thyroid advice?? goiter with nodules

[jlm333]

I was diagnosed with goiter with nodules a couple weeks ago. My doctor has not order any tests or anything and every time I mention how cancer runs heavily in my family and I heard nodules could potentially have cancer cells in them she blows it off like it's nothing. She had asked if anyone in my family had thyroid problems and I said my great aunt and great grandma had their thyroid taken out, all she said was so it's just a matter of time then. .she wants to have it checked again in 3 months. My great aunt had what I have. They did a neck ultra sound and that's how we discovered what was going on. My question is: should I ask to see an endocrinologist? Is she just being under cautious? Where should I go from here???

[Barb135]

Basically, they are right -- that there's nothing to be done for the goiter.  A nodule only needs to be biopsied if it exhibits unusual characteristics that could indicate cancer.

I'd be more concerned about getting adequate blood work than I would about a biopsy.  

You need the tests I mentioned in my initial response.

[jlm333]

They called back and will not send me to the specialist because "there's nothing they can do for the goiter". I'm calling back tomorrow to say I want testing done.  I heard (and not sure how true this is) if a nodule is bigger than a centimeter it should be biopsied. Have you heard this?

[Barb135]

I think you need a different doctor.  While nodules are very common and typically are nothing to worry about, there are things she should be looking for, such as abnormal thyroid hormone levels and the antibodies, as mentioned above.

You do have some symptoms of hypothyroidism, such as feeling cold, dry hair, anxiety.  The feelings of guilt would probably go along with anxiety/depression, which is very common with hypothyroidism.

There really isn't anything for you to "do", except try to get further testing.

If your neck is bothering you, you can try laying a cool cloth on it, or take ibuprofen for the pain.  Do not, under any circumstances, keep palpating your thyroid; try not to even touch it.  Palpating your thyroid makes it hurt that much worse.

Anxiety, also makes things seem much worse than they really are and can cause a choking feeling, the racing heart, etc.

Start looking for another doctor and don't panic; you're not in any real danger; you just need further investigation into your condition.

[jlm333]

And she said my tonsils were swollen but I had no sore throat, sorry forgot to add that in. That was when she ordered antibiotics I believe.

[jlm333]

It started with the bump week of thanksgiving, went in she said it was just the one side felt like a swollen lymph node and she wasn't concerned at all cause it's just the one side. The next week both sides were swollen, she gave me antibiotics thinking it may be infection. (Zpack) Nothing. Called to see if she'd do blood test, tested for Mono and a cbc. Normal/negative. Still swollen/worried she orders ultrasound, and now we're here.

[jlm333]

She has ran no blood tests, no replacement hormones, anything. I was just diagnosed like 2-3 weeks ago but first noticed a little bump on left side of neck that felt like a little bean the day before thanksgiving, and had ran a fever for weeks, not sure if I'm still running one..and she just wants to wait and see basically. She blows it all off like it's nothing. She doesn't seemed concerned to check why it's enlarged/check anything, like I said thyroid problems run in my family and I have a "great cousin" who has graves disease. I just called to see if she can send me to an endocrinologist. I'm kind of over her wait and see attitude. I feel like my neck is so swollen and it's just uncomfortable. I'm 23 years old.  As far as symptoms of hypothyroidism: my hair has been more tangley, dry, possibly losing more hair than normal? It feels thinner and it looks like I lose a lot but then again I have really long hair so I think it could just look like more? I have also been very cold and can't seem to get warm, then again it's been freezing out. Even with it being 70 in my apartment I'm chilly and have to warm up. But I have also felt really anxious, heart racing at times, thought maybe coffee intake? And I don't know if this has anything to do with anything but have been feeling extremely guilty... over things I cannot control. Like seeing those aspca commercials on tv had led me to consider being vegetarian/animal activist..... I was worried for a minute. Lol. I just hate not knowing what to do! I feel this way and that way but always chalk it up to something else. And try not to be a hypochondriac over everything..

[Barb135]

A goiter is a swollen/inflamed thyroid.  It's very common to have nodules on your thyroid; many of us do and if the ultrasound doesn't show any unusual characteristics, it's common practice to do nothing.  

That said, I would expect your doctor to have run thyroid related blood tests to determine whether or not you might have hypothyroidism.  The tests you need to have done are Free T3 and Free T4, which are the actual thyroid hormones.  Typically, TSH is done at the same time.  TSH is a pituitary hormone that stimulates the thyroid to produce thyroid hormones.

I would also have expected her to order thyroid antibody tests to confirm/rule out Hashimoto's Thyroiditis, which is an autoimmune disease in which the body sees the thyroid as foreign and produces antibodies to destroy it.  Hashimoto's is the  number 1 cause of hypothyroidism in the developed world.  Many/most of us, here on the forum, have it.  Treatment isn't any different from other types of hypothyroidism, but it's nice to know you have it, because as the disease progresses, the thyroid produces less and less of the necessary hormones, Free T3 and Free T4.  

The antibody tests you need are Thyroid Peroxidase Antibodies (TPOab) and Thyroglobulin Antibodies (TGab).  You need them both, elevation of either is grounds for a diagnosis of Hashimoto's.

Do you have symptoms of hypothyroidism?  If so, which ones?  Are you on any thyroid replacement hormones?  If so, which one(s), what dosage and for how long have you been on it?