My endocrinologist is recommending a complete thyroidectomy. I have one large-ish "hot" nodule and 3 other "cold" ones - two of which require further investigation. He claims that fine needle biopsies are often inconclusive or give false negatives and would be "impractical" given the number of nodules I have. I am planning to get another opinion because this doesn't seem right to me. I am concerned about losing my entire thyroid based on nothing more than a need for more investigation, especially since the "hot" nodule can be treated with meds or removed on its own. I am obese and have been my entire life and I don't want my efforts to lose weight to be further stymied unnecessarily. In seeking information about this condition I've read the stories of many many people who struggle miserably with the synthetic hormone meds they have to take after their thyroid is removed. My hyperthyroid symptoms started three years ago , a few months after the birth of my fourth child. The symptoms have been transient and mild, although recently, after starting birth control pills to treat migraines, my heart palpitations and hypertension became much worse. A low dose beta blocker is managing those symptoms beautifully.
So, would you recommend a complete thyroidectomy, without biopsies, given these circumstances?
P.S. Labs within the last 6 weeks: TSH 0 and 0, Free T4 1.6 and 1.5 ng/dL (range 0.7 to 1.7), Free T3 5 pg/mL (range 2.2 - 3.5). When I was diagnosed with postpartum hyperthyroid three years ago my TSH was low but detectable, my Free T4 was slightly high (1.9 I believe) and my Free T3 was not tested. No other labs have been drawn.