gland research and implied, possibly unitentially that those patients had some connection to the hyperthyroid case. I was just mearly pointing out for those unaware that your comments where not specific to the thyroid case that the information you referred to was probably Sjogrens and not hyperthyroidism. I see your point, they took the radioactive junk that was not pleasent and they had to keep their saliva flowing, but your post is not clear. I really don't see what you think you corrected me on, I stand by my previous statements and think you should seriously consider reading them rather then make unfounded acusatoins. Besides there's not millions of people on SDN, and I wouldn't care is what I said was wrong, but the truth is ... you need to get a life.

 

[Lee]

Come on folks, SDN is not for medical advice.

It says it right at the bottom of each page. 😉

Anyhow, go see your doctor!