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From Roanoke, Virginia, USA:

Twenty-five years ago, my mother was considered to have borderline diabetes and was also diagnosed with a benign thyroid nodule. She was quite overweight at the time. Her thyroid nodule was suspicious for cancer, so she had a subtotal thyroidectomy and was started on thyroid hormone. She lost 60 pounds in about six months after treatment and all signs of borderline diabetes have been absent for the past 25 years. When she has blood work, we see that if her TSH is as high as 1.0, her free T3 and free T4 are near the bottom or actually below the reference range. When they are midrange, her TSH is totally suppressed (TSH less than 0.004).

Additionally, I have multiple signs and symptoms of hypothyroidism and after having these for about five years, I too have a nodule which is mostly cystic and considered to be benign. My TSH is usually around 0.7 to 0.9, but my free T3 and free T4 are near the bottom of the reference range also. I have been allowed to take thyroid medication with improvement in many symptoms also (especially lowering of my elevated cholesterol and improvement in my hair, skin, mood and energy). Can I have hypothyroidism with numbers like these? Could this tendency to have low or at least low normal free T3 and free T4 along with fairly low or suppressed TSH represent a familial problem?


First, the tendency to have thyroid nodules is familial, so it is not surprising that you and your mother both have these findings. However, I do not believe that taking thyroid medications is appropriate when your TSH is normal. I usually use the TSH as the screening test for the presence of hypothyroidism. If that is not high, I would not treat for hypothyroidism.

Some physicians have tried to suppress nodules by giving thyroid hormone. However, this is not usually very helpful. Finally, thyroid hormone should not be dosed on the basis of symptoms.


Original posting 16 Oct 2002
Posted to Thyroid


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Last Updated: Tuesday April 06, 2010 15:09:38
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