Ask a doctor on the topic of Internal medicine

thyroid gland

February 3, 2017 | 20,00 EUR | answered by Dr. med. Frauke Gehring

Hello,
I have been struggling with the following problems for almost a year now: quick exhaustion, severe fatigue, a pulling sensation on the left side of my neck, night sweats, hot flashes, partially blurred vision in my left eye, tingling in limbs with slight numbness, frequent pulling in the calf muscle and knee left. I have been to numerous doctors such as: neurologist, MRI head and neck, orthopedist, ENT, general practitioner several times and most recently to the nuclear medicine specialist who diagnosed the following on the thyroid ultrasound:
Echo-reduced bilateral, heterogeneous somewhat loosened internal reflex pattern without signs of hypervascularization, total volume with clear emphasis on the right 7.5ml
Thyroid values:
FT4 11.5 pmol/l (9.8 - 26)
FT3 4.0 pmol/l (2.5 - 6.9)
TSH Basal 1.7 mU/l (0.3-4.0)
TSH after TRH 16.1 mU/l (2 - 24)

Assessment: rather small thyroid with typical appearance of autoimmune thyroiditis without nodules
The antibody values ​​came a few days later and were within the normal range, thus ruling out autoimmune thyroiditis.

My general practitioner has prescribed me Prednisolone 20mg as he suspects a subacute thyroid inflammation and rules out an autoimmune disease due to the absence of antibodies.

However, my question is, wouldn't it perhaps be advisable to take hormone tablets due to the small size of the thyroid and all my symptoms that could potentially indicate an underactive thyroid?

Dr. med. Frauke Gehring

Good day,

You have symptoms that occur with both an underactive and an overactive thyroid, such as hot flushes. Additionally, an underactive thyroid has been definitively ruled out, so these symptoms must have other causes. Giving you hormones would immediately put you in an overactive state with trembling, weakness, sweating, and possibly high fever.

Not a good idea!

Best regards, Dr. Höllering