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Gastroenterology (Expert Forum)
High Bilirubin and Thyroid Mass
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
High Bilirubin and Thyroid Mass
by raciere, Aug 18, 2005 12:00AM
Hello,
I have recently been diagnosed with two separate issues:
1. A 4cm x 3cm mass that has taken over virtually the entire left part of my Thyroid. There is a 2cm x 2cm mass on the lower right lobe, and several 9mm nodules throughout the Thyroid.
We noticed the larger mass about 10 days ago, and i can now feel it pressing against my esophagus. the ultrasound showed that the mass is made up of both tissue & fluid. My hormone (t4 and t5) levels are normal. My white blood counts are also normal. We are awaiting a biopsy appointment to determine malignancy, and understand that surgery is likely even if it is benign.
2. Two separate blood tests over the last 6 months have shown abnormally high bilirubin levels. I am not jaundiced, and do not feel any abdominal pain. Liver blood test results are also normal. My general practitioner does not know why my bilirubin is high. He is telling me "one thing at a time", but i'm wondering if i should press for a liver/gallbladder/pancreas CT scan. I have read that high bilirubin "might" be a sign of early pancreas cancer? Or a blockage in the common bile duct? I have an *abnormally* high level of cancer in my family history. I am only 37 yrs old.
My most pressing question is what to do about the high bilirubin? Should I just not worry about it, or should I press for a CT or ultrasound? And... could it at all be related to the Thyroid issue?
I have recently been diagnosed with two separate issues:
1. A 4cm x 3cm mass that has taken over virtually the entire left part of my Thyroid. There is a 2cm x 2cm mass on the lower right lobe, and several 9mm nodules throughout the Thyroid.
We noticed the larger mass about 10 days ago, and i can now feel it pressing against my esophagus. the ultrasound showed that the mass is made up of both tissue & fluid. My hormone (t4 and t5) levels are normal. My white blood counts are also normal. We are awaiting a biopsy appointment to determine malignancy, and understand that surgery is likely even if it is benign.
2. Two separate blood tests over the last 6 months have shown abnormally high bilirubin levels. I am not jaundiced, and do not feel any abdominal pain. Liver blood test results are also normal. My general practitioner does not know why my bilirubin is high. He is telling me "one thing at a time", but i'm wondering if i should press for a liver/gallbladder/pancreas CT scan. I have read that high bilirubin "might" be a sign of early pancreas cancer? Or a blockage in the common bile duct? I have an *abnormally* high level of cancer in my family history. I am only 37 yrs old.
My most pressing question is what to do about the high bilirubin? Should I just not worry about it, or should I press for a CT or ultrasound? And... could it at all be related to the Thyroid issue?
Doctor's Answer
by Kevin Pho, MD, Aug 19, 2005 12:00AM
, Aug 19, 2005 12:00AM
I would consider at least an abdominal ultrasound. If there was pancreatic cancer, it may block the bile ducts, which would show up as dilation on the ultrasound.
If the ultrasound was negative, and the bilirubin is the only abnormal lab value, then a benign disease like Gilbert's syndrome may be considered (which is a hereditary disease leading to isolated elevations in the bilirubin). Typically, observation is all that is needed.
I am not aware of a connection between this and the thyroid.
You can discuss this option with your personal physician.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
http://www.straightfromthedoc.com
If the ultrasound was negative, and the bilirubin is the only abnormal lab value, then a benign disease like Gilbert's syndrome may be considered (which is a hereditary disease leading to isolated elevations in the bilirubin). Typically, observation is all that is needed.
I am not aware of a connection between this and the thyroid.
You can discuss this option with your personal physician.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
http://www.straightfromthedoc.com
I had a multi-nodular goiter -- much the same as you describe. Taking it out was the best decision. I can swallow without annoyance and talk without that gravelling hoarse voice. But the best thing is not worrying if the thing is malignant.
Best of luck to you on the thyroid issues as well as the mysterious elevated bilirubin.