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US Thyroid Report- Questing the Endo Doctor's Approach

I started seeing a new Endo Dr. and she ordered an US but I am not sure if I should follow her wait and see approach. Need some advice.

Findings: The isthmus region is unremarkable with a normal echotexture.

Right: The right lobe measures 4.2 x 1.4 x 1.6 cm. The right lobe is heterogenous in echotexture and demonstrates multiple tiny heterogenous hypoechoic nodules, the largest measures less than 1 cm.

Left: The left lobe measures 3.4 x 0.9 x 1.2 cm. The left lobe is heterogenous in echotexture and demonstrates heteregenous solid nodule in the mid left thyroid lobe, measuring 0.8 x 0.4 x 0.7 cm.

Impression: Multinodular thyroid gland, with multiple subcentimeter nodules. Short term follow-up is recommended.

Health background: Hypothyroid for 12 years on Levothryoxine. PCP had me on Levoythroxine at 25mcg at first and then upped be to 112 mcg over the years. The new Endo doctor just changed to name brand Synthroid 150 mcg. She wants to wait 6 - 12 months for follow up US. TSH was at 2.15 last check. She wants to get TSH to 0.5-1.0. She is running repeat labs every 2 months for TSH levels. T3/T4 in normal limits. Antithyroglobulin Antibody was 212 (H) normal range was 3 - 100.

Should I be concerned about any of this or just listen to her advice and wait the 6 - 12 months for the repeat US and every 2 months TSH level....
2 Responses
Avatar universal
Your TGab is elevated, which indicates you have Hashimoto's thyroiditis.  Nodules are very common if you have Hashi's.  If they're less-than 1 cm, with no alarming characteristics, they're usually just monitored for changes.  So, your doctor's advice on the U/S is pretty standard.

Please post your actual FT3 and FT4 levels with reference ranges.  Ranges vary lab to lab and have to come from your own report.

How were you feeling before the increase to 150 mcg?  Were you having hypo symptoms? Is she only planning to test TSH every two months?  
Avatar universal
Right: The right lobe measures 4.2 x 1.4 x 1.6 cm. The right lobe is heterogenous in echotexture and demonstrates multiple tiny heterogenous hypoechoic nodules, the largest measures less than 1 cm.
lobe size normal; texture suggests inflammatory process

Left: The left lobe measures 3.4 x 0.9 x 1.2 cm. The left lobe is heterogenous in echotexture and demonstrates heteregenous solid nodule in the mid left thyroid lobe, measuring 0.8 x 0.4 x 0.7 cm.
Same as above ; nodule can form as result of inflammation ; not clinically significant based on its size.
If nodule forms in otherwise homogeneous gland it is more suspicious if nodule formed in the gland with inflammatory process
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