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Thyroid Nodule- Got my results today:

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October 24th, 2011
Hi all,
Im writing in here in hope of getting some type of stress relief by hopefully finding someone who is going through,or has gone through with what is happening to me at the moment.

Im one of those people who cnt stop worrying and hate waiting to find out whether there is something really wrong or not.
Anyway my story is this:

I am a 35 year old male. I had a blood test about 6 months ago which showed slighlty elevated T4, and normal TSH, pathologist suggested repeating blood test 4 - 6 weeks later.

Second blood test showed slightly high T4 almost insignificant 19.2 pmol/L - Range (10.0 - 19.0)
And Low TSH: 0.16 mIU/L - Range (0.50 - 4.00). This blood test was done in April this year. (2011)

However not many symptoms apart from not sleeping well, and shaky hands (Have had shaky hands for years though, so not sure if its because of this).
Feeling unusually hot and moody. Doctor did not prescribe any meds, didnt think i needed them. (I didnt either, sysmptoms were not too bad). He did give me a form to get blood test done around end of may. (symptoms still the same in may, not too bad, so didnt do blood test)

Went to see other doctor, around early August, because my symptoms were getting a little worse. (By the way both docs are not endocrinologists). I told him the story so far, and he thought I should take meds for a week and see how i felt. He prescribed Neo-Mercazole - 5mg twice daily. ( I didn't buy them, so still taking no meds at this time) He asked me to show him my blood test request i got from the first doctor, and he added a test to check for thyroid antibodies.

Still I thought I would wait and see if everything went back to normal, so left it till the 17th of this month (Oct - 2011) Yesterday to do third blood test. My symptoms have progressively got worsew.
Feeling hot almost every day, trouble concentrating sometimes, sleep is crap, more moody than before, still shaky hands (not very bad though), eys sometimes feel irritated and sting a little (havnt noticed any swelling, just irritated eyes), just an overall feeling of disconfort)

Got my results today:
TSH normal - 0.66 Range (0.50-4.00) Previous test in april was 0.16
Doc didnt check for T4, or T3 levels this time though???? Dnt know why??? Would ve thought he would want tpo check them again to compare.

Antibodies:

Anti-Thyroid Peroxidase: Little high - 88 kIU/L - Range (<60)
Anti-Thyroidglobulin: Normal - 37 kIU/L - Range (<60)

Pathologist said these are markers for autoimmune diseases like Hashimotos and Graves disease. However they are also detected in healthy people.

So my symptoms are getting a little worse, tests are very inconclusive!! and no T4 or T3 levels tested this time.

I also had an ultrasound of my thyroid, and they have found one nodule. Worried that it might be cancer.


Very long story I know, but thought that i need to put the whole story to give a better picture of what has been happening so far.

Hoipe someone out there has had a similar thing happen to them, any suggestions stories would be appreciated.

Thanks in advance
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First Helper User Profile MyrahU
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MyrahU
replied October 24th, 2011
Extremely eHealthy
Question: why didn't you take the medication the doctor prescribed and see if it made you feel better? I'm confused.

I think your next step should be going to an Ear, Nose, and Throat specialist or a surgical Endocrinologist who has experience treating thyroid cancer. I'm not saying it's definitely cancer, but you might need further investigation, such as a biopsy. If it were just the symptoms and blood tests, I would say just an Endo would be fine, but should you need surgery, you probably don't want to have to go to another doctor for that, one that you haven't established with. Bouncing around from doctor to doctor isn't fun for anyone.

My nodule didn't affect my thyroid hormone test results, but I know that sometimes they do. Also, sometimes non-cancerous nodules can effect thyroid hormone tests. From my understanding, the positive antibodies plus the low TSH spells Grave's disease, but since the antibodies are still low, that may not be conclusive. However, you do have hyperthyroidism, regardless of the cause. I think you should talk to the specialist and go on the medication that he/she recommends for that while investigating the nodule.

Until you know more, there is no way to tell whether or not your nodule is cancer or not. Waiting is going to be the worst part. I didn't even get a clear answer after the biopsy. Unfortunately, these things aren't always as clear as we would like them to be. Just try to be patient, keep yourself informed, ask a lot of questions, and be a full participant in your own care. That's all you can do.

Make sure you have all your test results sent to the specialist before you go and have a list of questions that you have for the doctor, as well, and bring those to the appointment. It's easy to forget things in the middle of the conversation, so have it all written before-hand.

