Hello,
Thank you for your query at DoctorSpring.com
Although your symptoms and scan suggests hyperthyroidism, TSH is normal. Thyroid function is normal.
You need follow up and only symptoms need to be treated as of now.
Your tremors and palpitations can definitely be attributed to your anixety.
So if thyroid disorder is your worry, then i can reassure you, your thyroid is fine and in fact the values are pretty good.
Have you taken any medication for your pinched nerve?
Do reply as a follow up,
Regards.

Patient replied :

Dr J Muthukrishnan

Thank you for your reply, my parents both have diabetes, high blood pressure, but I do not, nor do a drink or smoke.
I don't understand if my thyroid function is normal then why hand tremors and heart palpations, as you can see by my x-ray i have ostenpenic so is one of the symtoms of symptom of hyperthyroid. I drop things I handle all the time, one example is putting a key into a key hole, some days i have tremors all day for a few days and some days i have none, and these are accompied with heart palpations.
Can you be hyperthyroid with normal labs? if so what is that called? what can i do or tell my doctor?
I understand there are several types/catagories of hyperthroyidism where does my fall into?
I'd like to able to understand what is happening to me and why and if there is more I can do, when my body goes through these symptoms it is exhausing, I'm tired but I have not exhauasted my self physically or emotionally.

Thyroid hormone overproduction

? Graves’ disease

? Toxic multinodular goiter

? Toxic adenoma

? Metastatic thyroid carcinoma

? Human chorionic gonadotropin–mediated thyrotoxicosis

? Thyroid-stimulating hormone–mediated thyrotoxicosis, pituitary resistance to T4 and T3

? Iodide excess (Jod-Basedow)

Uncontrolled release of preformed thyroid hormones

? Subacute thyroiditis

? Painless thyroiditis

? Postpartum thyroiditis

? Hashimoto’s thyroiditis

? Amiodarone induced thyroiditis

? Nonthyroidal excess

? Thyrotoxicosis factitia

? Struma ovarii

Its taken about several weeks now my index finger and thumb feel numb almost like I burned them on a hot stove, between my breast I also have pain when I have certain movements especially getting up from a laying down face up like when you get out of bed.
Thank you
Past Medical History
Do you have a history of only my parents

Diabetes MOTHER AND FATHER NOT MYSELF	Hypertension MOTHER & FATHER NOT MYSELF
Allergies SEASONAL
Surgeries partial thyroid ectomy

Smoke NO I DO NOT SMOKE

Consume Alcohol daily NO I DO NO T DRINK alchohol

Hello,
Thanks for your reply.
Your report is really confusing because with high myeloperoxidase antibodies, but normal levels of thyroid, leads to a diganosis of Hashimoto's Thyroiditis. But in that case patients present with hypothyroid features and not hyperthyroid like you. Your thyroid scan also shows borderline high intake of radioactive iodine, which again points towards hypothyroidism rather than hyperthyroidism. But i do agree most of your symptoms do indicate hyperthyroidism. One possibility that can make sense is subclinical hyperthyroidism, but in that invariable the TSH is low. The only possibility that comes out from your history and reports is the Hashimoto's with a hyperthyroidism component. It's rare but possible. An FNAC of the thyroid will be helpful.

I will advise you to get a neurology opinion directly to localise the cause of the tremors. Infact being highly anxious can also lead to heart palpitations and tremors. The burning sensation can be due to a piched nerve/ vitamin deficiency and you can start taking vitamin b complex capsules. The osteopenia can be again due to age.
I will request you to a proper neuro follow up and get back to me with what the doctor has to say.
Regards.