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Thyroid Diseases

Possible Diagnosis Of Hahimoto's Thyroiditis

06/30/2008

Question:

Hi. About 6 months ago I had a thyroid scan and a fine needle biopsy done because I have a goiter and nodules on my thryoid. I also had all the bloodwork done. Everything came back normal. Then, about 2 months ago I started dealing with major fatigue and exhaustion, making it difficult to just get through the day, let alone exercise. I recently had more bloodwork done and everything came back normal again, except my thyroglobulin levels. The normal range was between 2 and 35 and my level was at 503. My M.D. put me on 120mg of armour thyroid once a day.

I am still battling the fatigue and wondering what else to check for. I seem to be experiencing some of the syptoms of Hashimoto`s, but I have gained about 10 pounds instead of losing weight. I am wondering if I could still have Hashimoto`s even with normal bloodwork (with the exception of the thyroglobulin)? Also, what would high levels of thyroglobulin mean? What is my next step so I can feel normal again? Thanks!

Answer:

Patients with an enlarged thyroid gland or inflammatory thyroid disease (thyroiditis), or thyroid hyperfunction may have increased circulatory levels of thyroglobulin, however, this test is not ordered for these conditions. Having antithyroid hormones, including thyroglobulin antibody (proteins that the body's immune system makes against thyroglobulin) may suggest the diagnosis of Hahimoto's thyroiditis, although this disease would not contribute to any of your symptoms, unless your thyroid function test is abnormal. Having normal thyroid function test (normal thyroid status), assuming that they are normal, indicates that your symptoms are not related to any thyroid disease, therefore, you don't need any thyroid hormone treatment particularly in the form of armour thyroid, which provide non-physiologic concentrations of different components of thyroid hormone. You will need to see an endocrinologist to re-examine your condition for the appropriate treatment.

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Response by:

Marzieh  Salehi, MD Marzieh Salehi, MD
Assistant Professor of Endocrinology
College of Medicine
University of Cincinnati