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Abnormal Echotexture, Hypervascular Thyroid Nodule
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Questions in the Thyroid forum are answered by Mark Lupo, MD. Topics covered include Goiter, Graves Disease, Hyperthyroid, Parathyroid/Calcium Problems, Thyroid Cancer, Thyroid Nodules/Cysts, Thyroiditis, Thyroid & Pregnancy, Thyroid Stimulating Hormone (TSH), Thyroid Tests, and Thyroid Surgery.

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Abnormal Echotexture, Hypervascular Thyroid Nodule

Hello,

I am having some trouble with my thyroid (pain in neck, difficulty swallowing, sudden bouts of exhaustion & weakness, hair loss, etc). I had blood work done and a CT & US. My TSH on 11/7 was 2.5 but I had it retested on 11/16 and it is 3.8. What does that sudden increase mean? My other levels are: T3U=1.05U (0.8-1.3) & T4=6.9mcg/dl (4.6-12.0). No antibodies were tested and I'm not sure why?

Also, the CT showed an enlarged left lobe which lead to the ultrasound. The US findings where:
-Right lobe 1.3x1.7x5.3cm, Left lobe 2.0x2.4x4.7cm in AP, transverse & longitudinal dimensions respectively
-Mixed echotexture small nodules in right lobe, the larger measures 8x5x15mm
-On the left side, the large dominant nodule measures 2.0x1.6x2.5cm. Is somewhat hypervascular in nature and abnormal echotexture is noted.
-Consideration could be given to ultrasound guided biopsy.
-The isthmus is unremarkable 2mm.

I understand that I should make sure I am ordered a biopsy but my problem lies with my PCP and waiting for an endo. My initial PCP wrote my symptoms off as stress & anxiety. I am now seeing a different PCP in that office and have had to ask for these blood tests to be ordered. Are there other tests that I should make sure I'm getting?

Finally, I can't get in to see my endo until February. Would you wait or go somewhere else?

Thanks!

Katrina
97953_tn?1193367871
This sounds like probable Hashimoto's thyroiditis with a nodule.  Biopsy is recommended.  Would check thyroid antibodies.  The TSH is normal but 3.8 is considered high normal and in the setting of a nodular enlargement, levothyroxine treatment may be indicated.  You should probably see an endocrinologist about this.
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