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Subacute thyroiditis - Not resolving !
Hi All,
around may 2018, I started feeling pressure (no PAIN) on the left part of my neck (below the left chin and above the thyroid area but deep, not superficial). also, I had (still do) left upper quadrant (LUQ) pain which seems as if a nerve is stretched from there to the top of my chest. I also had shortness of breath along with heart palpitations. I went to my primary care physician in July and my TSH was slightly elevated (4.6[ref: 0.4-4.2]). The doctor re-did the tests after 1 week and it came down to 3.3. This time, we did Free T3 and T4 which were within Normal range. She said it must've been a false positive. She treated me for Vit B12 and D3 deficiency I had at that time.
2.5 months later, i went back with the same symptoms and we repeated the TSH, T3 and T4. the TSH this time came down to 0.257 (lower than reference range). This time, I was referred to an Endocrinologist.
He performed some thyroid antibody blood tests and ordered US and Radioactive Iodine uptake tests. the antibody tests were negative for Grave's, endocrine tumor etc. US showed multiple colloid benign cysts with largest measuring 5 mm. The Radioactive Iodine update scan showed no goiter and showed decreased uptake. He said it's subacute thyroiditis. He put me under observation.
I went back to him in 7 weeks with new TSH, FreeT4 and Free T3 tests. My sysmptoms are the same as 8 months back (heart palpitations are there. Shortness of breath comes and goes, LUQ pain shooting up as gas). TSH was frankly supressed at
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I did not realize the message was cut off after a certain point. Here's the continuation...
TSH was frankly supressed to
Hi @svinjamu and welcome to Connect. I apologize that your post was cut off. I think it may have been cut off in your second message as well. Sometimes if you put the "-" symbol, it will cut off everything after that point.
Back to your symptoms, would you be able to tell us what your TSH was suppressed to?
Hi @Ethanethanmcconkey,
TSH was Frankly surpressed to
Oh no. I think it's not taking the less than symbol as well. I'm smart this time..I copied the text to a notepad before hitting reply button. I'll modify and paste it in my next message (trying ?@#$%^&*()":{}[].,/!`~ )
trying ;:-_=+'\|
back to my thing:
Hi @Ethanethanmcconkey,
TSH was Frankly surpressed to less than 0.005 and Free T3 was 4.9 (went up from 4.1 in 7 weeks) and Free t4 was 1.71 (went up from 1.51 in 7 weeks). The biggest questions I have are 1. can hyperthyroidism phase in subacute last 8+ months ? 2. Do I need to get my US and radioactive update scans done again ? 3. what will happen if I start thyroid medication, do I need to take it life long ?
in these 7 weeks, i had neck CT scan and holter monitor for my pounding heart done and both of them came out normal. Also, my ENT doctor did laryngoscopy a couple times and he found no issue at all.
Thanks a lot for following up .
Ok, the earlier message went through in full. Please get with your IT to fix greater than or less than symbol which are the culprits that are truncating the text after either of them...
Hi @svinjamu thank you for bearing with us and sending the rest of your message. Figuring out that problem is on the list of to-do's.
I wanted to introduce you to @jenniferhunter and @parus as they have experience with hyperthyroidism and may be able to help you find answers to your questions and offer you support.
How is your pain now? Does your doctor think you should have those scans done again?
The pain comes and goes. The doctor doesn't think I need to get the scan done again. He wants me to come back at the end of March and he will see how the values look.
@svinjamu These symptoms might not be related to your thyroid. I used to feel some pain in my neck and thought it was thyroid because I have Hashimoto's Thyroiditis and my thyroid hormones are too low, so I take desiccated pig thyroid. I was told that thyroid problems usually don't cause pain, and what I was feeling for those few years was not thyroid related; it was a degenerating disc in my neck that I found out was the cause because it was resolved with surgery. I had an old whiplash injury with a bulging disc that years later herniated, then bone spurs grew and I had central canal stenosis with spinal cord compression. I had spine surgery at Mayo which resolved all that and I no longer get that pain.
Another possibility for the pain you're describing is thoracic outlet syndrome which causes muscle tightness and nerve compression in the chest and neck which I have. For me, that can sometimes trigger a chest wall muscle spasm into the left side of my chest near the sternum with a certain position of my neck if things are tight. I had some emergency room visits because of that because it seemed like a heart issue, and my dad had heart disease, so I worried about that, but there isn't anything wrong with my heart. It has affected my breathing because I can't expand my chest properly. Physical therapy helped a lot. Lots of nerves exit the spine in the neck between each vertebrae and run down alongside it before branching out to the body. These nerves can be compressed by neck muscle spasms causing more muscle spasms and contractions further down where nerves are passing though small spaces. I also have asthma and allergies that were contributing a lot to breathing difficulties with excess phlegm that I wasn't clearing because of the abnormal chest wall tightness, and I would get repeating chest infections, and/or elevated heart rate because of this. Since I've solved the allergy problems, this isn't happening now.
My thyroid function has improved over time and that has put me into an hyperthyroid state for awhile because my medication dose was then too high before I recognized what was happening. My heart was pounding, but I also didn't sleep well, and had my digestive system was working too fast. I had unplanned weight loss and headaches. If you don't have those overactive symptoms, you thyroid levels are probably not too high. Sometimes there are benign nodules in the thyroid, and I have some because of Hashimoto's, and they have been shrinking over time since starting thyroid medicines. I pulled up some of my test results and checked my TSH Sensitive 5 numbers and had a .9 and .6 result and I'm on thyroid medicine. I had a radioactive scan years ago with a lot of uptake, but that was when I still had my old dental amalgam silver fillings in my teeth and no thyroid medication, and since having those removed and replaced with safer restoration, my thyroid has improved a lot. I had antibodies against my thyroid so high that it was off the charts and the results could not be determined. After removal of the old dental filings, the antibodies dropped to a low level. If you are older and have these, they can contribute to thyroid disease because of the leaching of Mercury in close proximity to the thyroid. You thyroid function can change, and some foods can even slow it down. Nodules can be biopsied with a needle which I have done.
Here is some information on TOS, and I go to physical therapy for this and do myofascial release work to open up the tight tissue. Releasing layers of tight tissue near the thyroid also has to help by allowing more blood to circulate there, and my surgical scar is very close to the area. MFR has helped release that surgical scar tissue from the operative path. If you don't find anything conclusive with your thyroid, you might ask for a physical therapy evaluation and some neck/spine imaging. A neurologist can help pinpoint where pain is coming from and sites where nerves can be compressed.
Thoracic outlet syndrome
https://www.mayoclinic.org/diseases-conditions/thoracic-outlet-syndrome/symptoms-causes/syc-20353988
Myofascial Release
https://myofascialrelease.com/
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