multinodular goiter and RAIU - Question and Answer Forum - Elaine Moore Graves' Disease and Autoimmune Disease Education

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Tuesday, February 07, 2012

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Welcome to The Q&A with Elaine Moore. Registered members are invited to ask any question of Elaine Moore on autoimmune diseases, Graves' disease, other thyroid diseases and subconditions, laboratory work, traditional and complementary medicine, triggers and environmental influences, thyroid and immune disorders in pets and animals, and other relevant areas of inquiry.

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Questions are answered solely by Elaine Moore, a medical writer and clinical laboratory scientist, MT, CLS, with more than 30 years of experience in immunology. Moore has also authored and edited over a dozen books in the area of health sciences and is an editor for McFarland Publisher's Health Topics Series.

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multinodular goiter and RAIU

4/22/2009 7:34 PM

lilly

Joined: 12/2/2008

Posts: 3

multinodular goiter and RAIU

Hello Elaine,

I am a naturopathic physician and have a patient who has been diagnosed with multinodular goiter. Her TSH has been below normal, although her T4 and T3 are always in normal range. Ultrasound showed cystic nodules, but I would like to recommend a RAIU study to determine more about the nodules. She doesn't have many symptoms of hyperthyroidism, in fact she has more sx of hypothyroidism. Her EENT doc put her on synthroid to shrink the goiter? But I am concerned she has subclinical hyperthyroidism and this will only make things worse. Her fatigue is worsening every day and I am concerned the doctors have missed something.

If she does do the RAIU study, does she need to stop taking the hormone for a period of time before the test? I have seen several weeks recommended.

Thank you.

4/24/2009 2:13 AM

Elaine

Joined: 8/1/2008

Posts: 3166

Re: multinodular goiter and RAIU

Hi,

I'm not a big fan of the RAIU. The uptake itself will likely be normal since the thryoid hormone levels are normal. So many things influence the test that it's no longer recommended by pathologists. I123 can also rarely stimulate the thyroid gland and worsen hyperthyroidism.

Thyroid replacement hormone is often used to shrink nodules because TSH increases cell growth. The goal here is to lower TSH. The college of American pathologists also recommends a low iodine diet to reduce the size of nodules and any associated hyperthyroidism. Acetyl-l-carnitine used along with replacement hormone would reduce any symptoms associated with an increase in thyroid hormone levels. Best, Elaine

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multinodular goiter and RAIU

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