Let us know what happens or if you have any more questions. I hope this helps.
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Users who thank MyrahU for this post: sgvh55  sgvh55 
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sgvh55
replied March 29th, 2012
If you have a thyroid nodule, it is important to have a Fine Needle Aspiration (FNA) biopsy to check it out. I am 56 and recently had a thyroidectomy that showed papillary cancer. Sometimes a FNA can be inaccurate sort of, as it is only testing some of the nodule. My ex had a FNA for a large mass and it did not show cancer, so he had a hemithyroidectomy and it came back papillary cancer so he had to go back and get the other half removed and he had the iodine ablation with scans afterwards. I agree, you should see a Ears, Nose and Throat(ENT)also called otolaryngologist and a endocrinologist (endo). After I had my FNA and it showed suspicisous for papillary cancer, the nodule was 1cm solid, smoothe with calcifications and increased vascularity. I made an appointment with an ENT to discuss a hemithryoidectomy with a possible thyroidectomy and I made an appointment with ENDO to get his opinion and become established as a patient in case he is needed after the surgery. I didn't want to delay being seen after the surgery as a new patient and the possibility of taking time to get an appointment, etc. This worked out well because the endocrinologist gave me a order before the surgery took place for me to have lab work 5 to 7 days after the surgery and an appointment with him 10 days after surgery. There is the concern for your calcium to drop afterwords and this needs to be stabilized as it can affect your muscles and (heart). I had a post op appointment with my endocrinologist and got my pathology report showing papillary cancer, with the nodule, right side and small amount on the left side. The thyroid capsule showed invasion, 2 nodes and margins were clean. so he said I need to see an endocrinologist to set up the thyrogen I131 treatment. I saw my endo within a few days of getting the report and he is setting up the treatment and obtaining prior authorization with my insurance as it requires for nuclear medicine. Basically, by making appts. with endo and ENT, it cut down on some of the waiting time for these appointments. I am taking levothyroxine 125 mcg daily and 2,000 mg of calcium w/vitamin D. I am going to try B6 and B12 to help boost my energy level.
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impackt
replied October 25th, 2011
Thanks for the reply, my symptoms have got a little better, however i think they flared up due to the first doctor giving me imovane for sleeping. I read after i had finished taking the tabs that people who have a thyroid condition should not take them...Dnt understand why he gave me them.. Anyway, lesson learned, i will do my own research and educate myself as much as possible to avoid things like that happening again.

So anyone out there with sleeping trouble due to their thyroid condition, do not take imovane, it will make your symptoms worse..

Anyway these are the results from my scan:

This is what they found:
Within the Right mid pole is a hypo echoic nodule measuring 6X5X4 mm in diameter with internal vascularity. Vascularity elsewhere is normal, no retrosternal extension is seen.

Conclusion: Solitary nodule in the right mid pole. Suggest nuclear medicine to exclude toxic nodule

Still not clear, will have to do the FNA i think, only way to be completely sure.
The nodule has no calcification, or irregular margins and its less than 1cm in size. As i stated in previous question i have a history of overactive thyroid, then normal TSH with he latest blood work being positive for thyroid peroxidase antibodies.
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MyrahU
replied October 28th, 2011
Extremely eHealthy
Unfortunately, doctors don't always know the counter-indications of every medication they prescribe, especially when it comes to things like thyroid conditions, which are relatively rare as compared to high blood pressure, for example.

The fact that the nodule is so small is very good news, so even if it is something, it's likely to be very very curable.

Let us know how the FNA turns out. Best of luck to you.
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impackt
replied October 28th, 2011
Thanks Myra,
I had a nuclear scan yesterday. My thyroid uptake and apperearance was normal. However the nodule was not seen. I read the report and it said that everything was normal, and the nodule was not picked up because it is smaller than the resolution limit for the scan. <1cm.
They didnt use idoine either, they used technetium,im wondering why they did the scan knowing that the nodule was smaller than what the rsolution would pick.

I have specialist appointment on monday. We'll see what he says...
Thanks again
AA
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impackt
replied November 9th, 2011
UPdate
I had my specialist appointment with endo, he examined me, read all the reports and he said that the nodule is too small to ven do a FNA, he said hes not worried about it being cancer> So we should do a scan in a years time!!
I certainly dont want to wait a year, so I said what about in 6 months. He said if it makes you feel better thenn do it in 6 months.

Nothing else; im sorta feeling not completely satisfied with what is happening.
I got other results today, my vitamin D levels are <10 which is moderate/severe defficiency,, and moderate iodine defficiency as well.

Is this part of the same thing? I know iodine is related to the thyroid condition,, but dont know about vitamin D??
Does anyone else know? If you do please msg. my selenium levels were ok though.
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MyrahU
replied November 9th, 2011
Extremely eHealthy
I don't blame you about not wanting to wait a full year for another ultrasound. If it grows, then that'll be more more information. Benign nodules can grow, but from what my ENT told me, if it's growing, it puts it more into the risky category.

The iodine deficiency would cause hypothyroidism because the thyroid uses the iodine to make the thyroid hormone, but you have hyperthyroidism....strange.

I know this may sound nuts, but I just saw an episode of "House" where a guy had Plummer's Disease (aka Toxic Nodular Goiter). His symptoms were such TV stuff, so unbelievable, but I wonder if that's not your issue, but to a more real-life extent. The nodule causing your problems. Just a thought. Look up the symptoms and see what you think.

I don't know if the Vitamin D has anything to do with it. You may just be deficient because of lack of sunlight exposure or poor diet. Did they prescribe supplements?
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