Nodules and Low TSH

I've spent lots of time in the Chronic Pain forum during the past 16 months following cervical fusion surgery. My newest diagnosis leads me to this forum where I've already learned a great deal about a confusing (to me) subject.

An incidental finding on my cervical MRI over 16 months ago was thyroid nodules. I was sent to a surgeon who sent me to an endocrinologist to have a fine needle biopsy on two small nodules a year ago. The results were good/no cancer. I don't have test results, just remember it was all ok. Six months later the endo did another US and said nodules had not changed-good. Another six months later US showed the same results and first ever blood work for thyroid was done. It seems that blood work should have been ordered earlier but was overlooked, possibly because of my lack of symptoms and no family history. Results:

ULTRASENSITIVE TSH 0.079 L Range 0.500-4.700

Dr was surprised at this, had me come back in a month for more labs. Results 2 days ago:

ULTRASENSITIVE TSH 0.068 L (0.500-4.700)
FREE T3 3.4 (2.3-4.2)
FREE T4 0.99 ( 0.73-1.95)
THYROID PEROXIDASE AB 67 H (<9)
Blood Pressure 122/78

Dr said this shows hyperthyroid, must be treated even though I show no symptoms since it could cause heart problems. He gave me an Rx for Tapazole: 5mg SIG. and wants more labs in a month.

I've not filled it yet. I'm 65 years old, on no medications and would like to keep it that way unless really necessary. I've just been healing from the cervical surgery and taking everything easy for the past 16 months. HYPER does not describe me in any way! I've gained 8 lbs in the past year that I do not need to add to my already fluffy body so right now I'm starting to be much more careful about diet and will attempt to start moving more. Honestly, I'm quite lazy which has served me well while healing. I've done all my PT for neck and shoulders but not much other exercise.

I didn't have a good feeling about this doctor or his office. I expect to get a 2nd opinion soon or at least will discuss with PCP.

So, your ideas, please. Should this TSH be treated now?

You need a 2nd opinion. Technically, youre hyper with Hashimotos. Its obvious by the suppressed TSH, low T4, and normal T3 that the nodules are actively making hormones. Considering your age and lack of symptoms, a doctor would take a wait and see approach with blood tests and US scans every 6 months, unless new symptoms arise.

You feel fine, nodules are not cancerous and not growing....theres no need to treat you right now. Again, you need a second opinion.

I have a 2nd opinion scheduled for early June with an Endo/Internal medicine doctor. That will be 6 weeks since the last labs were done. Of course I will take my past lab reports with me. I wonder if the new doctor will repeat labs that soon.

In the meantime, I'm quite motivated to being as healthy as possible, like having a better diet. I've cut out sugar and decreased other carbs, drinking lots of water. In the older threads here, I read that gluten is a problem for some with thyroid issues, because it causes inflammation, so I've cut down on that. I also read in several of the older threads that the problems with sleeping might be caused by sleep apnea, so have that checked. I've already checked that and started treatment 8 months ago. I sleep well. I'm working on being more active.

Can you suggest anything else I can do to help myself now? I don't seem to be having any symptoms and I'd just like to keep it that way longer. Is that anything I have any control over?

I had my 2nd opinion appointment. This Endo agreed with the first one, but explained everything much better. She had me fill the same Rx the first dr had given me for Tapazole 5mg. Labs were repeated and my TSH was a bit lower now at 0.04. This dr will do labs again in 6 weeks and also repeat the US. I was examined and asked more questions searching for symptoms but I just do not have them now. So she said I'm sub-clinical hyperthyroid. She did not mention Hashimotos until I asked about it and she said Yes, that's what this is.

She also cautioned me about internet researching for thyroid disorders. She said she has seen far too much inaccurate information related to thyroid. Except for that comment I liked this doctor very much and will continue to see her. I will also continue to research. Some may not be accurate, but some may be very helpful. I will just have to be very careful what I accept. Going from NO knowledge to SOME from being on this site was very helpful to me. Thank You!!

Low magnesium levels have been linked to thyroid problems. Might have your magnesium levels checked. If you do not want to take a supplement use a diet consisting of high amount of green leafy vegetables. That is how we get our magnesium. You may want to get your iodine level checked. Lack of iodine has also been linked to thyroid problems.

You can get the test done for a lot less money if you go to the labs directly.

http://www.accesalabs.com/vitamin