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911Doctor
911Doctor, Doctor
Category: Health
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Experience:  Board Certified Emergency Physician
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I have received a diagnosis of Hashimotos. I have elevated

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I have received a diagnosis of Hashimoto's. I have elevated TSH and low but within range Free T3 and Free T4 however, I was placed on 1/2 grain Nature Throid. Last week I had a sonogram of my Thyroid. The results are as follows: Right lobe measures 6.8x3.1x2.7 cm and is diffusely heterogenous, hypervascular and enlarged
Left lobe is 6.2x2.8x2.4 cm and is diffusely heterogenous, hypervascular and large
The isthmus measures 8 mm and is diffusely heterogenous, hypervascular. The impression is "Diffusely heterogenous, hypervascular, enlarged thyroid as described above without evidence of focal nodularity". When I looked at the images there was one of the right lobe and isthmus that the color was bright red and covered about 1/4 to 1/3 of the area. I have worked in the OR for several years therefore, I have some idea about these results . But my questions are: 1. Because there are no stated nodules or "Focal nodules" what does that mean? 2. The extremely vascular blood supply image seems to indicate a large arterial blood supply demand therefore, is this indicative of a tumor even though nothing was noted? 3. What would be the next step in my evaluation that might be recommended or that I should seek to have done? 4. Since my sonogram I have had a sore throat off and on everyday (which started within moments after the test) is this typical? I like to know what to expect so I have my questions prepared for the next visit.
Thank you,
D.

911Doctor :

The ultrasound report is consistent with inflammation of the thyroid, which is Hashimoto's

911Doctor :

It is NOT indicative of cancer

911Doctor :

As there are no nodules

911Doctor :

The next step is likely to be simply to get you stabilized on your medicine and watch how you do

911Doctor :

Standing by

Customer:

Thank you for clearing up my questions. I was not sure for certain if the hypervascularity was a problem to be concerned about. What about the soar throat issue?

911Doctor :

The sore throat can go along with thyroid inflammation

911Doctor :

and should subside

911Doctor :

standing by

Customer:

okay, One thing further since I have started taking the medication I have had heart palpatations and began to feel poorly is this a sign that I may be experiencing both hypo and hyper symptoms of the disease?

911Doctor :

stand by

911Doctor :

yes it is possible

911Doctor :

why are you not on synthroid?

Customer:

I have done some research and it seems that the bioidentical hormome replacement is often considered a better choice since it is made from dessicrated pig thyroid.

911Doctor :

sometimes these are prone to more side effects than the synthetic

Customer:

Thank you for the website. I will review it to see if there is other information I can glean. Is there a website I can reference for that information as well? Do you have any specific side effects that I should be aware of?

911Doctor :

stand by one... patient call

911Doctor :

okay

911Doctor :

let me get you a reference

911Doctor :

you are taking 'nature thyroid', correct?

Customer:

It is spelled without the "Y" and that is correct.

911Doctor :

okay

911Doctor :

it's rather involved but does list side effects

911Doctor :

which do include palpitations and others

911Doctor :

though it is generally well tolerated

911Doctor :

as this disease evolves you may need your medicine adjusted a few times

911Doctor :

standing by

Customer:

Great, I appreciate your assistance with this matter. Have a good day.

911Doctor :

and you as well

911Doctor :

Thank you so much for your question. It was a pleasure talking with you. Should you need my assistance in the future simply start your question with ‘for 911doc only’.


Positive feedback is always appreciated.


Be Well


911Doc

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