Best Dx test for nodules

[capcomop]

I have pretty normal bloodwork, TSH 2.9 and everything else in the normal range with antibodies that are the >20 thing.
I do have very strong family history of hypothyroidism and a very strong symtpom pattern for the past year and half. I laso have had a lump in my throat and find that I start coughing when I speak for very long or when I am not standing up. I told this to my endo who had a ultrasound done and found four small nodules. My thyroid seems to be of normal size (I keep finding conflicting information...if can be up to 5cm then yeah fine if it can be up to 4 then no...I am under forty and also under 5 foot :-)
I am not getting a lot of communication from her office. I had the ultrsound results THREE WEEKS before the office contacted me and that was because I called them!
She wants me to do a biopsy. I asked the person who called why not a scan instead and was told that that was only good for hyperthyroidism? What?
My questions...I thought a scan could tell, within reason, how the nodule and thyroid were functioning. So if I have parts of my thyroid that are over functioning causing the symptoms a scan could tell. A biopsy will only tell if it is cancer right?
My problem is that with the normal bloodwork most drs think I'm nuts and won't do anything, yet this dr doesn't seem on top of things and doesn't seem too communicative. Gee if you are going to indicate to a patient that she might have cancer at least an office visit might be appropriate!
What do ya'll think...should I seek a second opinion and risk the wasting time and money and humiliation or should I just suck it up and do the biopsy and hope she doesn't forget to call with the results :-)

[redheadaussie]

I know that here in Australia sending people to get their thyroids checked for 'hot/cold' nodules is expensive and also difficult to get an appointment. So, many doctors will do a FNA (biopsy) to evaluate for any type of cancer.
   Blood tests are done for hypo and hyper thyroidism. But you must make sure the doctor requests the correct tests. TSH on its own will not give the bigger picture. You need a Free T4 and Free T3 test as well. You can also ask for an anti-bodies test as well, as this will show if you have Hashimoto's disease. Hashimoto's can cause swelling and extra nodules which can in most cases be benign, but again only a FNA will know that if they are or not.
  So one test on its own is not going to tell you if you are hyper or hypo. Ultrasound can only see if there is a solid or hollow nodule/cyst and the size of your thyroid.
   If you really aren't happy with the doctor you might need to change and find one in your area that deals with endocrinology. Make a few phone calls to the offices and ask the receptionist, they usually have a good idea of what the doctor is like.

[898]

The AACE recommended "thyroid neck check" self-exam can reveal nodules of 2 cm or more. According to present clinical guidelines, the boipsy is needed for "cold" nodules of more then 1 cm size. If nodule is "hot" based upon RAIU scan, the biopsy is not necessary.

[Linda1068]

First let me say, I am sorry you are having such bad communication with your doctor. I feel that way sometimes too. I had my Endo tell me in person that my nodule could be cancer. I don't know, either way, it's all bad. I had both a scan, to check function, (nodule was cold), and then a biopsy afterwards, which still didn't give me a positive answer. I ended up having my left thyroid removed so the pathologist could do better exam of the nodule. It was not cancer thank the Lord. Most important through all of this is you need support from your family or friends. However you are feeling or if you need to vent because of all the frustation. Keep us updated on your condition. Oh yeah, go to another doctor if you are able to. If you have insurance and it's covered, it couldn't hurt.