97953?1193367871
Mark Lupo, M.D.  
Male, 44
Sarasota, FL

Specialties: Thyroid Nodules, Thyroid Cancer


Thyroid & Endocrine Center of Florida
(941) 342-9750
Sarasota, FL
My Posts
It is best to stay on synthroid and keep TSH in low-normal range -- usually we retest every 4-5 weeks in the first half of pregnancy especially as the dose may need to increase.
In short - no. If the WBC is very low, then anti-thyroid drugs may not be an option. Your dose of MMI (methimazole) is high -- if the levels are going down, and the WBC/liver tests are acceptable, would hold the course and decrease the medication with time. I assume you are on betablocker (atenolol or propranolol). You have some eye involvement. If MMI no...
This sounds like autoimmune thyroid disease - usually hashimoto's - would test TSH and TPO antibodies if not already done. The nodule is small and assuming no other abnormalities (ie, lymph nodes) then FNA biopsy is not needed. Just repeat US in 6-12 mos.
This can improve with time - usually the first few weeks are the worse. There is a small chance of long-term low calcium that may require calcitriol but future pregnancy should be fine even in that case.
There is no right answer - since T4 has a long half-life, it is probably best to take in AM before breakfast in whatever time zone you are located.
It takes several weeks for the welling to decrease after surgery - usually by 6-8 weeks this swelling is resolved and the pressure/swallowing should improve. Would ask your doctor if you really need synthroid and if that dose is adequate.
The nodules are small and would no likely cause compressive symptoms. You didn't mention overall overall thyroid size - so if large (diffuse) goiter even with small nodules, could cause symptoms. The lymph node description is unclear, so would need to look closely at ultrasound images. The nodules seem to fall below criteria for FNA based on what you ...
were you on prednisone 5mg am and 2.5mg pm ? That is an ok dose, but many patients with hypopit do better with the hydrocortisone like you are on now but the dose may need adjustment over time especially if you are very active -- may need 25-30mg total per day and some will take 20mg AM and 5-10mg afternoon
usually synthroid in AM 30min before meal/meds but can also take at bedtime.
Please review my initial response (before the results returned) -- while 2nd TM surgery is acceptable, most situations can defer until after delivery with no change in outcome unless there is aggressive behavior/growth noted. Using levothyroxine to keep TSH slightly low is also a consideration during pregnancy until surgery done after delivery. Careful ultr...