Thyroid Goiter

[Alexis8368]

Hello:

41 y/o female, all thyroid related blood work within the normal range (but on the low end of the normal).
Squeezing sensation in my neck prompted a thyroid ultrasound, which found 2 small nodules and one 1.2 cm nodule that required an FNA.

I had an FNA of the 1.2cm nodule on 6/28/10, below are the results:

Negative for malignant cells, favor nodular goiter.
The slides show benign appearing clusters of follocular cells together with abundant colloid. Although the appearance would be consistant with nodular goiter, clinical/radiologic correlation is recommended.

I have not spoken with the doctor yet.

My questions are:
1) What type of specialist should I follow up with?
2) What is the usual course of action based on the above diagnosis?

Thank you~

[mammasluv2]

Hello, I was recently diagnosed with Hashi's and have a large goiter that is 6.4cm long...My Endo did me the same way as far as blowing me off, until he saw the ultrasound and saw how many small nodules I had.  He didn't see a dominant nodule, so he prescribed me 160mcg Synthroid (was already on 150mcg) to see if we could "shrink" it. He did say, however, that he didn't think it would shrink.  The Synthroid is supposed to have a chance in keeping the goiter from growing larger though, from what all I have researched. I would suggest getting a different Endo and getting a second opinion.
Take a copy of your PCP records, your ultrasound, and your FNP.  Let them know that you are suffering from the symptoms and that you have a family history of Hashi's and BE FIRM in treatment!!!  I would also, personally, continue on the Synthroid that your PCP prescribed, just to begin feeling better and to keep it from growing.
I hope this helps and I will be praying for you. I know exactly what you are going through and I wish other's knew as well so they would help us! Melissa

[Mark Lupo, M.D.]

The FNA was straight-forward benign.  Ultrasound followup in 6-12 months is fine.
The synthroid question is less clear -- would consider checking TPO and Tg antibodies (for Hashi) and clarify what "low-normal" means.....if this means borderline or slightly high TSH (>3-4), then treating is reasonable but not manditory.  If the TSH is already <2-3 and the antibodies are negative, then no reason to treat.  Lastly, 125mcg is a large start dose for borderline low levels....

[Alexis8368]

Thanks Melissa!

I havent started the synthroid yet.. still waiting to talk to my doctor (pcp) about the dose.
Originally, on the phone the other night- I thought he said 125mg., but when I researched that- I see that is a high dose to start with. He will be back in the office next week and we will discuss it then. My pcp was hoping that the endo would concur with his idea of me going on the meds, but since my endo said no- perhaps my pcp will want a 2nd opinion before starting me on meds.I am lucky, because this was caught very early and the goiter is still very small- I would like to keep it that way!
Can you tell me, has the meds helped with your symptoms? Due to my blood work, I have no been diagnosed with HD- but I know it is coming in the future.

~Alexis

[Alexis8368]

Hello All: (( adding to my post from earlier today with Dr. update ))


My recent FNA results indicated that a 1.2cm nodule on my left thyroid was a Goiter. I have two smaller nodules (mm) as well. My PCP wants to treat with Synthroid, 125 mg. per day. My endo just had his office call me and tell me to follow up in 6 months, no meds. So far, my blood work has been normal, but in the low end of the normal range. My sister has Hashimotos and is being treated for it. I have many of the Hashi symptoms.
I really didnt like my visit with the Endo to begin with, he outright told me that based on my blood work I do not have a thyroid condition, but he would send me for the FNA biopsy of the nodule to r/o cancer.
My PCP seems to think it is better to get me on meds to avoid the goiter growing, or to at least slow the growth.
I found this out all because I was having this pulsing/squeezing sensation in my neck and insisted on a thryoid ultrasound, which found the nodules.

My question is: Is taking Synthroid 125mg. a viable treatment option for this? I would really LOVE to feel normal again!

Thank you~