Re: Small Complex Nodules - 1st Endo visit - need advice

[Guest guest]

They won't do an FNA below 1CM. Six months is the norm between

ultrasounds. I was going every six months for two years. I'm now at a

year because there as been no growth. I have had one more 3 mm one appear, but

my largest is now under 7mm.

Are you on thyroid replacement? If so what dose and how long? What symptoms?

Kate G

At 01:50 PM 4/15/2008, you wrote:

Hi everyone, I'm new to the board. My PCP ordered an ultrasound on my

thyroid after a routine visit and it showed two small (5mm and 9mm) " hypoechoic

complex nodules " on the right lobe. He told me to see

and endocrinologist, which I did yesterday. The Endo didn't seem

concerned about the nodules and even surprised they did an ultrasound

as he couldn't feel anything on my thyroid. He wants me to come back

in 6 months and see if he can feel anything then.

Because it is not 1cm, there are likely endos who will do the wait and

see thing. My fiancee wants me to get a second opinion and thinks they

should just do the FNAB.

I'm curious to what everyone here thinks? Thanks!

[Guest guest]

If you are not currently hyper, the first thing I would want to try is to attempt to shrink the nodules with a suppressive dose of thyroid hormone. That is a dose which brings your TSH down below the bottom of its range.

Are you currently on any thyroid meds? What do your labs look like?

I would lose that endo.

>> Hi everyone, I'm new to the board. My PCP ordered an ultrasound on my > thyroid after a routine visit and it showed two small (5mm and > 9mm) "hypoechoic complex nodules" on the right lobe. He told me to see > and endocrinologist, which I did yesterday. The Endo didn't seem > concerned about the nodules and even surprised they did an ultrasound > as he couldn't feel anything on my thyroid. He wants me to come back > in 6 months and see if he can feel anything then. > > Because it is not 1cm, there are likely endos who will do the wait and > see thing. My fiancee wants me to get a second opinion and thinks they > should just do the FNAB.> > I'm curious to what everyone here thinks? Thanks!>

[Guest guest]

I would add that I would not be in a hurry to do an fna before suppression, if appropriate, is attempted.

But a second opinion never hurts.

>> Hi everyone, I'm new to the board. My PCP ordered an ultrasound on my > thyroid after a routine visit and it showed two small (5mm and > 9mm) "hypoechoic complex nodules" on the right lobe. He told me to see > and endocrinologist, which I did yesterday. The Endo didn't seem > concerned about the nodules and even surprised they did an ultrasound > as he couldn't feel anything on my thyroid. He wants me to come back > in 6 months and see if he can feel anything then. > > Because it is not 1cm, there are likely endos who will do the wait and > see thing. My fiancee wants me to get a second opinion and thinks they > should just do the FNAB.> > I'm curious to what everyone here thinks? Thanks!>

[Guest guest]

I have no symptoms and am not on any meds. The endo ran a full

thyroid panel yesterday and told me to call tomorrow for the results.

Every other time, they have come back in the normal range and I

suspect they will again.

Thanks everyone for replying, at the very least I think a second

opinion will ease my mind and am hoping for a better ENDO as well.

> Hi everyone, I'm new to the board. My PCP ordered an ultrasound on my

> thyroid after a routine visit and it showed two small (5mm and 9mm)

" hypoechoic complex nodules " on the right lobe. He told me to see

> and endocrinologist, which I did yesterday. The Endo didn't seem

> concerned about the nodules and even surprised they did an ultrasound

> as he couldn't feel anything on my thyroid. He wants me to come back

> in 6 months and see if he can feel anything then.

>

> Because it is not 1cm, there are likely endos who will do the wait and

> see thing. My fiancee wants me to get a second opinion and thinks they

> should just do the FNAB.

>

> I'm curious to what everyone here thinks? Thanks!

>

[Guest guest]

So when you look at a thyroid symptom check list...you have none?

Kate G

At 06:09 PM 4/15/2008, you wrote:

I have no symptoms and am not on any meds. The endo ran a full

thyroid panel yesterday and told me to call tomorrow for the results.

Every other time, they have come back in the normal range and I

suspect they will again.

Thanks everyone for replying, at the very least I think a second

opinion will ease my mind and am hoping for a better ENDO as well.

[Guest guest]

Looking at the symptoms, the only one I could say I have is being tired

but, I can easily attribute that to working full time, raising two kids

and being inactive. I wouldn't say I'm so exhausted I have trouble

doing things. My primary care physician ordered the bloodwork and

ultrasound after feeling my neck. I'm not sure if he felt a nodule or

just thought it felt enlarged. I should have the most recent bloodwork

results the endo ordered later today.

> I have no symptoms and am not on any meds. The endo ran a full

> thyroid panel yesterday and told me to call tomorrow for the results.

> Every other time, they have come back in the normal range and I

> suspect they will again.

>

> Thanks everyone for replying, at the very least I think a second

> opinion will ease my mind and am hoping for a better ENDO as well.

>

[Guest guest]

Well, I finally got a copy of the most recent labs and here they are:

TSH = 1.304

T4 = 15.6

fT4 = 4.7

T3 Uptake = 30%

T3 = 180

According to the lab sheet the T4 is high but all others were in

the " normal " range. I read that the free T4 is more important than

total T4, is that correct?

One thing I'm curious about, with reading about the microcarcinomas,

why does it have to be over 1cm or even 1.5cm before some endo's will

order the biopsy?

[Guest guest]

Can you post the lab range for the Free T4? The FT4 and FT3 are the most

important...but I see no FT3.

Free is the UNBOUND hormone ready for your body to use.

It has be over 1cm to get a good amount of tissue to use. Thyroid cancer

in all but one is very, very, very slow growing. The one type that is a

fast mover makes up less than 1% of ThyCa. Also nodules happen with

age...healthy people can have them. But I wouldn't wait until 1.5 cm for

an FNA...I'd see another doctor.

I have four nodules. Have had three of them for at least four years. I

don't worry..I just follow up. My sister is a ThyCa survivor.

Kate G

At 03:25 PM 4/21/2008, you wrote:

>Well, I finally got a copy of the most recent labs and here they are:

>

>TSH = 1.304

>T4 = 15.6

>fT4 = 4.7

>T3 Uptake = 30%

>T3 = 180

>

>According to the lab sheet the T4 is high but all others were in

>the " normal " range. I read that the free T4 is more important than

>total T4, is that correct?

>

>One thing I'm curious about, with reading about the microcarcinomas,

>why does it have to be over 1cm or even 1.5cm before some endo's will

>order the biopsy?

[Guest guest]

The lab range for the Free T4 is 1.2 - 4.9 and my level was 4.7

There is no free t3 listed on the lab report. The total t3 range is

85 - 205 with mine at 180. Total T4 range is 4.5 - 12 with mine high

at 15.6

>

> Can you post the lab range for the Free T4? The FT4 and FT3 are

the most important...but I see no FT3.

>

> Free is the UNBOUND hormone ready for your body to use.

>

[Guest guest]

Your FT4 is " in range " , but you need the FT3 tested too for the full

picture. Total T4 is the bound hormone....it is not released for your body

to use. Someone correct me if I'm wrong, but can't that be an indication

of possible conversion problems.

Kate G

At 08:53 AM 4/22/2008, you wrote:

>The lab range for the Free T4 is 1.2 - 4.9 and my level was 4.7

>There is no free t3 listed on the lab report. The total t3 range is

>85 - 205 with mine at 180. Total T4 range is 4.5 - 12 with mine high

>at 15.6