Heterogenous Thyroid

Hi. Please forgive how basic my questions are, I am new to this. I had a thyroid ultrsound last week. After the technician finished she went out and returned with a doctor who took additional images, said my thyroid was "very heterogeneous" and that I had a few small nodules. Does this mean I have Hashi's?  I haven't heard the final report yet and was curious. In between my TSH test (slightly elevated) and my ultrasound the Hashi's anitbody test came back and I basically didn't have any ( a fraction was the result).
Is it common to have this ultrasound result and not have antibodies? Could something else be affecting the tissue and not Hashi's?  


Thank you very much, this is my last question for at least six months.

[Mark Lupo, M.D.]

Heterogeneity is typical of thyroiditis and Hashimotos (chronic lymphocytic thyroiditis) is the most common type.  About 10-15% of patients with Hashimoto's have 'normal' antibodies.  So, with a slightly high TSH and a heterogeneous gland on US, this most likely is Hashi.

The other possibility is a recovery from a subacute (painful) or silent (painless) thyroiditis.  In these situations, rechecking TSH in 5-6 weeks should determine if the thyroid medication is needed -- ie, in transient thyroiditis, the TSH should normalize (0.3-3.0) and in Hashi, it may typically remain elevated.

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