prolactinoma and thyroid nodules

[englishmum]

Was not sure which forum to post in as i'm new to this. Have found out lots about my thyroid problem from the forum posts. I have multinodular goitre (and a pituiary prolactinoma for which I've been on cabergoline for 8 - 9 years). Have had multi nodular goitre for 15 months and had FNA in december 2005 and 2006 and ultrasound scan last week. Scan shows 1 dominant nodule of 11 - 12 mm diameter and a smaller nodule with calcification. Is the calcification a worrying sign?
Thyroid blood tests were OK although I have symptoms of tiredness, difficulty losing weight, thinning hair.
Does anyone know if the two conditions are linked?
Thyroid/neck is becoming more uncomfortable, sometimes painful - is this usual?

Many thanks for your advice (in advance)

[utahmomma]

Okay, deep breath.

Calcification *is* a worrisome sign on nodules and most of us with thyroid malignancies have had NORMAL labs.  Have you had a FNA (needle biopsy) on the nodule or a nuclear scan to show if it is "hot", "warm", or "cold"?

I'm no expert on the endocrine system but the pituitary and thyroid are VERY closely related.  Here's some good info on both and how they interact.  
http://www.endocrineweb.com/
http://www.cumc.columbia.edu/dept/thyroid/

Please have your doctor keep a very close eye on that nodule - especially since you are feeling pressure and pain.  Please let us know what the doctors say too!!!

[englishmum]

Thank you for your reply. The nodule biopsied was the other one! Haven't had the one with calcification FNA'd. Was told at last clinic appointment that the option of surgery would be discussed after the scan. Just need to wait for next appointment now to see what they say

[utahmomma]

Let us know!  My nodule was too small to biopsy so I'm not surprised that they didn't biopsy the calcified one.  It's the small ones that you've got to watch out for (said the 5'2" woman).

Have and appointment soon?

[englishmum]

I'm only 5'4'' (!)
The doctor is supposed to be writing to me when the results are available. I guess things may be done differently in the UK where I am, as I haven't had a copy of the results given to me. They just tell you. I think I need to be asking more specific questions. Am wondering if I need to have the other type of scan (to show up hot or cold nodules), or any other blood tests. (i had 'TFT's' thyroid function tests, but am not actually sure what they measure)
Thanks for all your advice so far, everyone on the forum seems very helpful, friendly and knowlegeable. Glad I found you!

[utahmomma]

See . . . like I said, it's us little ones.  :-)

I would ask for the scan to determine the function of the nodules.  I'm going to past some references for it.  It's a radiation scan but in very low doses (compared to what some of us have to go through with RAI).

http://www.endocrineweb.com/fna.html
http://www.cumc.columbia.edu/dept/thyroid/

In the U.S. I know that the radiation scans (or thyroid scans, or I-123 testing) is done by either giving the patient a pill or a liquid to ingest.  I have heard of injections too but only in texts - haven't heard from anyone who has had the injection.  Anyway, the radioactive substance (either I-131 in low doses, I-123, or other formulas involve radioactive iodine then following to see how much is taken up by the thyroid tissue.  This will also show whether nor not the nodules are producing thyroid hormones or not.  Read the parts of the references on "hot", "warm", or "cold" nodules.  I'm not sure how the tests are done in the U.K. but it can't be that much different.

This scan won't tell you whether or not you have cancer.  Really nothing can except a lucky FNA or a full pathology report.  This test can help give your medical team more information about your nodules.  You have the small nodule with calcification, which you know is not the best of signs, if the nodule is a "cold" nodule the recommended treatment may be very different than if it is a "hot" nodule.

It doesn't hurt to ask about the testing.  Honestly, where you have already had a tumor of the endocrine system I'm surprised they aren't being a bit more aggressive with your testing and treatments.

I'm glad you found this forum too - everyone here is amazing!  I really wish I would have had this when I was going through my nodule and surgeries but better late than never!

Please let us know!!

[mamahen]

well this seems like a good place to get some answers. i was told today that i have a very small nodule i think 6mm....when doc drew it on nhis hand smaller than a pice of corn kernel...anyway my "T" tests came backl litle off so i have an rx of armor, which was what my homeopathic doc friend had said was one of the better thyroid meds if i chose to or had to take one.  anyway, with a nidule so small , should i request them to do the radioactive scan or remove this thing before it does become a problem? i didn't eve think to ask the doc until later?  this is all so new..........thanks in advance!

[cyannrod]

i have had seven lesion in my thryoid since 2005 and now o my left side my neck has three lump and is had the drink and eat and sallwoe , it hurts and i get very dizzy the size of the nodules our from the ultrsound
gland measure 4.1x1.7x1.8cm right lobe, 4.2 x 1.8x 1.4 cm left lobe, and 0.4 cm isthums. there are multiple nonspecific hypoechoic noild nodules ranging from approx 2mm to 2.5 cm greatest cross sectional  diameter. the largest nodule is a sonogrphically complex mass measuring 2.5 x 1.9 x 1.8 cm in the left lobe containing multiple cystic foci. now they will be doing a biospy on the 11th of feb . and that ok but is it going to find a problem adn help me or not? i have gain 13 pounds in the less 3 months and can not lose it.my hair is dry and my nail are brittle.and feel tried all the time so do you have any sugguestion. thank you for the time
cc from texas