Hot Nodule

[Lori0220]

My doctor found a low TSH reading in a routine test.  Since then T3 was found to be high and a radioactive scan & uptake was done and the cause is a hot nodule on one side.  The surgeon said he felt a second nodule on the other side.  That one is presumably cold since it wasn't on the scan.  Today's ultrasound showed a heterogeneous appearance with all sorts of diffuse darker areas on both sides.  The endo seems to lean toward radiation.  The surgeon suggests surgical removal of the whole gland.  They don't seem to agree on much.  The endo says 80% taking radiation become hypo.  The surgeon say more like 20%.

Either way, I may well end up trading hyper for hypo according to what they tell me.  Aside from occasional slight shaking in a couple of fingers, I don't really have any symptoms.  I feel pretty good.  Given that I feel OK, do I need to treat it?  If so, should I have the whole gland removed or just the side that's hyperactive now?  Is radiation a better option than surgery?  I hate to remove or destroy the half that working and I am getting conflicting answers about the possibility of avoiding being hypo with either treatment.  Is there a treatment option that offers a chance to solve the hyperactivity without getting hypothyroidism?  The weight gain that comes with hypo is another fear since I am already overweight and struggling to lose the excess.

Frankly, the whole thing scares me.  I want to do the best thing for my long term health, but with all the conflicting information, I'm not at all sure what the best thing is.  Any insights will be greatly appreciated!

[michele710]

Does anyone know what it means when you have about six hot nodules but one cold? I was dx with Graves based on labs including antibody testing. Waiting to get levels normal before biopsy. Do you think would be concerning for Ca?

[mags59]

I had the same tests done.  As far as I know, these are the correct tests.  I had a hot nodule that was causing hyperthyroidism as well.  I had surgery to remove the left side of my thyroid since the nodule grew to take up the entire side (my right side stayed put, so I didn't go hypo).  At first (before the surgery), though, I had very little symptoms, but as time went on I got very bad tachycardia (rapid heartbeat) and high blood pressure.  Even after the surgery, I'm still on heart medication (beta blocker).  My suggestion would be to take care of it right away before it does permanent damage like mine did.  Radioactive Iodine will usually destroy the entire thyroid.  With surgery, they can just remove the part that's a problem and look to make sure the rest is okay.  It's up to you, of course, but if you're unsure, maybe you should get a second opinion from a different endo or surgeon.

[Lori0220]

30 years ago?  They gave me the impression these tests were the latest thing.  What's available that's newer?

[898]

The ultrasound image can be good step now to see what 'nodule' was felt on the other side. Based upon ultrasound finding , size and types of nodules the decision about the  treatment should be made.
How come the doctors are making their recommendation based upon 30 year old diagnostic methods????