thyroid nodules and goiter

My thyroid enlargement was found during a routine exam. My TSH was 2.6 (normal) and was not tested for T3 T4 due to sinus infection at the time. I had an ultrasound that stated the following. The right lobe measures 7.3x2.3x1.7 cm. Left lobe 5.1x1.9x1.8 cm.There are multiple small nodules of varying echo patterns noted in both lobes. The largest is in the mid portion of the left lobe measures 1.9x1.5cm.  That nodule is more discrete than the other nodules. I'm going next for a radionuclide scan. Could this just be a multinodular goiter? If so, what treatment would they do? I've never had a thyroid problem before. Thanks for any help.

[Mark Lupo, M.D.]

Skip the scan and do a fine needle aspiration of the left 1.9cm nodule under ultrasound guidance -- odds are that it is benign but this is the next indicated test, not the scan -- the scan is usually helpful only if the TSH is low and the concern would be an over-active thyroid nodule.  

Regarding treatment - if the FNA is benign then a trial of synthroid suppression could be considered but unless there is a compressive symptom (trouble swallowing, cough, hoarseness, choking, etc) this may not be indicated.  If there are suspicious cells then the treatment would be surgery, but this is less probable.

[ancientmariner]

Regarding treatment, I just wanted to make you aware that other treatments besides Synthroid are available. In my opinion, the best treatment for thyroid is Armour, which a natural desiccated porcine thyroid. I wish someone had told me about the alternatives. I was started on Synthroid and did not feel well for 3 years, although my endo told me I was fine. Finally I found out about Armour, found a doctor who would prescribe it, and now I feel much more like myself. But I'm not a doctor, just wanted you to know there are other things available.

[cakana]

I was diagnosed with a goiter last year.  I had the ultrasound and then FNA and was told it was not cancerous, so no treatment was needed.  My thyroid panel was per my Dr. "a bit confusing", which I understood to mean some levels were low but the others that should've been correspondingly high, were not.  He put me on .5 mg a day of Cytomel.  I feel that the goiter is larger and very noticeable and really want it removed or shrunk.  Is there some treatement that is successful for this?  I read a little about achohol ablation and iodine radiation, but is this an option for me?

[andrec]

I am kind of new to this but have a basic understanding of it. Anyways I'm writing for my wife which has an enlarged thyroid (goiter). I read about iodine deficiencies and Wanted to know if a multi vitamin containing iodine could hurt her in any way such as causing a problem with horomone release from the thyroid or growth of it. She is currently on medication to control the growth of it. any help  would be appreciated.

[ancientmariner]

I've read that if you have Hashimoto's Disease, indicated by high thyroid peroxidase antibodies, iodine is not a good thing. It stimulates the antibodies to increase their attack on the thyroid, I think.