RIght Lobe 4.4 x 1.6 x 1.7 cent Echotexture extremely heterogeneous. Color flow normal. 5-mm Hypoechoic nodule within mid to uppper pole of rt lobe unchanged.
Left lobe 4.5 x 1.3 x 1.5 cent. Echotexture extremely heterogeneous. Color flow normal Isthmus measures 3 millimeter thickness.
I am concerned about this should I do anyhting further? Last TSH 4.407, (2005- TSh 1.42, 2007 -TSH 1.63, 2008 -TSH 2.93) Do I need a biopsy, t3, t4? I am a constant nervous wreck, can't calm down, depressed, palpitations at times and moody. Could be menopause am 56 yrs old. Help. Thank you.
the small STABLE nodules are usually have very little "clinical significance" (means they are just recorded on the report. The overall structure iof thyroid suggests of scaring process took place possible due to the inflammatory process in the past (because NOW the blood flow is normal) the TSH is borderline elevated. T4 may be needed
Many benign (non-cancerous nodules are grow about 10% per year plus the ultrasound machines can be more or less sensitive, so this dimension should be considered stable.
The scarring in this case represents the “dead” tissue so unless it is hard and causing pain it usually left as is. The biopsy is suggested for nodules larger then 1 cm with calcification and blood flow or the nodule that grew up 2 times its size in a matter of few weeks. The TSH itself can vary, but if T4 is low it supports the hypothyroidism due to the “lost” thyroid tissue which was destroyed by past inflammation.
I can't provide any info on the ultrasound results, but wanted to suggest that if you do go back for further testing, I suggest that you insist on testing for free T3 and free T4 (not total T3 and total T4). The latter tests are largely obsolete and not very useful, compared to testing for the "Frees". Free refers to that portion of the hormone that is biologically active because it is not bound up with protein. Free T3 is most important because it is at least four times as active as FT4, plus FT3 largely regulates metabolism and many other body functions, plus FT3 correlates best with hypo symptoms. TSH is a pituitary hormone that does not correlate very well at all with hypo symptoms and it is inadequate as a diagnostic for hypo symptoms. And symptom relief should be all important, not achieving a TSH level..
Being that the nodules are small, they will probably be monitored every 6mos or so. As far as the symptoms go, you may need to be medicated, the other tests as well as the TSH will figure out what's goin on.
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