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Old 03-18-2011, 07:33 PM   #1
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New here and concerned

Hi there.

New here and I have some concerns. I had an MRI on my upper back a few weeks ago and a mass was discovered on my thyroid. I understand that they are quite common.

I am seeing an ENT doc on Monday. I am awaiting the results of my bloodtests ordered by primary doc a few days ago, but 3 months ago things were normal.

Anyway, I picked up the CT scan and report today so I can take it with me Monday. Here is what it says.

"Right thyroid lobe mass (4.3 x 1.7 x 1.8 cm) is not vascular and is essentially benign at this time. In the inferior midportion shows relative hypoechoic mass shows normal vascularity (no evidence of hypervascularity).

A 3.9 x 1.5 x 1.5 cm left thyroid lobe, which shows no significant vascularity."

After doing research I understand that not being vascular is "good" so to speak, but being hypoechoic is more characteristic of malignencies. Although I realize that thyroid cancer is quite rare and two of the three kinds are "easily" dealt with through surgery and then lifelong medication. I also understand that a needle aspiration will likely be the next step.

My questions are if I should worry about this report, and if others have received similar info. How long does it take to get the bioposy results back once they do it? If there is no sign of cancer cells will they try to shrink it with medication or will they want to remove it anyway due to its size? If surgery becomes the best plan how rough is the recovery? How much time before one feels good enough to work again (my job has me running conference calls-- I work from home-- several hours a day)?

I virtually had no symptoms a month ago, but I now have a mild sore throat that never really goes away. Now that I know about this, some other things make sense.... I have been ultra-good about dieting to virtually no avail (grrr). Very dry skin and this past month my period was very heavy (yet they have been light for several years as I've aged), and ongoing constipation. My energy level is good, but I take estrodiol and test/progest cream for low hormones (peri-menopause).

Anyway, sorry this is so long but any guidance anyone might have is much appreciated.

Jill

 
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Old 03-19-2011, 09:34 AM   #2
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Re: New here and concerned

Sorry- I should have introduced myself too! My name is Jill (age 45), I live in Phoenix, AZ and am married with 2 girls (ages 10 and almost 4). I work full-time as a project manager for a for-profit university, working from home (I am very blessed in that regard, among others, of which I am very grateful). We are big animal lovers and have: 3 dogs (Great Dane, black Lab, and Puggle), a bearded dragon, teddy bear hamster, and a 55 gallon salt water fish tank. Makes going on vacation tough!

Thank you, in advance, for any input on my concerns. :-)

 
Old 03-19-2011, 03:11 PM   #3
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Re: New here and concerned

You will know the results within a few days. My doc called me at home one night during dinner and said it was benign but because we have T cancer in our family he wanted it OUT lke yesterday. We let Christmas go by and did surgery very quickly.

I too had a mass discovered on one lobe by accident when they were ultra sounding my neck lymph nodes.
They did the needle biopsy which was inconclusive. My doc felt a needle biopsy was not enough.

I had been gaining weight, choking on food and felt sluggish and unmotivated by life. I had a very busy life at the time and felt bogged down by it and thought I was just getting old!

He took out one lobe and I was in hospital one day and night. You will have a scar across your neck which may look scary for awhile. I wore things that covered it up. The black thread dissolves over time and the scar itself will become invisible after about 6 months to a year. They cut on a fold already on your neck. No one knows I have had this surgery unless I mention it.

Pain is very minimal. You may feel like a sore throat tho. My choking issues eased up right after surgery.
I have to take synthroid and recently cytomel to compensate for my lack of full T gland. I just can't get along without it.


However, it takes time to get your meds adjusted. I am still going every 3 months and getting tested.
If you had your surgery on a Thursday and went home on Friday you would be able to go to work on Monday!

Are you feeling bad now? I too was shocked to hear I had a mass. With T cancer in my family I had no choice but to go ahead. I didn't realize how bad I felt until I started meds and felt better. The mass was sucking up all the thyroxine in my blood so it could grow I guess.

Last edited by golfhat; 03-19-2011 at 03:16 PM.

 
Old 03-19-2011, 05:37 PM   #4
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Re: New here and concerned

Thank you for the reply! Yes, I am having some issues such as minor sore throat pain and a major problem losing weight despite being very good and moderate exercise. I think you have good points about getting it over with and having them removed rather than worry about it. Especially if you have to do the meds anyway, and they don't tend to shrink on their own with meds. It's SO good to hear that I could have surgery on Thursday and be working on Monday. That's really important as I run several conference calls each day. Not a lot of "down time" when I'm not on the phone.

I will post again what I find out. Thank you, again, for the info. Much appreciated!! :-)

 
Old 03-20-2011, 07:00 AM   #5
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Re: New here and concerned

Hi!

Your masses are quite large. They can be benign, the result of thyroid disease, but I'm surprised you have no compression symptoms of such a tremendous mass "shmushed" in your neck.

Those are large masses growing out of control, and they can grow down into your chest and possibly already wrap themselves around your trachea.

You are going to have to face surgery in this case. If these were cancer, which I doubt, keep in mind this is a very treatable and usually curable cancer. I had it over 6 years ago, and thankfully I'm fine. I had an easy surgery, and I have no scar that is noticeable even to neck surgeons.

Considering the size of your nodules, I wouldn't let an ordinary ENT touch it. I would go to either a cancer center, or university hospital, and look for a thyroid specialist. This is going to require more expertise than the typical thyroid remover. You can have a needle biopsy, but on masses that large, they won't get enough cells. Unfortunately, you've got to get these out. But you can replace the thyroid with hormone pills, as many people who even have thyroids take. You are going to do very well, just get great care.

 
Old 03-20-2011, 09:18 AM   #6
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Re: New here and concerned

Face surgery? Could you elaborate?

