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Thyroid (Expert Forum)
Disparity between lab results and nuclear thyroid scan
Answered by
Mark Lupo, M.D. - Thyroid Nodules, Thyroid Cancer, hyperthyroidism, hypothyroidism, Thyroid Ultrasound
Thyroid & Endocrine Center of Florida
Sarasota - FL
Questions in the Thyroid forum are answered by Dr. Mark Lupo. Topics covered include goiter, graves disease, Hashimoto's thyroiditis, hyperthyroid, hypothyroid, thyroid cancers, thyroiditis, and thyroid stimulating hormone (TSH).
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Disparity between lab results and nuclear thyroid scan
by springtime.norma, May 27, 2007 12:00AM
I have symptoms of hyperthyroidism.
Is it possible that I have Graves disease, as my nuclear thyroid scan suggests (my 24-hour iodine uptake is elevated at 68.8%) eventhough my thyroid antibodies, antinuclear antibodies, T3 Total/Free, TSH, Sedimentation Rate-Westergren, Serum Magnesium, and Complete Metabolic Panel are all normal?
Additional information: My thyroid ultrasound shows thyroid megaly with multiple bilateral thyroid nodules in both lobes. There is normal color Dopler flow. My isthmus is slightly thickened, and it measures 3 mm in thickness. My Thyroglobulin, Quantitative is 119 (normal range is 0.5-55.0). I don't know my T4 numbers.
According to the thyroid scan there is a photopenic defect in the upper pole the left lobe of the thyroid gland wich correlates to a nodule noted on the ultrasound (cold nodule measuring 1.2 X 2.8 cm).
Thanks.
Is it possible that I have Graves disease, as my nuclear thyroid scan suggests (my 24-hour iodine uptake is elevated at 68.8%) eventhough my thyroid antibodies, antinuclear antibodies, T3 Total/Free, TSH, Sedimentation Rate-Westergren, Serum Magnesium, and Complete Metabolic Panel are all normal?
Additional information: My thyroid ultrasound shows thyroid megaly with multiple bilateral thyroid nodules in both lobes. There is normal color Dopler flow. My isthmus is slightly thickened, and it measures 3 mm in thickness. My Thyroglobulin, Quantitative is 119 (normal range is 0.5-55.0). I don't know my T4 numbers.
According to the thyroid scan there is a photopenic defect in the upper pole the left lobe of the thyroid gland wich correlates to a nodule noted on the ultrasound (cold nodule measuring 1.2 X 2.8 cm).
Thanks.
Doctor's Answer
by Mark Lupo, M.D., May 28, 2007 12:00AM
, May 28, 2007 12:00AM
The way to diagnose hyperthyroidism is the TSH, T4 and T3 -- if these are normal then the thyroid hormone status is normal.
The high uptake may be from low iodine in the diet. With a normal TSH, the 68% uptake is not easy to interpret.
The negative antibodies suggest against latent graves, but do not rule it out.
The nodules are causing a high Tg level -- this is not whatsoever predictive of the nodules being malignant, but you will need an FNA of the cold nodule at least.
The high uptake may be from low iodine in the diet. With a normal TSH, the 68% uptake is not easy to interpret.
The negative antibodies suggest against latent graves, but do not rule it out.
The nodules are causing a high Tg level -- this is not whatsoever predictive of the nodules being malignant, but you will need an FNA of the cold nodule at least.
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