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.
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. :-)
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.
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!! :-)
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.
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.
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.
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.
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 11:10 AM.
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
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.
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.
__________________
Dx'd Graves' June 2007..used ATD's, achieved remission Nov '09....went hypo Mar '10
What I have to say is based upon almost 4 years of extensive research about the thyroid and thyroid disease....participating on several thyroid forums...and my own personal experience. Glad I can help.
Yes, T4 is thyroxine (that's where "levothyroxine" comes in - it's a T4 replacement med)
The T3 uptake is useless - it's a lame calculation.
The FreeT4 by dialysis is, by far, the best (and most expensive) test so you know your .9 value is VERY accurate....and horribly low
As you move forward, it would be best for you to get just these labs done:
FreeT4 (T4 or thyroxine, free, direct)
FreeT3 (tri-iodothyronine, free, serum)
and the doctor will insist on TSH (lol)
It's very important to get a FreeT3 level done. You see, T4 is our storage hormone and our bodies convert it to T3, the active hormone - the one we feel.
Sometimes, our bodies have difficulty converting - if we don't have enough T3, we will have hypo symptoms.
So, while most people can take levothyroxine (T4 med) and fare well, there are some of us that also need T3 (I'm one of them)
Not sure if I recommended this book to you but, I consider it to be one of the best out there. It's written by an endo who explains all about hypothyroidism and how levels in the normal range aren't necessarily your normal.
"What Your Doctor May Not Tell You About Hypothyroidism" by Dr. Ken Blanchard
__________________
Dx'd Graves' June 2007..used ATD's, achieved remission Nov '09....went hypo Mar '10
The Following User Says Thank You to cd37 For This Useful Post: starryGal09 (03-22-2011)
Yes it was done at a different lab. Of course, I might be reading it wrong. It says this exactly: "Free Thyroxine Index: 2.0 (1.2 to 4.9). Is that not the same as T4 Free? Being new to this, I'm not sure.
Quote:
Originally Posted by cd37
Interesting but sad for you - you have been hypo for while - this could have very well contributed to the development of the nodules you have.
Was the April 2010 lab done someplace different? That's a very odd result and lab range.
No matter what, your current labs and symptoms confirm hypothyroidism. Hope you can convince your doctor to start you on some levothyroxine.
I would like to clarify something.....in your very first post, you listed some measurements and, the way it read, it seemed as if you had a mass on the right lobe that was as big as an entire right lobe. Is that correct?
Did further investigation reveal a multi-nodular thyroid vs. a huge mass?
This is something you'd really want to clarify.
__________________
Dx'd Graves' June 2007..used ATD's, achieved remission Nov '09....went hypo Mar '10
Yes it was done at a different lab. Of course, I might be reading it wrong. It says this exactly: "Free Thyroxine Index: 2.0 (1.2 to 4.9). Is that not the same as T4 Free? Being new to this, I'm not sure.
Well, even though you had it done at a different lab, it is also a different test.
Free Thyroxine Index is another one of those useless calculations.
FreeT4 is FreeT4.....(T4 or thyroxine, free, direct)
Again, the dialysis measurement is top-notch but not really necessary....
Don't worry about the questions you ask - it's all part of the learning process.
I fought to have my FreeT3 tested by my first 3 endos and they never ran it. When my current thyroid doctor ran triodothyronine, free, serum - I didn't know what it was......it was FreeT3
Knowledge is definitely power when dealing with thyroid disease.
__________________
Dx'd Graves' June 2007..used ATD's, achieved remission Nov '09....went hypo Mar '10
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)?
