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thyroid uptake results explained

i am a 65 yr old healthy female who had an slightly elevated sed rate for a few months. had cat scan done which showed enlarged throid which led to an US which showed bilateral nodules 2 on each side
need help interpreting my RAIU scan results:
1)grossly heterogenous radiotracer distribution with increased uptake consistent with toxic multinodular goiter
2) a focal area of decreased radiotracer within the midpole of right lobe (known 1x1.5x1.4 cm nodule)
3) large focus of mixed radiotracer uptake within the left thyroid lobe (known 5.5cm nodule)
does this require biopsy, surgery, radioactive iodine treatment or medications
tsh 0.24 t3 and t4  normal
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649848 tn?1534633700
What are the actual levels of your T3 and T4, with reference ranges?  Just because they're within the labs so-called normal ranges, doesn't mean they're really normal.  

A toxic multinodular goiter is when nodules produce thyroid hormones, independently of the thyroid.  Meaning - they don't respond to the lower TSH that's telling the thyroid to stop producing hormones.

Does the report contain an "impression" or recommendation?  Typically, they will say whether they recommend FNA (biopsy) or other action to be taken.  

Since a toxic nodular goiter is not the same as being suspicious for cancer, you won't necessarily require biopsy, but, at some point you may need surgery to have your thyroid removed, if anti-thyroid medications don't stop the nodule(s) from producing hormones.

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