Expert: Karen Brawner - 11/16/2004

Question
Hi.  I am a 31 year old female 7 months postpartum.  I have had significant weight gain since the baby was born, hair falling out in clumps, intolerance to cold.  My internist said that my thyroid was enlarged and ordered bloodwork and a thyroid ultrasound.  My blood work came back comepletely normal and I just got the results of the ultrasound.  The report reads as follows:  Grey scale images of the thyroid gland demonstrate diffuse enlargement of heterogeneous echo texture.  No solid nodules or cysts identified.  The left lobe measures 4.8 x1.9 x 1.6cm. The right lobe measures 4.7 x 1.6 x 1.5cm.  IMPRESSION: Enlarged heterogeneous thyroid gland.

I was wondering if you know what this means and what could cause it.

Thank you so much for your help.


Answer
Dear Jackie,  It is not unusual for thyroid blood work to come back "normal" or "within normal limits"...  The only problem with this is that, thyroid blood work is NOT like a "one size fits all" and this is what MOST doctors forget or ignore when patients tell them their symptoms and doctors turn more to inaccurate blood tests.....

Your doctor was SMART to get the ultrasound done and sounds like she/he is listening to your symptoms, rather than the blood test results....

You definately have an enlarged thyroid gland...  It is GOOD that you have no identifiable nodules or cysts...  Heterogeneous simple means "consisting of dissimilar elements or part" or "completely different"....  Therefore, what the radiologist is seeing is a thyroid gland that is NOT NORMAL like the other thyroid gland whether it be celluar or tissue abnormality.....

It is NOT uncommon for women who have just had children to get an enlarged thyroid or to have symptoms like you are having...  Even though your blood work is normal, it sounds like you doctor needs to treat you as if it is not normal and put you on thyroid medication to see if this reduces or stops your symptoms....

thank you,   karen