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Old 04-20-2006, 07:01 AM   #1
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my story (so far)

not really sure where to begin...

I'm 35, male. Started gaining a lot of weight in my early 20s after leaving college and getting a desk job, chalked it up to that. Mother told me she was hypo and that I should get checked, but never did. About a year ago, decided I was tired of being fat and went on Weight Watchers, long story short I lost 55 lbs. I'm pretty near my optimal weight now.

Anyway, I was feeling pretty good about myself and decided to get a checkup. I hadn't had any bloodwork done for 3 years since surgery to have my gallbladder removed. So, remembering what mom said about her thyroid, asked the doc to check that as well. He seemed surprised(I guess since I'm male and was able to lose weight and not overly fatigued etc) but agreed. Had my blood drawn in early Dec '05. Everything was very good except my TSH was 25. Doc(GP) was very surprised by this and suggested I wait a couple months and test again, early Feb. '06, TSH was 21. At that point he put me on 75 mcg of generic Levothyroxine. I didn't really notice too much change except maybe a little more energy in the morning. After researching symptoms a little more realized, I had cold hands and feet, irritability, depression, anxiety, some constipation, hearing problems, dry skin and fatigue(but only when I didn't get enough sleep).

Early April, had my levels checked again and TSH was down to 15 but my GP didn't feel he could treat me adequately, so suggested I see an Endocrinologist. I had that appt last Friday...saw a very nice and attentive doc that spent 45 mins with me, changed my meds to Levoxyl 112 mcg and recommended an ultrasound. I ended up getting that Friday afternoon. Got the US results on Monday, 1 cystic/complex nodule, 29mm(2.9 cm) and others that were less than 1 cm. Endo has recommended a U/S assisted FNA on the 2.9 cm nodule and any others that they see are > 1cm.

So, that's where I'm at. I'm pretty new to this but because of prior health anxiety issues, I've done some reseach already. I know there is a chance I have some form of thyroid cancer, but the risk is fairly small(5-10% chance?) and even if I do, it's likely it's a very treatable kind....right? I feel I am with a good doc now and I do feel a little better taking the upped meds even if it's only been a few days. I'm having the FNA next Thurs, so I guess I'll know more then. Any opinions on my situation? Anything I'm missing? Thanks in advance.

 
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Old 04-20-2006, 07:08 AM   #2
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Re: my story (so far)

Glad your GP KNOWS it is out of his league! They are RARE. Sounds like you know how to do your homework! Yep - FNA on nodules over 1 cm are standard.

Didn't they do any antibody tests for hashi's or graves? How about T4, T3, Free T4, FreeT3 (frees are more important than total T4 and T3)?
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Old 04-20-2006, 07:11 AM   #3
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Re: my story (so far)

It's great that your doing research for yourself, you might find out a bit more about your situation, and be more able to understand what is going on with you and your body as well as with the things the doctor is suggesting you do. I'm glad that you are seeming to handle this so well. I hope that everything goes well for you. I wish I really understood your situation better, but since I have really know clue about what you are going threw, just a word of encouragement, Take care of you, seems that you are doing well as of so far.

 
Old 04-20-2006, 07:24 AM   #4
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Re: my story (so far)

Quote:
Originally Posted by illmakeit
Glad your GP KNOWS it is out of his league! They are RARE. Sounds like you know how to do your homework! Yep - FNA on nodules over 1 cm are standard.

Didn't they do any antibody tests for hashi's or graves? How about T4, T3, Free T4, FreeT3 (frees are more important than total T4 and T3)?
yeah, I like my GP a lot...I don't expect him to know everything and he has no problem telling me when I need to see a specialist.

No antibody tests so far. I know they did some T3 and T4 tests but I don't have them in front of me, I'm pretty sure the T4 was lower than it should be. I'm guessing they did total T3 and T4. At my first endo appt he had me set up an appt to recheck my thyroid levels in 2 months plus things like cortisol and a CBC(more that I can't remember as well)...this was before we had the U/S results though.
Should I be asking for antibody and free T3 & T4 tests?

so what can I expect from the FNA, I've heard it's really no worse than a blood draw or injection. I've had moles and cysts removed before, I assume the procedure will be similar to that. Am I right about the chance of cancer being 5-10%? The endo told me on the phone that there was a 95% chance the nodule would be fine but that it was fairly large(does that matter?). Thanks again.

Last edited by amr5150; 04-20-2006 at 07:29 AM.

 
Old 04-20-2006, 07:26 AM   #5
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Re: my story (so far)

Quote:
Originally Posted by lookin4aclue
It's great that your doing research for yourself, you might find out a bit more about your situation, and be more able to understand what is going on with you and your body as well as with the things the doctor is suggesting you do. I'm glad that you are seeming to handle this so well. I hope that everything goes well for you. I wish I really understood your situation better, but since I have really know clue about what you are going threw, just a word of encouragement, Take care of you, seems that you are doing well as of so far.
I'm probably coming across as handling it a little better than I actually am, but I've been through some scares and I'm getting better at coping. I'm a lot more rational than I used to be and it seems that the chances of a favorable outcome are pretty good here....that's my hope anyway.

