Blood Test Showed Presence Of Anti TPO. Does Hyperaemic Thyroid Indicate Thyroid Disease Even If TSH Is Normal?

Posted on Thu, 4 Jul 2013

Question: Hi - Is a Hyperaemic thyroid indicative of thyroid disease when TSH level is normal? Also two very small cystic nodules (3mm) left globe. Should those be biopsied? Rest of thyroid, size, shape, volume etc all normal. Also have presence of Anti TPO in blood test.
I do have some symptoms of thyroid disease - cold hands and feet, muscle and joint pains, tightness around neck, gastrointestinal - chronic spasms, belcing and constipation, very bad anxiety and black throughts and fatigue but with insomnia. No weight gain or hair loss though.

Answered by Dr. Shehzad Topiwala (2 hours later)

If the thyroid function tests in the bloodwork such as TSH, free T4, total T4 , total T3 are within normal limits then it is extremely likely your thyroid is functioning fine. So the symptoms you are reporting are most likely not from your thyroid being off.
Regarding positive anti-TPO in the blood test, it suggests you may have 'Hashimoto's thyroiditis'. However, since your thyroid function is normal at this point, there is nothing to be done about it now. It implies you may have a tendency to develop an under active thyroid in the future. So checking the thyroid once a year or so with a blood test like TSH, will be beneficial.
These weblinks will give you more information about this condition

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So if you feel at any time you have these symptoms you can proceed to get the lab tests done. Otherwise yearly intervals are fine .

Regarding thyroid nodules, they are fairly common in females and benign in the vast majority. In your case, there are only cysts where the chance of cancer is negligible. Sometimes Hashimoto's can give the false impression of nodules. The hyperemia is not concerning in this context. When I see a patient like yours in my office, I do not generally recommend a biopsy.
Peruse this weblink to learn more
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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Shehzad Topiwala (26 minutes later)

Thank you for your prompt reply. I am waiting on results of free T4 and free & total T3 which should be available in the next week. I have also done urinary iodine, serum cortisol and urinary cortisol - those results may provide further clues. Is there any other tests that I should consider?

Answered by Dr. Shehzad Topiwala (22 hours later)

For assessment of thyroid status, the tests you have undergone so far and the ones you are scheduled for, are sufficient

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Shehzad Topiwala (6 minutes later)

Thankyou

Answered by Dr. Shehzad Topiwala (15 hours later)

You are welcome.

Regards,

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar