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jbmd, Board Certified Physician
Category: Endocrinology
Satisfied Customers: 615
Experience:  Board Certified physician in Internal Medicine - 30+ years experience
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21 yr old female student, goitre since 14yrs nodules & cysts.

Customer Question

21 yr old female student, goitre since 14yrs nodules & cysts. Suffered from painful periods/ mild hirtusim/ constantly cold. get very itchy face/nose after eating. 2hr nap a day as get exhausted. Suffer from anxiety/ panic attacks for 2 yrs treated with Sri 's improved but not cured. Can be withdrawn or hyper. Recently slept 35 hrs in 48 & fellow flat mates worried. (I still slept fine that night. Have never been easy to wake up - even firm shaking doesn't rouse me easily. (Pre Sri) . Don't feel it's a mental issue. My blood tests have all but twice been found normal but goitre is very large and now gone from size 8-18 in 2 yrs despite similar diet. Dr refuses to hear it's a thyroid issue. Seems hung up on mental side. In happy relationship for 4 yrs & no one else thinks it's depression as I'm happy. Saw endo when 16. He said keep goitre & as bloods normal nothing to do. Help - need to escape symptoms.
Submitted: 4 years ago.
Category: Endocrinology
Expert:  Dr. David replied 4 years ago.
This is Dr. David

you need to get every 6-12 months thyroid hormone testing to check your TSH levels and thyroid hormones given your history of goiter and thyroid nodules

you want to make sure your TSH levels are between 0.3 and 3.0. low thyorid hormones with a TSH of greater than 3.0 could be causing you to feel cold and have low energy. low thyroid hormone can cause itchy face and skin as well.

also you need your iron levels and B12 and vitamin D and hemoglobin levels checked as well. low iron levels and low B12 or low vitamin D levels could also be part of your symptoms as well.

what was your recent TSH levels? did you have that checked?

have you had your iron levels checked for?

Expert:  jbmd replied 4 years ago.
I have a differing opinion. You have stated that all but twice your blood levels have been normal. You DO have a thyroid issue: the goitre. However, I firmly believe that your primary endocrine problem is most likely to be polycystic ovary syndrome, which often occurs with, and often is mistaken for, thyroid disease.

Hypothyroidism can cause weight gain but so can PCOS--often marked weight gain, plus hirsutism, menstrual problems, reddened &acne-prone skin, lethargy and, most seriously, diabetes. You need to be tested for PCOS and have a diet and exercise regimen and possibly also metformin or spironolactone prescribed. If your goiter is big, discuss removal if you wish.

It can be very hard to sort out the presence or absence of mental/emotional issues in a person who has untreated hormonal/endocrine issues. First of all, when you don't feel well and you don't feel your problems are being taken seriously, that throws you off kilter.

Return to the endocrinologist. 5 years is a long time when you started out only 16 and are now 21. Get everything checked out.

Any questions? Just ask. If you do Google "PCOS and thyroid" you will get lots of links. See your doctor before following any advice you find there.

Regards and good luck!
Expert:  jbmd replied 4 years ago.
I see that you have viewed the answers. Do you have any questions? I want you to get help with the problems you are having.