Brief Answer:
hyperthyroid symptoms

Detailed Answer:
Hi! Since your history is suggestive, you might be having single hot nodule leading to oversecretion if thyroid as you have been getting treated with.

You need to keep few things in mind. Apart from rare conditions like transient hyperthyroidism, rest are not resolved at their own, but can be controlled with medications like carbimazole or propyl thuouracil.

It is also an endocrine disorder like diabetes, so basically you control such conditions and nor treat them as such by the replacement or controlling therapies.

So, getting the thyroid function tests once under control doesn't resolve the disease until surgical measures like thyroidectomy or radioactive ablation haven't been done.

Best approach is to follow the tests every three monthly, so that dose of carbimazole can be adjusted according to that regularly.

As far as symptoms like chest pain or palpitations or BP are concerned, they are explained by high levels of thyroxine in blood. Prompt measure should be to get an EKG done and urgent blood tests to rule out thyrotoxicosis.

Using beta blockers whether Intravenously or oral depending on EKG or clinical symptoms will ne compulsory.

Later on, after emergency management keep on using beta blocker like propanolal alongwith thyroid medications with regular follow up is essential.

Hope this has answered your query. In future, you can approach me directly through my profile. Leave a review if possible. Thanks.

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Brief Answer:
interpretation of some reports

Detailed Answer:
Hi! Your reports suggest a condition called multinodular goitre. Good news is that, presence of hot or overactive nodules are very rarely malignant.

Rest of the work up which is aimed at finding out other causes, conclude that evidence of autoimmune diseases are not found.

Now as far as management is concerned, it is advisable to first bring thyroid levels and control and then proceed to surgical options like total or subtotal thyroidectomy.

Since your last thyroid functions suggest, those levels are in normal levels, so carbimazole current dose should be continued with a follow up of thyroid function levels every 3 months and get consultation from surgeons for surgical options.

For palpitations, EKG, echo and stress tests should be performed to rule out other causes and beta blockers like propanolal should be continued.

Hope this answered your query. In future you can reach me directly through my profile.

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Brief Answer:
subtotal thyroidectomy can be better for you

Detailed Answer:
Hi! It is a tough ask, ad it has been a tricky decision to chose one the two.

For younger patients surgery is more preferred option to avoid risks of infertility, hazards of radiation exposure and better recovery prognosis.

Though surgery has risks of, anesthesia complications, or damage to sorrounding structures and risks of bleeding or infection.

Advantage of surgery is that partial thyroid tissue can be left, to avoid some production of thyroid hormone naturally and thus life long need to take thyroxine is often not needed.

Advantage of radioactive Iodine therapy is that it is a less invasive option and no cutting is involved.

My opinion would be a near total thyroidectomy by an expert surgeon. Best regards.

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