So before I booked the ENT appt I called around to try to get in to see an Endocronologist. They were booked WAY out so that's when I made the ENT appt. However, an Endo offc called me back and I have that appt a week from tomorrow. I'm thinking I should go to both to get two opinions if nothing else.

Thoughts?

Thank you for the input, Reece!

 
Old 03-20-2011, 10:14 AM   #7
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Re: New here and concerned

I meant you would have to "face the fact" that you will likely need surgery, not surgery on your face........

I would see both the endo and ENT, but the endo. doesn't remove the thyroid, the ENT does, so you do need both in general, especially if you will have the thyroid out, you need the endo. to manage your medication. But don't necessarily go with the first ENT---ask the Endo for the best thyroid surgery specialist he/she knows.

 
Old 03-20-2011, 11:52 AM   #8
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Re: New here and concerned

Oh, LOL. Man, this is what happens when a person is stressed! Thank you again for the advice. :-)

 
Old 03-21-2011, 11:19 AM   #9
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Re: New here and concerned

Thank you for the info and sharing your story. Considering how large mine are I am really thinking I want them OUT. But I know getting the thyroid hormone levels can be very challenging. Both scare me, frankly.

 
Old 03-22-2011, 12:10 PM   #10
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Re: New here and concerned

Saw the ENT yesterday (seeing Endo doc next week). Also got my bloodwork back.

ENT doc said we will do fine needle biopsy, but, basically he would be very suprised if they are cancerous. I have multiple nodules and they have normal vascularity. At this point he thinks surgery is overkill and the risks outweigh the benefits unless they get out of control (e.g. become uncomfortable). He wants me to see the Endo doc for a 2nd opinion and to discuss meds. After the biopsy he said we can talk about meds to possible shrink them, or at least keep them from growing more. He also wants to repeat the U/S every year.

Here are my bloodtest results. All were noted to be "in range."

T3: 29.4
T4: 6.2
T7: 1.8
TSH: 1.02
T4: .9

They also tested my female hormones and everything was normal except DHEA was 266 (normal range is 32-240) and Testosterone was 85 (normal range 2-45). I am on Estradiol and a Progesterone/Testosterone cream so I have a call into my PC doc to ask about whether the cream needs to be stopped or changed.

Also, what happens if you take thyroid meds with normal ranges?

Thoughts on all of this? Kinda confusing after everything we discussed about surgery.

Jill

Last edited by JillinPhoenix; 03-22-2011 at 12:10 PM.

 
Old 03-22-2011, 12:59 PM   #11
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Re: New here and concerned

We need to see the reference ranges for your labs.

And "normal" levels just mean in-range....most people's "normal" would be levels towards the high end of the range.

I had debilitating hypo symptoms with mid-range levels....even dropping to the upper third is too low for me.

Nodules and goiter can shrink when thyroid hormone levels are optimized for the patient.
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Last edited by cd37; 03-22-2011 at 01:14 PM.

 
Old 03-22-2011, 01:11 PM   #12
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Re: New here and concerned

Oh, sorry. New to all of this. Here is the range info from the labs.

T3: 29.4 (range: 23.4 to 42.7%)
T4: 6.2 (range: 4.5 to 12.5 ug/dL)
T7: 1.8 (range: 1.2 to 4.3)
TSH: 1.02 (range: .45 to 4.5 mU/L)
T4: .9 (range: .8 to 1.7 ng/dL)

A few other quick questions, if you don't mind. Will the meds help pick up my metabolism? Would I still get symptoms if I was taking them as replacements (meaning part or all of thyroid had been removed)?

TIA for your input. This board is amazing!!


Quote:
Originally Posted by cd37 View Post
We need to see the reference ranges for your labs.

And "normal" levels just mean in-range....most people's "normal" would be levels towards
the high end of the range.

I had debilitating hypo symptoms with mid-range levels....even dropping to the upper third is too low for me.

Nodules and goiter can shrink when thyroid hormone levels are optimized for the patient.

 
Old 03-22-2011, 01:20 PM   #13
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Re: New here and concerned

Truly, the only "good" lab that was done was the last one - I do believe that's a FreeT4 level (T4, free, direct) based upon the lab ranges.

The other lab work that was done is basically obsolete since the "free" T4 and T3 measure the thyroid hormone that is fully available (aka "free") to meet the body's needs.

The "plain" T4 & T3 also measure hormones that are bound to proteins and not usable by the body.

At the end of the day, your thyroid hormone levels are at the bottom of the range - this explains your symptoms.

The meds will definitely help speed up your metabolism and, if you are dosed properly, your FreeT4 and FreeT3 levels should rise towards the high end of the range - those are the types of levels healthy people have.

Whether or not you have all of your thyroid, part of your thyroid or no thyroid, your needs for thyroid hormone would be predicated upon your thyroid hormone levels - again, yours are very low so you would benefit from thyroid hormone right now.

I still have my thyroid but it's not functioning too well....I'm on what is considered a full replacement dose - similar to what people without a thyroid would take.

Bottom line, you take hormone if you need it - whether or not you have a thyroid.
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Old 03-22-2011, 01:26 PM   #14
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Re: New here and concerned

Thank you SO much. What you are saying makes sense.

BTW, the lab report notes that the T3 is "uptake" and the T4 is "thyroxine" with the T4 Free Non-Dialysis being the .9 number.

 
Old 03-22-2011, 01:30 PM   #15
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Re: New here and concerned

One other interesting piece of info are my labs from the recent past. Since T4 free is the only one of value, here is what that was:

Nov 2010: .84 (range .82 to 1.77)
April 2010: 2.0 (range 1.2 to 4.9)
and, of course, now: .9 (range .8 to 1.7)

Interesting!!

 
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