Thyroid mass

[distillers]

Hello, I am new to this site but have some questions.  I currently have a 6cm solid mass on my thyroid,  I have surgery scheduled for 08/13 to remove half of my thyroid.  They are not doing a biopsy since it has to be removed no matter what the results.  My thyroid results were free T4 1.33 and TSH 3rd generation <0.022, is this bad.  Will I have to have this treated after surgery?  Someone please help me with the results and advice on the surgery.

[Barb135]

I can maybe see scheduling surgery, based on the size of that  nodule, but I'd want to assess actual thyroid function before deciding on whether to have just 1/2 the gland removed or if it's best to have the whole thing taken out, rather than risk having to go back for a second surgery, later on.

[distillers]

Thank you for all this information, I see a different doctor on Monday and I am going to asked to have these blood test done to get A better idea of what is going on with my thyroid and possible treatment. My family doctor has been less than helpful, and the first ENT I saw Just scheduled surgery with no further testing. The surgery was scheduled just based on a thyroid ultrasound.

[Barb135]

No need to be sorry; we all make mistakes...I've just been around long enough to spot them pretty quickly... :-)

Your FT4 doesn't really indicate hyper, but your symptoms and TSH do... I guess they didn't do a Free T3 or antibody tests, did they?   I'm wondering if the nodule is producing thyroid hormones on its own, independently of the thyroid or if you might have Hashimoto's, which is an autoimmune thyroid disease, which slowly destroys the thyroid gland, regardless of nodules... These are questions you might be asking your doctors between now and when you have your surgery...

You might do nicely on 1/2 the gland for a while only to find that you have to undergo a second surgery later on...

You should ask for a Free T3 test, with Free T4 and TSH, along with TPOab and TgAb (Antibody tests to determine Hashimoto's) and then go from there.

Two things in your favor are that 8/13 is really not all that far away, and we're here to help get through the next month... for what that's worth...

[distillers]

Yes, 1.76, I'm sorry

[Barb135]

Can you recheck the reference range for the FT4, please?  Should that maybe be 1.76, instead of 7.76?  

[distillers]

Reference range for the Free T4 is 0.89-7.76 so that seems normal, the TSH 3rd gen reference range is 0.350-4.00, mine is <0.022 so that is way low.  I have symptoms, racing heart yet fatigued, painful joints, always hot and sweating -- no weight loss (unfortunately) = I can't get into an endocrinologist for a few months so I am wondering if this is dangerous to have levels like this.  I am not on any medication for my thyroid.  With the partial thyroidectomy, is it possible that my thyroid levels will go back to normal? Is it routine to not biopsy the mass until it has been removed?

[Barb135]

What's the reference range for the Free T4?  Reference ranges vary lab to lab and have to come from your own lab report.

Are you currently taking a thyroid replacement hormone medication?  Do you have symptoms of hyperthyroidism?

Since they are only removing half your thyroid, you may not have to take thyroid replacement hormones after the surgery, but many people do, eventually, have to, since the remaining half of the thyroid is unable to produce enough hormones to supply the body.

I've never had thyroid surgery, but I'll try to help you... what would you like to know about the surgery?