Hyperthyroid? And Goiter?

SC Natalie · 05-19-2005, 02:01 PM

I could really use anyones knowledge & help!

I have an ultrasound scheduled for next Friday, to check my thyroid.
My doc thinks I have a goiter on my neck...
I believe she is associating this with my quicker heart rate and BP recently.
She said it is one of the symptoms of hyperthyroidism.

I have no idea what HYPERthyroidism is, although I know it is associated with PCOS.
What are the differences with Hypo & Hper?

And..... does anyone on this board have this?
What are your symptoms?

Thank you soooo much for you help!

Natalie!!!

Lydia9 · 05-20-2005, 05:43 PM

Hi-

You shouldn't panic about this... I have Graves' Disease, which is a hyperthyroid condition (meaning that your thyroid is working too much). Being hyperthyroid can mean increased BP, heat intolerance (because of increased metabolism) hair loss, tremors, etc.... Most people with PCOS tend to have the opposite problem, an underactive thyroid, but overactive is not unheard of. If you have hyperthyroidism, or a goiter, you most likely also have Graves' (I think that Graves' accounts for about 90 % of hyperthyroid conditions). A goiter is when one or both of the lobes of your thyroid grows as a result of this condition (it's actually an autoimmune reaction, but a little complicated to get into).

I was DX about a year after I started treating my PCOS... it turns out that PCOS can actually kind of shield the Graves, so when you start to deal with the PCOS symptoms the others can start to emerge. If you do blood tests, they'll check your T3, which measures the amount of thyroid hormone you produce and TSH, which is the hormone which stimulates the gland. You're looking for a balanced ratio, not necessarily at the numbers themselves.

This condition can be a pain, but it's not life-threatening and most people can control it with meds. I take an anti-thyroid medication, some people recieve treatment with radioactive iodine and some people have their thyroid removedI've felt a lot better since I started treating is, and the most annoying thing now is the frequent blood tests I have to get to keep my medications adjusted correctly. In the long term, either the thyroid is knocked out with drugs or it kind of burns itself out, and then you can expect to become hypothyroid.

Anyway, good luck with your test, try not to worry too much. I'm not sure there's much else I can tell you...You might have to do a radioactive iodine uptake test later, which made me nervous but is really only about as harmful as a regular x-ray.

Best,

Lydia

DrewM · 05-26-2005, 08:58 PM

Lydia, since you seem to know a lot about this, I have a question for you.

I was diagnosed as hypothyroid, but what led me to an endocrinologist was an enlarged thyroid. So my chart says "goiter" but I was never told why. Is it normal to be hypo and have a goiter, or are goiters normally only associated with hyperthyroidism?

Actually, my real question is this: My endo recently increased my levoxyl and added cytomel, and I'm finally losing weight and feeling not so tired. However, my goiter has gotten bigger. My DF can actually see it now. Could I have passed over into HYPERthyroid? Why would it get bigger?

I see my endo again on June 13, so I can talk to her about it, but in the meantime I'm really curious to know what's going on.

I guess that was more than one question.

Thanks!

Lydia9 · 05-26-2005, 09:29 PM

Natalie-

I don't really know a lot about hypothyroid problems, I know that the thyroid tends to react to a number of imbalances by enlarging, or becoming a goiter. A goiter refers to any swelling of the thyroid. A goiter and a "diffuse toxic goiter" are the same thing. Diffuse toxic goiter just means that the whole gland is swollen, as opposed to there being a nodule. Though many people have both (I do).

My understanding is that when it's HYPER it is going into overdrive because of an auto-immune reaction, it thinks it's being made sick and starts pumping out hormone to fight back. When it's HYPO, it's enlarged because it's trying to make enough hormone, but either it can't, or it is making enough but your body's receptors can't take it in (like in insulin resistance, you make enough but it's not being absorbed properly).

I'm not really sure what's happening with your medication. Going on drugs might be shocking your thyroid a little bit and it might be trying to fight the meds themselves, it might also be that your thyroid is responding correctly but your body needs more time to catch up... It's complicated because when there is something wrong with your thyroid it actually means that a number of your parts aren't communicating properly and it can take a while for things to sync up. I know that when I started taking medication I was unresponsive and continued getting worse until my doctor prescribed a huge dose and then started tapering me down to where I needed to be. My experience is that there's a lot of tinkering with doses to get things right.