 
Old 04-20-2006, 08:08 AM   #6
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Re: my story (so far)

Yes you should have your Free T4 and Free T3 and antibodies done. They tell if it's one thing or another, and most docs refuse to do them without a bit of pushing from the person needing it. At least the Free's. They are very important. Because if they only test the TSH your Free T4 could be off. and if the T4 is not converting into T3 then the Free T3 needs to be tested as well, there all pretty much needed. I do beleive that the antibodies can also tell if it is cancer, not sure about that! I think that is what I saw once!!(I think, but don't take me to the bank on that!)

Last edited by lookin4aclue; 04-20-2006 at 08:09 AM.

 
Old 04-20-2006, 08:30 AM   #7
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Re: my story (so far)

Hi,
amr5150: Cancer of the thyroid is rare! If it is cancer, the cure rate is almost 100% except for one kind - and IT is VERY VERY rare. The size of the nodule doesn't matter. Many many people have very very large nodules removed and they are not cancerous. We had a whole thread on FNA a while back, try searching at the top right of the thyroid board for "FNA" - hopefully you can find it. Everyone was telling how theirs were done - their whole experience.

Lookinforaclue: You're right, in my opinion, about the T4's and T3's. However, the antibody tests tell you if you have an autoimmune disease but cannot tell about cancer. An FNA in a nodule can possibly detect cancer and of course a biopsy can too. There seems as if there is another way but I can't remember what it is - but I didn't think it was worth going that route since I had to have a large nodule removed anyway. I don't THINK there is a blood test that can detect cancer of the thryoid at this time.

Hey guys - IF I AM MISTAKEN - please correct me!!!
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Last edited by illmakeit; 04-20-2006 at 08:32 AM.

 
Old 04-20-2006, 09:04 AM   #8
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Re: my story (so far)

thank you both so much for the information...I'll look for that FNA thread.

 
Old 04-20-2006, 09:52 AM   #9
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Re: my story (so far)

I think that what I had read was something to do with tests that the doc would do, if one thing came out this way then they should do these tests and so on and so forth, until it came to some results and if the results showed something then they should test for cancer, that is what it was. Thanks for the info. I'm sure your right. I know about the antibodie tests. I have Graves. Man what a name, it sounds so morbid.

 
Old 04-20-2006, 10:18 AM   #10
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Re: my story (so far)

They can also tell if you have Hashimoto's (very common cause of hypothyroidism) when they do the FNB. They can also tell by testing for antibodies. But the FNB is a better test because you can have Hashimoto's without having antibodies. (about 10% of the time)

There is also a test to check if the nodule is "hot" or "cold". If it is "hot" the chance of cancer is almost nil. If it is "cold" there is a little more chance, but it can still be benign.

I had the FNB. My nodules were fairly large. One was 1.5 and the other was 2.0. They were benign. And the FNB was not a bad procedure at all. It only took a few minutes. My neck was a little sore for a few days. Search at the top for "FNA". If you know what to expect it won't be as frightening. They deadened both sides of my neck with a shot and that didn't hurt.....felt about like getting a tooth deadened. Then the rest you really don't feel. A few on here have had it done without the deadening and said it hurt some. Call before you get the procedure done and talk to the one that does it and ask them to explain exactly how they do it and ask for the deadening shots and you will be more relaxed and it will not be bad at all.

 
Old 04-20-2006, 11:39 AM   #11
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Re: my story (so far)

hmmm....that is good to know, I didn't know that. Thanks for the info

 
Old 04-20-2006, 11:44 AM   #12
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Re: my story (so far)

thanks for all the great information, it will be nice to know if I have Hashimoto's or not, although I'm not sure how it will affect future treatment, etc.

I did ask about the FNA when I called to schedule the procedure and they will be using local anesthesia and using an ultrasound for guidance...the lady told me they will insert 5 or 6 needles into my thyroid and someone from the lab will be present to make sure enough of a sample is taken...

thanks again.

 
Old 04-21-2006, 01:24 PM   #13
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Re: my story (so far)

wishing you all the best with your upcoming FNA ultrasound...your story is interesting and its something how thyroid runs in our families...its in mine...thank goodness you got your thyroid checked...please let us know what happens!

 
Old 04-27-2006, 09:13 AM   #14
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Re: my story (so far)

I've got my FNA this afternoon, a little nervous, but anxious to find out more about my situation...I'll post when I get some results. Thanks again for all the help.

 
Old 04-28-2006, 07:57 AM   #15
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Re: my story (so far)

had my FNA yesterday afternoon. Guess I will have results sometime next week. Had a very nice nurse and ultrasound tech. The tech let me see the nodule on the screen, he said it was about 2.5 cm and looked mostly cystic(not sure if that is favorable or not). He let me watch when the doctor was inserting the needle etc, was kind of neat at first but I grew tired of watching it. They took 3 samples and then sent them to the lab to make sure there was enough tissue. They didn't get enough on the first pass and had to take 3 more samples. As he was inserting the needle for the 6th time it started to get annoying. Second time they got enough and I was done, thankfully...my neck is a little sore today but overall not a bad procedure.

 
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