thyroid nodules

[Josie88]

Dear Dr. Lupo,
  
I have been diagnosed 2 years ago with Hashimoto's thyroiditis based on 2 FNA's and positive thyroid antibody tests. My TSH has been normal so my doctor has not placed me on l-thyroxine so far.  I feel like I do have some hypothyroid signs though-lethargy, weight gain, alopecia, muscle aches.   I now have 4 nodules, 3 on the right lobe and 1 on the left lobe.  The one on the left has grown from 1.5-2.0 cm to 2.3-2.6 cm in the past 6 months.  I have been reading that nodules in Hashimoto's thyroiditis can become lymphoma so I am concerned.  I also have had ear pain intermittently  which my ENT is not sure why since my ears look ok.  I had the same ear pain 1 hour after my first FNA was performed so I think it could be stemming from my thyroid.  My doctor wants to wait and repeat another ultrasound in 4 months.  Does this sound like a reasonable course or should I be on l-thyroxine to see if it suppresses the growth or get a second opinion?  Thanks for your help.

Josie88

[kathyMMM]

You may want to buy the book "Is Your Thyroid Making You Fat"  - it lists many of the symptoms YOU have and tells you some other ones plus some really good recommendations.   Your symptoms sound like what I had when I needed to go on meds.  Be sure and google side effects of Synthroid and other T4 drugs & then look up the ones like Armour and Thyrolar that have both T3 & T4.  Find out as much info on the internet as possible about your thyroid so you will be an informed patient - getting good help depends on it.

[Josie88]

I never had any ear pain or ear problems before my first FNA.  I truly believe my ear pain is referred pain from my thyroid gland.  Anyway I have to go for new bloods and another ultrasound (and I guess another FNA if it still is growing) next year.  Good luck at the ENT.

[canadaeh]

I could not believe when I read your post.  I just had a 2nd FNA of a 2.6cm nodule, which grew from 2.2cm in the last 4 months.  I too had ear pain off and on and it was worse after the 2nd biopsy.  My problems began with ear infections and then the discovery of the nodule.  I also just had a thyroid ultrasound which showed several nodules in my right lobe and a cyst.  Will get test results in Jan.  My thyroid tests are normal except my antibodies TPO also keep going up.  I see a ENT on Jan.7. for the 1st time.  

[Mark Lupo, M.D.]

If the TSH is high-normal (>3)- then levothyroxine may help prevent goiter growth.  Lymphoma is rare and FNA would usually point towards this lymphoma if that was the case.