benign thyroid nodule and lab work

[nicoleT3]

I had a biopsy of a nodule on my thyroid 5/26/15.  Just got results back of "consistent with a benign thyroid nodule with cystic change and suggestion of an underlying lymphocytic thyroiditis."  "Low cellular aspirate consisting of a few small clusters of thyroid follicular epithelial cells in a backround of a moderate amount of colloid, few macrophages, few lymphocytes and few lymphoid tangles.  "suggest clinical and radiologic correlation and follow up as indicated"

So also my blood work was tsh 1.18 (range .4 to 4.5)  and free t4 1.1 (range .8-1.8).   They didn't test anything else, despite how I am feeling and the fact that I presented in January with a goiter (fluid filled cyst).  Had that drained, found another nodule to which these are the results for.

Doctor visit today they said you don't have cancer and sent me on my way.   What do I do now?  Just suffer with how I am feeling?  Please help!

[nicoleT3]

I saw my primary this afternoon who cares more than this endo.  He is testing cbc, comp metabolic, b 12 , d, folic acid serum, lipid panel, tsh and ft4. He is sending me to a new endo who hopefully will test my free t3 like you said.  I just really want to feel normal again.

[Barb135]

Unfortunately, I'm not an expert at reading biopsy results, but it does say there's the suggestion of thyroiditis... What "followup" was recommended?  

Your FT4 is only at 30% of its range; most of us find that we need FT4 about mid range, which using the your reference range would be about 1.3, so you're on the low side.  Unfortunately, your doctor didn't order the most important test, which is FT3.  FT3 is the active thyroid hormone that's used by every cell in our body.  You should also ask to be tested for thyroid antibodies to determine if you have Hashimoto's Thyroiditis, which is an autoimmune thyroid disease that ultimately destroys the thyroid.  Those antibody tests are Thyroid Peroxidase Antibodies (TPOab) and Thyroglobulin Antibodies (TgAb).  You need them both, because they are both markers for Hashimoto's and some of us have one or the other, some have them both.  

It's not unusual to have Hashimoto's and symptoms of hypothyroidism for years before regular labs (TSH, FT3 and FT4) indicate a problem.

Many doctors only look at TSH and quite frankly, yours is picture perfect.  For the few that look beyond TSH, all they care about is whether or not the thyroid hormone levels are "in range" and admittedly, your FT4 "is" in range.  Unfortunately, all that does nothing for your symptoms, so my suggestion is to find a different doctor who will take your symptoms more seriously than the labs...

Along with the FT4, FT3, TSH, and the 2 antibody tests, I'd recommend that you ask to be tested for Vitamins B-12 and D, plus ferritin.  Ferritin is the iron storage hormone and both iron and vitamin D are necessary for the metabolism of thyroid hormones.  Vitamin B-12 deficiency can cause the most horrendous fatigue you could imagine, which is also one of the primary symptoms of hypothyroidism.