Anyway, good luck with everything, it sounds like you're feeling better, so something good must be happening, right? According to my doctor, Hypo is easier to treat (the whole point of MY meds is to MAKE me hypo, permanently so that I can treat that instead). But I'm no expert. If you're concerned with the goiter, there is a good definition here:

http://www.healthatoz.com/healthatoz/Atoz/ency/goiter.jsp

Good Luck, and feel well!

Lydia

DrewM · 05-26-2005, 10:07 PM

Thanks, Lydia! Your explanation and that link helped me understand the basics a lot better. But I'm now even more concerned that I may be hyper--I'm definitely losing weight without really trying (which is a miracle in itself) and I'm suddenly hot all the time. I used to freeze anytime I'm indoors, but not anymore. I'm getting bad hot flashes and night sweats now too. But I guess that could be my body adjusting to all my meds. I AM more energetic, I sleep MUCH better--through the night sometimes!--and I've noticed my once beautiful nails are getting back to their old, strong selves.

I just wish I knew when this goiter would go away. The thinner I get, the more noticeable it becomes. I asked my endo last time I saw her when I could expect the swelling to go down. She didn't really answer me but decided right then to increase my meds. I wonder what she'll say when she sees it's bigger now!!

Anyway, thanks again for your help!

Drew

shenacat · 06-04-2005, 06:15 PM

Hi Drew, how are you doing?

If you are hyper, you will have BAD symptoms. Feeling good is not a symptom of hyperthyroid.

Headaches (in the eyes, mostly) are a symptom of hyperthyroid... diarrhea, muscle weakness (loss of muscle tone and strength), difficulty with attention span and so forth are some symptoms of hyperthyroidism. Also, some people who are hyper are also very tired and fatigued, yet too wired to sleep properly. Feeling hot all the time can be a hyper symptom, but it can also be a symptom of a returning hormone balance (women usually get hot flashes during certain times of their cycle).

DrewM · 06-05-2005, 09:39 PM

Shenacat, Thanks for asking!!

I'm feeling okay. About two weeks after I upped my meds, I felt a lot like what you described. I pretty much felt awful all the time. I was tempted to call my doctor and tell her, but I was afraid she'd pull me off them altogether so I just toughed it out, especially since I was finally losing weight. But I slowly started to feel better, although I'm still hot a lot of the time. And I've noticed in the past two weeks that the weight loss has slowed down.

Is it possible that I went slightly hyper with the change in meds and then adjusted to them? I know a lot about PCOS, but this thyroid thing is still new to me.

Thanks!

shenacat · 06-05-2005, 10:44 PM

Yes, it's possible at first to feel worse before you get better. It takes roughly 6 weeks for changes in t4-only medication (like levoxyl) to level out in your system. When you are taking T3 as well (cytomel) since it starts acting immediately, your body can sometimes lag behind it- meaning that when you increase doseages, your body might take a while to realize what to do with all of the extra hormones.

If you still have a partially functioning thyroid, as it struggles to perform it will slowly get weaker as time goes on. (You'll need more replacement hormone.) Upping your dose can signal to it that it doesn't have to work so hard, so it can relax a bit- but it takes a little while to fully get the message (thyroids go through very slow changes).

Arina74 · 06-24-2005, 12:24 AM

Okay, how do you know if you have a goiter. I am starting a new job and am currently without insurance so i have to wait a few weeks, at least, before i can go to the doctor.

I do feel like my neck has been feeling strange for the last several months with what i think is a buffalo hump at the back of my neck, neck stiffness, and neck enlargement. In fact, I can now pop my neck when i rotate it. This is a problem ive never had in the past.

But how can you tell if your thyroid is enlarged...what does it feel like?

shenacat · 06-25-2005, 07:21 AM

The buffalo hump on the back of the neck is more related to high levels of cortisol than to thyroid issues. It can be a sign of cushing's disease (a disease of the adrenal glands where you have too much natural steroid in your body). In any case it sounds like you perhaps want to go see a doctor to get your hormones tested for adrenal and thyroid.