nodular thyroid, biopsy?

[coralmarina]

Hi! I am a 20 yr old female diagnosed with hypothyroidism on January 2011. I went to the doctor for a routine test, and because my mother has hypothyroidism, my doc annually checks my TSH levels. I went to the lab to have my blood test that particular day because I felt good and haven't been sick in some time. To my surprise, when I received my results, everything was normal except my TSH, it was 20.20 but my T3, T4 and T7 were normal.

T3-U - 33.98 %           Range: 22.0 - 40.0
T4 Total - 6.70 ug/dL   Range: 4.50 - 12.0
T-7 - 2.28                   Range: 1.20-4.70

I was in shock, I felt completely normal, no symptoms, nothing. My doc prescribed me Synthroid 0.025mg and told me to get my TSH tested again after 6 weeks of treatment. I started taking the pill and I didn't felt any change at all, not better, not worse. At the 4th week of treatment I started feeling different, I had two episodes of high blood pressure (chills, felt like i was going to faint) and started to feel a lump in the front-right side of my neck and it causes pain and discomfort whenever i apply pressure on that side when I bent down, make some force, tilt my head, talk loudly or laugh.

After 6 weeks I got  tested again and everything was fine, my TSH was 1.74 and my T3, T4 and T7 were normal again.
T4 Total - 9.60 ug/dL                     Range: 4.50 - 10.90
TSH 3rd Generation - 1.74uIU/ML   Range: 0.51 - 6.27
FTI - 2.81                                     Range: 1.01 - 4.03

Then, the doc gave sent me to do a sonogram. The results say: Thyroid gland diffusely heterogeneous and nodular in echotexture bilaterally in a symmetric fashion. Isthmus measures 0.4cm. Right lobe measures 1.8 x 2.8 x 4.3cm and left lobe 1.9 x 2.2 x 4.4cm. No suspicious solid nodules on either side. A tiny cystic lesion is seen in the left gland laterally, at the mid pole in measuring 0.3 x 0.4 x 0.5cm. No abnormal lymphadenopathy. Small sublingual nodule is identified measuring 0.7cm and small submandibular lymph node is seen measuring 0.7cm and a level III nodule is seen measuring 1.2cm.

The thing is, I am having concentration problems and have failed all my college tests this semester, I can hardly say I feel good, every day I wake up feeling groggy and am always tired and restless.  In addition to the two episodes of high blood pressure, I had a particular situation that thought it was pretty weird, I was taking off my hoodie jacket and it got stuck on my head so i had to pull harder to get it off and immediately after that I started feeling very sick, the front-right side of my neck started to hurt and i felt i had a golf ball in there! (but no choking sensation) I got dizzy and started to almost hyperventilate.

My doc referred me to a head and neck surgeon because she wants a biopsy of the thyroid tissue because my thyroid is very similar to my mother's and for the symptoms I have. Should I get the biopsy or it is not necessary at this moment? What do you think about my results?

[ChitChatNine]

Hi,

How are you feeling . .did you get any more info from your doc?

C~

[coralmarina]

I searched about what meant level III nodule and from what I could find it means a specific region of the neck.

Terminology of Lymph Node Groups:
Level I submental, submandibular
Level II upper jugular
Level III middle jugular
Level IV lower jugular
Level V posterior jugular
Level VI paratracheal, perithyroidal

[898_1]

The ultrasound needs more clarification about the lymph nodes a a statement about "level III nodule is seen measuring 1.2cm" in contradiction with statement "No abnormal lymphadenopathy" In general the thyroid looks inflammed (the lobes are "fat" rather then "long".) you may have to get a bllod test for the TPO antibodies and ask for more details what biopsy shopuld be used for (lymph node level III (at the base of the neck can be a possible place)