Worried

[kdblack]

I recently had a MRI on my neck and they discovered "Dominant" nodule on each lobe of my thyroid and that my thyroid gland is also enlarged. It also says that my cervical lymph nodes are enlarged. I have been having some pain on the right side of my neck and you can feel a lump on that side of my neck. I was diagnosed with hypothyroidism around 20 years ago but have not been on meds for around 10 years because my TSH levels were normal. I have an appointment scheduled with an endocrinologist but it is not for a couple weeks. Any help would be appreciated. Thank you.

[Barb135]

Your symptoms all indicate hypo, but, again, that can't be determined with only TSH, as TSH is affected by many variables other than thyroid hormones.

As I've noted, less than 5% of all nodules are cancerous and if you'd been left on medication, there's a good chance they wouldn't have grown like they did.  

[kdblack]

I have an apt with an endo on the 25th for an ultrasound and bloodwork and then I assume she will want to biopsy the nodules. I have difficulty swallowing, persistent cough, pain in my neck, weight gain, dry skin, intolerance to heat/cold. Just really concerned about the nodules, especially since my lymph nodes in my neck are swollen as well. I really appreciate you discussing this with me.

[Barb135]

It sounds like your doctor was only adjusting your medication based on TSH levels which never works...

When are you planning to get new blood work done?  They can't tell you much of what's going on, without testing your thyroid hormone levels and checking to see if you have Hashimoto's... There just isn't a lot I can tell you without blood work.

What symptoms are you having?  

[kdblack]

An endocrinologist diagnosed me as hypothyroidism after testing and did an ultrasound and said I had a goiter about 20 years ago. I was on Synthroid for a long time. That dr moved away and I started seeing my family dr. Sometimes they would test my blood and say it was normal and take me off the synthroid and then other times they would say it was low and put me back on it. The last time it was checked was only the TSH and mine was 3.37. I am worried that it is cancer with some of my symptoms, especially where the lymph nodes showed up enlarged on my MRI as well.

[Barb135]

The nodules are pretty large and there's a good chance they will want to do an FNA on them, however, less than 5% of all thyroid nodules are cancer.  

I hate to say this, but you probably needed a different doctor a long time ago...  What was it that prompted them to tell you that you hypothyroidism?  If "everything" had been normal, there would have been no reason to tell you, you had hypothyroidism...

Were you on medication at one time?  If so, why were you taken off it?  

Sore throat, raspy voice, trouble swallowing are all symptoms of hypothyroidism and just because your level may fall within the normal ranges doesn't mean you don't need to be on medication...

Do you have any idea "what" thyroid levels you've been tested for? I'm sorry, but without something to go on, there's not a lot I can tell you...

If you can call your doctor and get copies of blood work to post that would be really great... you should always get copies of blood work to keep for your own records.  

[kdblack]

Thanks so much for replying. I haven't had blood work done since last year and at that time it was normal. The dominant nodules are 1.7 cm and 1.4cm one on each lobe. My appointment with the endocrinologist isn't until the 25th so I haven't had an ultrasound yet. I was told many years ago that I had hypothyroidism and a goiter but haven't been on any meds for it for the last 10 years because my levels were normal. I have a persistent cough but I am not sick and also have trouble swallowing but just assumed it was allergies or something. I also have pain in my neck on the side with the largest nodule and you can feel my lymph node as well.

[Barb135]

Is TSH the only thing that's been tested?  What about Free T3 and Free T4?  Have those ever been tested?  They are the actual thyroid hormones and correlate best with actual thyroid status. If you've had those tested, it would be helpful if you could post the actual results, with reference ranges, since ranges vary lab to lab and have to come from your own report.

Do you know if you have Hashimoto's?  Nodules are very common with Hashimoto's - many of us, here on the forum have nodules; I have quite a few of them... Do you know how large the dominant nodules are?  If they aren't large enough, they won't be able to do an FNA or anything.  The lymph nodes could be enlarged because of inflammation.

Typically, nodules are nothing to worry about unless the characteristics are unusual... Do you have a copy of the actual ultrasound report?  

Sorry to ask so many questions...

[kdblack]

Really wish someone could help me out