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Thyroid Nodule
Hello, I am seeing my DR. tomorrow for an unrelated procedure and I am looking for some information on singular thyroid nodules, so when I see her and can ask her more questions.

Here is my background information:
I am 33 years old and had a baby last year. I went in for a regular check up this past April and my DR. noticed my "enlarged" neck. She was implying that I may have hyperthyroidism and she ordered an ultrasound and blood test. I had them done two weeks ago. At that time the ultrasound tech. informed me that I had a nodule and that it look benign. My DR. got the results and told me she wanted me to go to a specialist. She wouldn't say much other than I should get a biopsy. This is what the bloodwork and ultrasound came back:
T4 FREE: 1.13
TSH: 3.940
Color Doppler images of gland are unremarkable
Dominate heterogeneous solid nodule 1.3x1.2x1.1cm
There is flow in the margins of nodule
Thyroid gland is otherwise homogeneous in echogenicity

Any info would be nice to know.

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1756321 tn?1377771734
Thyroid gland is normal (homogeneous). TSH and free T4 aren't in optimal range though. Any hypothyroid symptoms? A single solid nodule over 1cm should be biopsied to rule out thyroid cancer.
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>TSH: 3.940

That's a little up there depending on ranges. But could be normal for you.  An endocrinologist would probably want to retest and check for thyroid antibodies.  However the ultrasound says your thyroid is homogenous and you don't mention feeling crappy.

>Dominate heterogeneous solid nodule 1.3x1.2x1.1cm

Not a very big nodule, probably 70-80% chance an FNA biopsy will come back benign.  There is a chance that the FNA won't get enough sample to make a determination and they'll need a do over.

A chance that the pathologist won't be able to tell if it's cancer.  And then might be cancer. The treatment for either is surgery.  If they can't tell if it's cancer, usually often remove one side of the thyroid, do a frozen section of the nodule and only remove the other side only if it's cancer.

Cure rate is extremely high, 99%, since thyroid cancer is mostly very lazy. Try not to worry.

Not a doctor but I'd suspect that your nodule and labs has more to do with your recent pregnancy since thyroid problems tend to show up during or after pregnancy.
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The "Flag Reference" on my lab work is
T4 FREE: 0.70-2.00
TSH 0.400-5.400

I don't know if that makes a difference.

As for symptoms, my husband has been complaining that he is finding my hair everywhere for the past year, a lot does come out when I shower. And for being tired, I chalked that up to 4-5 hours of sleep due to a nursing baby in the past. What are the other symptoms? Those are the main ones I know of. Also, my dad has a cousin that has an overactive thyroid and is extremely obese because of it. My grandmother had a goiter as well.
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It sounds like you are hypothyroid by symptoms and labs. I had a nodule that I had followed for 9 years. Eventually the characteristics changed on ultrasound (it became solid). I had a FNA and it came back as a Hurtle Cell Adenoma. They felt it should come out since they could not tell if it was malignant. I had the option to remove the lobe or the entire gland and decided to go with the total thyroidectomy because I had some other smaller nodules I would have to continue to follow. I was also told if the pathology report came back positive after the surgery I would have to undergo another surgery to remove the other lobe. I also was told it is easier to regulate thyroid levels with medication than having to adjust levels based on what the remaining tissue is producing especially since I had Hashimotos.

Thyroid cancer is slow growing and highly curable so that's the good news. Good luck.
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1756321 tn?1377771734
Hypothyroid symptoms include hair loss and fatigue.  The American Association of Clinical Endocrinologists (AACE) recommends a TSH range of 0.3 - 3.0 mU/L.

A hypothyroidism diagnosis needs to take into account clinical and physical symptoms, body temperature, and family history as well.  A youtube video that is worth watching: Four Ways To Diagnose Hypothyroidism - Dr. Hotze.

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