Thyroid problems -- and confusion!

My thyroid has been swollen and sore for about six weeks. By pushing hard, I’ve had the blood tests and thyroid uptake and scan. Now I’m more confused than before – and my family practice doc who ordered the tests says that I should just wait until I see an endo on Nov. 9 and has no treatment plan for me. In the meantime, my thyroid hurts and my voice is always hoarse because it’s pushing on my voice box.

Do any of you have an idea about what MIGHT be going on? Since I have Type 1 diabetes, I’m concerned that it might be another autoimmune problem. Mostly, I’d love to have someone give me the “big picture” view of what’s going on – before November 9!

Test Results

TSHPituitary and tsh
Tsh less than 0.02 (reference range .40 to 4.7)
Free T3 7.2 (reference range 2.8 to 5.3)
Free T4T4 test 3.1 (reference range .7 to 1.9)
Thyroid stimulating immunoglob less than 1.0 (reference 0 to 1.3)
Thyroperoxidase 232.6 (reference range 0 to 8.9)
Thyroglobulin 2.7 (reference range 0 to 3.9)

I also had a thyroid uptake and scan. The results showed very low thyroid activity:
Six hours: .7% (reference range 4 to 20%)
24 hours: .3% (reference range 6 to 32%)

Your thoughts? Advice? Do I need to see an endo sooner? In a nutshell – how serious it is?

You are definitely very hyperthyroid and it definitely looks autoimmune… but it’s hard to say for sure what you have. You could have Grave’s, or you could have Hashimoto’s - many people with hashimoto’s present in Hashitoxicosis, which makes you hyperthyroid, even though your thyroid is about to stop working on it’s own. Since you are only positive for the TPO antibodies it looks more like Hashimoto’s to me…but I am not a doctor.

I went through several (much milder) spells of hyperthyroidism on my journey to being diagnosed with Hashi’s… the entire process actually took a couple of YEARS… but during my hyper spells I was not as hyper as you currently are. I didn’t need medication, just monitoring… at times I was on super low doses of synthroid to treat hypo, and flip flopped a lot on that… I’d be hyper, then hypo, then hyper… eventually I went WAY hypo and stayed there. I am on full thyroid replacement now.

Are your heart rate and blood pressure okay? Those two are really the biggest immediate risks… if you are hyperthyroid for a very long time that can lead to osteoporosis. High levels of TPO antibodies can also cause some odd neurological symptoms.

Your family doc really can’t do anything else for you - if you weren’t already seeing an endo that would be their recommendation anyways. If you are super concerned you can call your endo’s office and push to get an appointment sooner, though you might not have a ton of luck with that since most are super busy. Unless you are having any HR or BP problems you should be fine to wait.

Thanks for your reply, Sarah. I feel relieved and grateful.

My heart races occasionally but my blood pressure is always on the low side (before thyroid problems and now, too).

I’m already on the call list at the endo if someone cancels an appointment but I’m not very optimistic that I’ll get in any sooner.

Thanks for your reassurance about waiting. Waiting isn’t one of my strong points but knowing that I’m probably not in a crisis situation makes it easier.