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I have a question about my ultra sound and blood work

Three years ago when I first found out I was pregnant my doctor ran thyroid blood tests and then an ultra sound. I was never told the results and from  then on I was seen by my obgyn who also said nothing to me about these results. I thought nothing of it. Fast forward to recent.  Been having issues. Raspy voice, clearing my throat allot,  dark spots on my skin headaches,  fatigue and muscle soreness.  My new doctor send me to endo who finds my results and tells me I had cyst back in 2014 and he wants to recheck.  Obviously a shock to me.  But I went and redid the tests.
My blood work both time are the low end of normal.
Here is what I'm concerned with the ultra sound findings.

01/09/2014
FINDINGS: Right thyroid lobe measures 5.9 x 1.6 x 1.4 cm. Multiple cystic lesions are noted in the right thyroid gland with largest cyst measuring 0.4 cm. One of the cysts has a small echogenic focus within it.

Left thyroid gland measures 5.7 x 1.6 x 2.3 cm. There is a complex cyst with some flow noted in the left thyroid lobe measuring 3.3 x 2.3 x 1.7 cm with echogenic foci  noted within the wall . Smaller 0.4 cm cyst is noted in left thyroid lobe.

07/11/2014
Findings: Right thyroid lobe measuring 5.3 cm length x 1.9 cm transverse x 2.0 cm AP. Complex, mixed echo density nodule with internal and marginating vascular flow mid right thyroid lobe measuring 5 mm diameter. Measure slightly larger than similar finding prior study. Slightly more anteriorly, cystic-appearing nodules x2 largest measuring 6 mm x 7 mm x 4 mm with internal septation. Slightly more caudal cystic appearing nodule measuring 4 mm maximal dimension. Evidence of similar changes prior study.

Left thyroid lobe measures 5.2 cm length x 1.8 cm transverse x 1.3 cm AP dimension. Multiple nodules noted with a large complex appearing nodule with internal and marginating vascular flow demonstrated lower pole left thyroid lobe measuring 1.5 cm x 1.1 cm x 1.1 cm. This measures smaller than prior study. Slightly more superiorly, complex appearing cystic appearing nodule demonstrated measuring 7 mm x 5 mm x 5 mm. Several previously noted nodules left thyroid lobe appear to have resolved

Should I be concerned I don't have a follow up for 5 weeks.  The ultra sound doctor said to call my doctor by Friday if he hasn't called.  He isn't in until Tuesday.  Just looking to ease my mind with information.
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Avatar universal
The ranges are
Tsh .34-5.00
Free T4 .60-1.80
Thyroglobulin 0.0-55.0
Vit D >29
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Avatar universal
From your symptoms and limited thyroid related test results it is likely you are hypothyroid.  With your relatively low TSH and negative TPO ab test, there is no indication of Hashimoto's Thyroiditis.   Instead, with your TSH and Free T4 that has ranged from a low of 21% of its range, to 46% more recently, there is the suggestion of central hypothyroidism.  Central is cue to a dysfunction in the hypothalamus/pituitary system that results in TSH levels that are too low to adequately stimulate the thyroid gland to produce hormone.  

Your status would be a lot more definitive if you were tested adequately.  You should make sure they always test for both of the biologically active thyroid hormones, Free T4 and Free T3.  Doctors tend to think that T4 always converts to T3 as needed, but that is erroneous.  So you need to also know your Free T3 level since it is the thyroid hormone that is metabolized in cells throughout the body to produce needed energy.  In addition, in some situations, T4 is converted to excess Reverse T3, which can block the effect of Free T3 and create hypo conditions.  So it is good to test for Reverse t3 also, at least at the beginning.  

Since hypo patients are so frequently deficient in Vitamin D, B12 and ferritin those need to be tested and supplemented as needed to optimize.  D should be at least 50 ng/mL, B12 in the upper end of its range, and ferritin should be at least 100.  It is also good to test for cortisol to confirm adequacy.  

Most important of all is to have a good thyroid doctor.  By that I mean one that will do the needed tests, and treat clinically, by adjusting Free T4 and Free T3 levels as necessary to relieve symptoms, without being influenced by resultant TSH levels.  Symptom relief should be all important, not just test results.  If your doctor is unwilling to do these tests and treat clinically, then you are going to have to find one that will do so.

If you want to confirm what I say, I highly recommend reading at least the first two pages of the following link, and more if you want to get into the discussion and scientific evidence of all that is recommended.  http://www.thyroiduk.org.uk/tuk/TUK_PDFs/diagnosis_and_treatment_of_hypothyroidism_issue_1.pdf
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Avatar universal
I did post the ranges
Helpful - 0
Avatar universal
Thyroid related test results should always be compared to reference ranges shown on the lab report.  Please post those.
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Avatar universal
They also tested
Hemoglobin A1C- 5.2%
Mean plasma glucose- 107mg
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Avatar universal
My tsh was tested
2014- .06
2016- .54
2016- .29
2017- .51

Free Thyroxine
2014- .96
2016- .85
2017- 1.11

Thyroglobulin
2017- 12.7

Vit D
2017- 24
Helpful - 0
Avatar universal
I'll leave assessment of your ultrasound results to someone who knows more about it.  But we will need to know your actual thyroid related test results and reference ranges shown on the lab report.   Also, if tested for Vitamin D, B12 and ferritin, please post those results as well.  
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Avatar universal
That last one was 7/11/2017 Not 14.
Helpful - 0
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