My 2cm cyst lies on the back of my throid (left side)

[Loretta02]

I am 53 year old female and last November I had a thorocotomy to remove a cyst out of my chest cavity. The CT scan also revealed a 2 cm cyst on the back left lobe of my thyroid. I have been taking .88 ml of Levothyroxine to try and shrink the cyst, but that has not happened yet. The cyst has not grown, so we continue this Thyroid Suppression Therapy. My doctor has told me to not take it but 5 days a week. My levels have dropped lower than they should and I feel terrible. I have started taking the pill at night and it helps. I was wondering if took Synthroid would it be better, since it is the name brand. I feel very edgy, tired, and nauseated on some days.

I am going to see an ENT doctor at the end of April and am nervous about taking out the cyst because of where it is located. The doctor cannot feel it or biopsy the cyst because of the location being at the back. The sonogram shows it to be consistent with a benign cyst. I want to know for sure since I cannot have a biopsy.

What is your opinion? My Endo doctor said the lower left lobe would have to be removed and therefore probably would have to take this medication forever.

Thank you.


This discussion is related to Considering Thyroidectomy.

[val1198]

When you say your levels have dropped lower than they should, what levels are you talking about?  Where are your TSH, FT3, FT4?

Did your path report actually call the mass a cyst?

[Loretta02]

Thank you for replying.

My TSH    is  .28 (reference range is .40-4.50)

I don't know the other levels. I can't find it on my blood test.

When I started my Thyroid Suppression Therapy I think my level was 2.

The last Thyroid ultrasound (1-15-08) said Reason for Procedures: Thyroid Nodule.

The report said: Since last test, no interval change has occurred in the appearance of the left thyroid lobe. There is a largely cystic focus measuring approx 2 cm in greatest dimension in the lower portion of the left lobe. This shows some areas of septation. It is oval in shape and parallel to the skin surface. The remainder of the exam was unremarkable. Stable appearing thyroid cyst, lower pole, left lobe. The findings are consistend with a benign process.

[AR-10]

Normally I would recommend switching to Synthroid, but in your case I don't think it really matters.

Taking the thyroid medication is making you Hyper, which makes you feel bad. Any brand will have the same effect.

Your situation is one that is difficult to offer advice on.

It may be worth continuing therapy to see if the cyst will shrink. The question is, if it shrinks and you discontinue the therapy, will it grow larger?

Maybe the ENT will tell you it can be biopsied.
Maybe the ENT will tell you to quit the meds and continue to monitor it.

If you decide it must be removed, and the ENT agrees, you may be able to get along without thyroid meds. You can get along with half of a healthy thyroid. You wouldn't know about that one way or the other until after surgery.

The only advice I can offer is to get several opinions before you make a decision. Thyroid meds are not a perfect substitute for a normal functioning gland.

If the cyst is benign and stable, then your best option would be to leave it alone and have it checked every six months or every year. But you don't know that.

You need several opinions for the purpose of risk assessment, and then the wisdom to decide who is guessing correctly.

[Loretta02]

    I do plan on getting several opinions. Both the surgeon that did my Thorocotomy and my Endo said the cyst couldn't be biopsied without opening the neck, which at that point you my as well remove it. Thanks.