ultrasound report

[cga18969]

"Gland is mildly enlarged measuring 4.4 cm x 1.5 cm x 1.5 cm on the right and 4.5 cm x 1.7 cm x 1.6 cm on the left.  No nodules are seen on the right although gland is markedly inhomogeneous in appearance.  In the left lobe there is a 1.5 cm solid nodule which is well circumscribed containing a thin septation."

I've been scheduled for  nuclear medicine iodine scan.

I find I'm very scattered and forgetful.  It would be helpful to know what to ask/tell my doctor as she is not familiar with me, so I could prepare a list.
My symptoms seem pretty standard with thyroid issues, fatigue, memory, dry skin, trouble sleeping and mood swings, however I went to the doc with pain below my breast bone, my third visit in a year span for this complaint the last was when she ordered the ultrasound.  I'm more concerned about the pain than the thyroid as I've been on synthroid since 12/2001  I was prescribed muscle relaxants that really seemed to spread out the pain along the spine rather than alleviate it and since taking them regularly I've started getting heartburn..
Bloodwork has all been normal. cbc w diff plt, comp metabolic panel, tsh 1.22, vit b12, D
Thanks

[Mark Lupo, M.D.]

You don't need a nuclear scan (but if you already had it, it does not hurt the thyroid or you) -- you need a FNA biopsy of the nodule.  The imhomogeneity reflects chronic inflammation -- ie, you have Hashimoto's as the cause of your hypothyroidism (for which you take synthroid).

[cga18969]

Phone message reported scan was normal but due to size of nodule they referred me to an endo. and gave me a number.  No instructions whether or not to restart stopped meds.  I've left a message for instructions but made an 'executive decision' pending instructions, to remain off considering the scan said I'm 'normal'  It's so nice to hear... tee hee
Thanks
Puzzled in PA

[cga18969]

I had my scan yesterday and hopefully ignorance isn't bliss.  The tech showed me 4 beautifully even pictures of a yellow 'butterfly'  nothing looked irregular at all to me.
Now if the doc says the scan was normal, does that mean I shouldn't bother with the FNA of the 'solid' nodule?  One member suggested I be tested for thyroid antibodies?
Thanks for your guidance,
Puzzled in PA

[cga18969]

Thank you for analysis.  I was scheduled to have it last thursday but it was rescheduled as I was still taking a medicine that needed to be cleared - 2 days.  From what I've read the only reason to do the scan was that they would skip the FNA if the nodule was hot? this would prevent scarring that may hinder things in the future.  I'm very cystic - breasts, ovaries, wrists, bakers knee ..blah blah.  I fully expect the solid nodule to be a cyst.   But I'm an engineer not a doctor..  Thanks again, I can follow your logic!