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Nodule treatment and causes

History: 43 yo female. During a routine neck exam from my ENT (I went there for a problem in my left ear initially) a nodule was discovered.Ultrasound found: .4cm cyst in upper rt; 2.1cm solid in med to lower rt and a .6cm solid in lower right. Left lower lobe had complex 2.4cm nodule. Blood tests: thyroid function normal. I saw an endocrinologist for 1st time today and have been told to go for repeat ultrasound at different facility, then the dr wants to look at it before ordering a FNB. Questions: Is it usualy that only the left nodule was felt during exam? Could I just have a "lumpy" thyroid (I have very large tonsils)? I gave birth 2 years ago to my second child, could this be pregnancy related? Had first child at 37 via IVF and with 2nd also developed asthma.  If FNB is not suspicious and the nodule is not interferring with breathing, etc, why would I have to have a thyroidectomy?  Then endo did not seem to give the option of removing just the nodule stating in a very casual way that it is no big deal, just take a pill a day and live a normal life....I don't want to be on medication the rest of my life....
5 Responses
649848 tn?1534637300
Many of us are on thyroid replacement hormone and will be for the rest of our lives; there are worse things than swallowing a tiny pill or two everyday.  

I think it's customary to remove the entire thyroid or at least part of it, rather than just remove the nodules.  Many of us have nodules, also and don't have to have thyroidectomy, so I'd say it's going to depend on the ultra sound and FNB.  

Did the endo say you HAD to have a thyroidectomy, no matter what?  Or was it merely "suggested" as a possible treatment if the FNB and ulra sound indicate a necessity?

Have you been tested for thyroid antibodies, which would indicate an autoimmune disease of the thyroid?  If you have one, eventually your thyroid will be destroyed and you will be on med the rest of your life anyway.  

I know it's hard, but maybe you should try to relax a bit until after the ultra sound and just take one step at a time.  

Avatar universal
You have nodules over 1 cm in both sides of your thyroid, you have both solid and complex nodules.  You need to have an FNA biopsy, although only 40% of the time that will give you a definitive result.  I had four nodules ranging from .8 cm up to 2.1 cm, the doctor could only feel one, it was not even the largest. I also had thyroid trouble after my second child was born, but it resolved after a few weeks. Not uncommon for them not to feel them.  Your levels are all fine, so were mine.  All normal except TPOab, which was an indication that I had Hashimotos.  BUT!  I still had cancer.  If you have a FNA biopsy and get an indeterminate result, you will have to remove the thyroid to get a diagnosis.  Many times they cannot see cancer until the thyroid is out and examined by a pathologist.  Barb is right, no problem living without a thyroid, but living with cancer is another story!  The nodules will not go away, you will probably lose thyroid function eventually, as my doctor/brother told me, do it now when you are young and get it over with!  As it looks, you have a 5-15% chance of being cancer, although solid are more likely to be than cystic or mixed...but my mixed nodule had the most cancer...there are no garantees when it comes to diagnosis of the thyroid.  Did the nodules have vascularity?  Irregular borders?  Both of those are more likely to be cancerous.  Please, I am not trying to scare you, but I, too, was reluctant to remove my thyroid.  I was having swallowing and hoarseness issues, though, so I had to do it for my voice, I am glad I did.  By the way, do you have a family history of thyroid disease?  My dad had Hashimotos, so does two of my brothers.  When I was diagnosed with cancer, I told my sister about how I found it, she had the same symptoms, went in and was checked...she had the SAME cancer, my younger sister has nodules and is being watched.  Get the biopsy, do some research and keep searching for answers...good luck.
Avatar universal
You know, everyone seems to have the same "take a pill" attitude as if there is no risk associated with this. I am 43 with a history of palpitations and "the pill" that everyone is referring to has the possibility of making these palpitations worse, or throwing me into uncontrolled AFIB..so then what, I take another pill so I don't throw a clot and have a stroke from the AFIB?  Both nodules are almost exactly the same in size, which does suggest that something happened to provoke them...IVF 7 years ago is the answer which warrants a watch and wait attitude since biopsy is negative.  I still don't unerstand why, when there is a logical, medically sound explanation for the formation of the nodules, the nodules alone cannot be removed.  It makes no sense to me.
Avatar universal
The biopsy was negative, but I am still going to get a second opinion on treatment since I am at the "wait and see" approach.  I will ask about the borders and vascularity.  I have no swallowing, or hoarseness issues, but I am not sure if a TPOab was done..I will have it done if not.  There is no history of thyroid disease, but my mom had a mass removed along with a partial thyroidectomy when she was 52.  My point is that many doctors have a "just remove it" attitude and I was to know why the nodules appeared first, then choose the treatment.  I had IVF 7 years ago and I h=am convinced that the ovary stimulating drugs caused the cysts since they are just about identical on both sides...with that said, why cant just the nodules be removed?  FYI: many years ago, I had a tooth ache in a molar that had a cap (from a car accident) 4 specialists I went to said "just romove the tooth"..I was in my early 30's and did not want to start with that kind of dental work (a bridge, etc)...I finally found someone who decided to test me for everything that was in that tooth, from the metals in the post to the composition of the cap...bottom line is that I am alleric to the permanent adhesive that was used to hold the cap in place.  IF my tooth was removed, then any replacement work would have had the rosin based material that I am allergic to...SOOOO I am not so much buying the "take it out" theory.....I think that this is just SOP for many MDs and surgeons.  Thank you for your input
649848 tn?1534637300
While breathing exercises may be of some benefit to help make you feel better, I do not believe that they can "get the thyroid back to normal".  

There is no cure for thyroid disease, such as Hashimoto's Thyroiditis or Graves Disease, in which antibodies are present; or in cases where the thyroid no longer works properly, you can't bring it "back to normal".  

It's not just a "take a pill" mentality here.  If your thyroid is not producing hormones, you have to replace them.  Your thyroid controls your body temp, metabolism, heart rate and other bodily functions; if your thyroid doesn't work, the rest of your body doesn't work!!  

There are a lot of us that have or have had palpitations and other heart issues.  Meds can be adjusted to help with that, and yes, some of us have to take beta blockers or something to counteract some of those effects.  It still beats the alternative.

As I said before, a lot of us have nodules on our thyroid (I, personally, have several), but don't need to have our thyroid removed.  You already said your biopsy was negative, so that would indicate that there is no need for thyroidectomy.  

By all means, get a second opinion in regards to your treatment and do a lot of research and reading.  You might also be interested in checking out the complementary medicine forum here on MH.  There are a lot of ideas that may be of help to you.

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