Thyroid Cancer / Nodules & Hyperthyroidism Expert Forum
multinodular goiter, positive anti-thyroglobulin, normal TSH, T4, T3......
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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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multinodular goiter, positive anti-thyroglobulin, normal TSH, T4, T3...

My question: With a positive anti-thyrogloblin and a multinodular goiter, should I continue with infertility treatments or should I continue to wtch and wait for my thyroid to improve? or will it?..... I understand that pregnancy may help my thyroid but my thyroid may actually be keeping me from becoming pregnant...

I'm a 37 year old BMI 24.0 with recent routine blood work as follows:
TSH 0.82  [ 0.34- 5.66]
T4 1.04     [0.52-1.21]
T3  2.88    [2.20- 3.80]

I was then sent for additional blood work and thyroid US since my TSH was on the low end of normal. I have no hypo/hyper symptoms.... though I would love to blame my weight and bad hair on hypothyroidism...( trying to insert humor)

Further values below:

thryotropin receptor AB <0.51  [ 0-1.75]
Anti-thyroglobulin Positive
Anti-microsomal Negative

Thyroid US: Multinodular goiter:

RIGHT LOBE: The right thyroid lobe is heterogeneous. The right lobe
measures 5.7 x 1.4 x 0.6 cm. It contains a solid nodule measuring 1.6 x
1.2 x 0.9 cm.

LEFT LOBE: The left thyroid lobe is heterogeneous and measures 5.4 x 1.2
x 0.9 cm. It contains 2 nodules, the larger of which is complex and
measures 1.7 x 1.0 x 0.6 cm. The smaller, more medial left thyroid nodule
measures 0.7 x 0.6 x 0.3 cm.
Your thyroid hormone levels are normal, but Tg-Ab high.  Was TPO-ab tested?  The description of "heterogeneity" on ultrasound is consistent with thyroiditis - most commonly due to Hashimooto's in this case.  The 1.7cm nodule may require FNA biopsy.  There is mixed data/opinion on th erole of using levothyroxine medication for this situation to help decrease miscarriage rate.  You should review this w/ your OB and an endocrinologist.
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Mark Lupo, M.D.Blank
Thyroid & Endocrine Center of Florida
Sarasota, FL
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