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Dr Adi
Dr Adi, Professor
Category: Endocrinology
Satisfied Customers: 440
Experience:  Director of the Pediatric Diabetes Clinics at UCSF.
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I have always been borderline hyper thyroidic, the past year

Customer Question

I have always been borderline hyper thyroidic, the past year all of my thyroid tests have been off, my TSH has been normal but my free T4 keeps dropping and is now low and I have secondary hypothyroidism
JA: Have you seen a doctor about this yet? What medications are you taking?
Customer: What does this exactly mean, also I have been having extreme headaches and my eyesight is getting worse, lost my peripheral vision about 4 months ago
JA: Anything else in your medical history you think the doctor should know?
Customer: I had a thyroid sonogram
Submitted: 2 months ago.
Category: Endocrinology
Customer: replied 2 months ago.
My thyroid is enlarged and heterogeneous throughout with several cystic nodules on my right lobe, also my cervical lymph nodes are a bit enlarged and wereseen on the Ct that was done on my neck, I am awaiting a call from the end for an appointment. Do I need to stress when they call all of these issues so I may be seen asap?
Expert:  Dr. David replied 2 months ago.

This is Dr. David. I am reviewing your question now and will be with you momentarily.

Expert:  Dr. David replied 2 months ago.

how old are you?

are you male or female

what have your free T4 levels been?

I am sorry you lost your peripheral vision. have you seen an eye doctor about this?

Customer: replied 2 months ago.
My t4 has been around 43 but my tag is normal, I am 42 and female. I haven't had a chance to see an optometrist yet, everything has happened so quickly the past few weeks with other issues going on, I feel most is due to this.
I have always had normal or borderline high tsh with a t4 always normal or borderline high. I have always been small and thin but I dropped from 112 to 91 in less than 6 months and was sent to a hemotologist, and had cts done from my neck to my tailbone and that is when I found out my thyroid was enlarged with cysts in the right lobe. It said it was heterogeneous throughout the thyroid
Customer: replied 2 months ago.
Also, my lymph nodes are mildly swollen surrounding the thyroid bilaterally with neck and ear pain in my right ear at times, I do have an enlarged neck and a neck mass wheremy right lobe is
Expert:  Dr. David replied 2 months ago.

T4 Free should be 0.8 - 1.8 ng/dL (conventional units) 10 - 23 pmol/L (SI units)

T4 Total should be 4.5 - 12.5 µg/dL (conventional) 58 - 161 nmol/L (SI Units)

Free T4 is what is more important than T4

your TSH levels should be between 0.3 and 3.0

it is very common to have cysts in the thyroid gland and heterogeneous thyroid gland.

it is normal to see lymph nodes in your neck on CT scan.

you don't need to stress. I know you are worried

but you will be fine to see the endocrinology doctors at next available appointment.

Customer: replied 2 months ago.
My free t4 is what is .46 and it actually dropped from the last visit which it was .62 at that time, there was 4 months between visits, my free t4 has been this low since august ( that's how far back I have my lab reports) and I am just now being sent to an end I, I have major dizzy spells, double vision, nausea, I have bouts of confusion and I don't know what is going on with me
Expert:  Dr. David replied 2 months ago.

this variation in free T4 is normal and not dangerous and not a sign of thyroid problems.

do yo have bad anxiety symptoms? severe anxiety symptoms can cause dizziness, nausea, brain fog, confusion.

Customer: replied 2 months ago.
My pap said it was secondary hypothyroidism, I started having these dizzy spells and brain fog feeling around October, my left eye has been progressively getting worse and my glasses, the prescription that I just got and could only see good out of them for about a month, are not helping. At times everything is blurry, my left eye has tears (involuntarily) pouring out and my left nostril always runs. I have major headaches, and do not feel like myself. I have this deep down feeling that there is something more wrong than just my thyroid being off. I have gotten to where I do not and can't get out of bed due to absolutely no energy. Also it feels like my milk glands are enlarged and I have had a complete hysterectomy and I don't have estrogen nor any type hormone replacement therapy, something is off
Expert:  Dr. David replied 2 months ago.

free T4 of 0.46 is less than 0.8 ng/dL which is hypothyroid.

you will most likely benefit from going on thyroid supplement hormone of synthroid like 25mcg which can help bring up your levels.

you may benefit from blood test to check your estrogen levels checked

you should get your prolactin levels checked as well.

you should get a brain MRI scan to check your pituitary gland as well.