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Hi all,

Newbie here -both to the forum and thyroid issues- just patiently awaiting my doctor appointment next week to find out if there is anything wrong. I am impatient though so here I am, maybe I'll find information that will be useful? I like to be proactive in my health care so it seemed like a good time to find a forum and read stuff.

A little back story, I found a tiny lump in my neck on the left side back in February so I saw my PCP in March. PCP verified that I had a lump so I got an ultrasound. Ultrasound came back as multi-nodular goiter (details below) so then I was sent off to an endocrinologist who didn't tell me anything other than he needed to run tests and get a biopsy. So fast forward to today, finally all of the tests are completed and soon I will find out what is wrong (come on 6/22!!). I had the biopsy done on two of the nodules last week - man that lidocaine sucked!

I don't know if newbie's normally post lab results or not but I have a lot of them so I might as well share, the labs might help paint a better picture of myself.

March 2017
TSH - 1.66 (0.35-4.01 u[IU]/mL)

September 2017
TSH - 0.64 (0.35-4.01 u[IU]/mL)

March 2018
TSH - 2.46 (0.35-4.01 u[IU]/mL)

April 2018
Free T4 - 0.90 (0.80-1.80 ng/dL)
Free T3 - 3.4 (2.3-4.2 pg/mL)
TSH - 2.517 (0.350-5.500 ulU/mL)
Ultrasound (4/3)
Right lobe: 5.9 x 2.3 x 2.5 cm
Left lobe: 5.6 x 2.5 x 2.3 cm
2 nodules in the left lobe (16mm - mid pole & 19mm - lower pole)
2 nodules in the right lobe (5mm - mid pole & 21mm - lower pole)
There is generalized hyperemia of the thyroid parenchyma on color Doppler evaluation.
The mid pole nodule demonstrates central intranodal vascularity on color Doppler evaluation, the other does not..
multi-nodular goiter and abnormal echotexture with hyperemia suggestive of autoimmune thyroiditis

May 2018
TSH - 3.15 (0.35-4.01 u[IU]/mL)
T3, Total - 108 (87-178 ng/dL)
T4, Total - 8.03 (4.30 - 12.50 ug/dL)
Anti-thyroglobulin - 20.1 (0.0-60.0 U/mL)
Anti-Thyroid Peroxidase - < 28.0 (0.0-60.0 U/mL)
CT Scan results - Large multi-nodular goiter with both carotid arteries slightly deviated laterally due to thyroid. No tracheal deviation or airway compromise.

Ultrasound (5/17)
Right lobe: 6.3 x 2.3 x 2.6 cm
Left lobe: 6.0 x 2.4 x 2.5 cm
Most distinct nodules is one measuring (10 x 9 x 7 mm) - category 4, and a solid hypoechoic nodule measuring 8mm - category 4.
probable multi-nodular goiter

Pulmonary test came back normal, no compression or obstructions (phew!)

June 2018
TSH - 1.66 (0.35-4.01 u[IU]/mL)
T3, Total - 81 L (87-178 ng/dL)

T4, Total - 7.08 (4.30 - 12.50 ug/dL)

Disclaimer: I am not a doctor but so far all the test results I have seen show up as normal (other than the recent t3) so maybe I just randomly have a goiter? Do goiters normally develop when there is no medical reason for it?

*edited for formatting.
 

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Your tests results may fall in the normal range, but they are low and you are trending hypo. That with your ultrasound and antibody results indicate that you have an autoimmune thyroid disorder.

You should definitely start on a low dose of thyroid medication. Sometimes that can help with the nodules.

And, of course, this all depends on your biopsy results.
 

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Discussion Starter · #3 ·
OK! Good to know, I always assume normal labs == no problems. Granted, I do have symptoms of hypo but I also take psychiatric meds and I think there can be an overlap of symptoms there so it's hard to me to differentiate between the two. I'll post another update to this thread once I see my doctor next Friday to hear about the results of my biopsy. Now that it's a week away the wait seems so long.

Thanks for your insights and information joplin1975, much appreciated!
 

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Update: I saw the doctor today, he said everything looks good and I have nothing wrong other than a giant genetic goiter. He highly recommends full removal. He said a normal thyroid on average is 5cc and mine is over 80cc, very slightly pinching my esophagus but not affecting my trachea yet. He said he can no longer help me so he is referring me for a surgery consult, he said I don't have to make a decision immediately but since I am young and healthy it would be wise to take care of it now before it becomes an emergency. He said he will take over my care once again after surgery but if I don't do surgery not to go back since there is nothing wrong and he can't fix my problem.

I did not see the biopsy results but he said they were benign - thank goodness! I will need to get a copy of the results at some point because I want to get a second opinion about the surgery before the surgery consult. I got to see the CT scan images today and my goiter was much larger than I imagined. It does not stick out too much but that is because it is filling the majority of my neck and is wrapping around towards the back.

I think that is all, I will probably hang out here at the forums a bit to read about surgery and decisions and stuff. I am still really confused about the genetic goiter, I always thought goiters were autoimmune inflammation but I guess not.

Thanks for reading!

Edited: for typo.
 

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Just make sure you see a surgeon who does a high volume of thyroid surgeries. That's the #1 way to insure a successful outcome!
 
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