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Nuclear Medicine to Remove Thyroid
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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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Nuclear Medicine to Remove Thyroid

Hi.  I have a cold nodule on the right side of my throid.  I discovered it over 2 years ago when I started having a fever every nigh for almost a week.  It was pretty strange.  One night as I was laying in bed fighting the fever, I happened to put my hand to my neck and felt the lump.  Since then, the nodule has grown and has pretty much replaced the thyroid tissue on the right side.  I had a FNB done on the nodule about 2 years ago. The tests were inconclusive.  I was told they did not get enough fluid (even though they put that needle in me 8 times) to determine conclusively whether the nodule was malignant or benign.  The nodule has progressively gotten larger over the past 2 years and is now clearly visible when I look in the mirror.  Since thyroid disease is prevalent in my family, I'm not too concerned about it being malignant since no one else's was.  I'm very nervous about having my thyroid taken out surgically because I'm afraid of something else being accidentally cut.  I'm in my early 30s and have no children.  Is nuclear medicine an option for me and will the nuclear medicine affect my ability to have children?  How long can I wait before having the thyroid removed.  Last year, a nodule formed on the left side.  I have not had it tested to see if it's cold or hot, but that one is getting larger and I don't want to wait until I can't swallow to do something.
Tags: Thyroid
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97953_tn?1193367871
A cold nodule is not likely to take up the I-131 treatment dose -- so it would not likely shrink.

A growing cold nodule of this size should usually be removed unless you have no symptoms whatsoever and repeat biopsy shows a clearly benign process.  With the nodule on the left, a repeat nuclear scan is not likely to add much to this decision making, but ultrasound guided biopsy of this may be necessary as well.

With an expert thyroid surgeon, there is little risk of damage to other structures.
7 Comments
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158939_tn?1274918797
I-131 does not remove the thyroid - only kills off thyroid tissue.  As Dr. Lupo said, a cold nodule will not absorb I-131 so all it would be doing is killing whatever healthy tissue is there.

A solitary, cold nodule is concerning and needs to be addressed - especially when it has grown.   Biopsies (fine needle) are not always conclusive.  Two of my sisters had them - no cancer cells were found - yet they both had thyroid cancer.

Find a reputable surgeon (either and ENT or a general surgeon) who has done A LOT of these surgeries.  The risk to surrounding tissues is minimized by a skilled surgeon.

Good luck and please take care,

Utah
papillary carcinoma '03 and three sisters with papillary carcinoma
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Thank you for your responses. I did find a surgeon who was highly recommended, so I will go ahead with the surgery.
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Avatar_f_tn
I have had my thyroid due to cancer in Oct. 2007. I have also had the radio iodine 2 weeks ago. I had got my blood test results back and my levels are 117. I have been gaining weight as well and I look like I am 7 months pregnant. Could you please tell me what might be causing all these symptons?
                                                  
                                                        A bit frustrated,
                                                                Jody
                                                                  
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I had my thyroid removes due to cancer
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I had thyroid therapy 2yrs ago was told I will feel so much better WELL I am still waiting for that day. I started out on 50mcg. now I am up to 150mcg and I am still gaining weight and don't know what to do I was told I use to be hyperthryoid now I am hypo any ideas I am going for more blood work to be done on Thrsday but won't see the Doc until next week. I just feel awful
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can anyone tell me what the correct or close to correct number level for TSH should be I went from 3.15  to 8.21 in 5 months
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Thyroid & Endocrine Center of Florida
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