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  • do toxic nodules ever go away on their own?

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    Old 01-06-2008, 09:36 PM   #1
    lesiablueeyes
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    do toxic nodules ever go away on their own?

    do toxic nodules ever go away on their own?

     
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    Old 01-07-2008, 07:40 AM   #2
    mkgb
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    Re: do toxic nodules ever go away on their own?

    You might want to expand upon your statement. Most will not reply to such a short missive. We tend to want to know a bit more facts on your situation. Like are you hyperT? Do you have Graves? What exactly did your iodine uptake scan say? What were your latest lab results? TSH, FT3, FT4, and antibodies?

    The general pathology of a toxic nodual groiter (TNG) is defined as follows:

    TNG represents a spectrum that ranges from a single hyperfunctioning nodule within a multinodular thyroid to a gland with multiple areas of hyperfunction. The natural history of a multinodular goiter involves variable growth of individual nodules; this may progress to hemorrhage and degeneration, followed by healing and fibrosis. Calcification may be found in areas of previous hemorrhage. Some nodules may develop autonomous function. Autonomously functioning nodules may become toxic in 10% of patients. Hyperthyroidism predominantly occurs when single nodules are larger than 2.5 cm in diameter. Signs and symptoms of TNG are similar to those of other types of hyperthyroidism.

    Treatment? Will it just go away? Normally no. Main treatment options are as follow according to my mother and one of her sister's Graves TNG histories:

    The optimal therapy for treatment of toxic nodular goiter (TNG) remains controversial. Unlike Graves disease, TNG is not an autoimmune disease and rarely, if ever, remits. My mother and her sister had Graves.. but they also had a TNG and Hashimoto's to boot. MD sources recommend patients who have autonomously functioning nodules should be treated definitely with radioactive iodine or surgery. My mother did the surgery straight up removing half of her thyroid. My Aunt went the RAI route.. this had to be repeated.. when they were going to have to repeat it a third time she refused and told them to cut the.. pain in the neck out. So in my family's eyes and my opinion.. surgery would be our only option from here on out. MD's recommend that patients with subclinical hyperthyroidism should be monitored closely for overt disease and only treated when the hyperT activates producing symptoms as well as blood work confirmation. Some suggest that elderly patients, women with osteopenia, and patients with risk factors for atrial fibrillation should be treated, even those who have subclinical disease.

    So the answer to your question is... TNG's hardly ever go into remission and almost always require treatment. If you have Graves you can try to manage it with anti thyroid drugs first, but in the end most MDs will recommend destruction or removal of the offending thyroid or node(s).

    Hope this helps. I am not an MD this is just personal opinion and experience talking always consult and MD that you trust.

    MG
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    Last edited by mkgb; 01-07-2008 at 07:42 AM.

     
    Old 01-07-2008, 07:57 AM   #3
    lesiablueeyes
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    Re: do toxic nodules ever go away on their own?

    Thank you for the info ......I go for the uptake test in feb. the dx right now is that I have Hashimoto's with toxic nodules. I am really scared of these nodules I am adopted so I do not know my family history. In the past I have fluctuated between hypo and hyper so one dr said i had graves then they did the ultrasound and found the nodules the dr who read the ultrasound didn't think it needed any follow up treatment but my dr wanted me to see an endo because my numbers were all over the place so I go to endo and after she does the ultrasound herself she says I need surgery this is all before the uptake test or the free t4 or free t3 tests are done....does this seem right?

     
    Old 01-07-2008, 08:09 AM   #4
    mkgb
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    Re: do toxic nodules ever go away on their own?

    Humm..

    If you are having thyroid storms that can not be controlled and have had a questionable biopsy then in my opinion surgery would be warrented.

    They are saying Graves and Hashi's.. there is a condition where you can have both. Hashitoxicosis. Have they actual confirmed it with blood work? TPOAb is a 95% positive indicator of the AI Hashimoto's and TGAb is the 75% cross positive test. For Graves TSI is the 75% indicatoe and TRAb is the 60% cross positive test.

    I would hold on the surgery until they have done the uptake scan and gotten a complete thyroid blood work up completed. Surgery would be my only option if i had to get rid of my throid.. but i would want to make sure it had to go first.

    The complete blood panel they should check you for is..
    TSH (3rd generation)
    FT3
    FT4
    T3 Uptake
    RT3
    TPOAb
    TGAb
    TSI
    TRAb
    ANA

    This will cover all the thyroid bases and give you a good view of your blood chemistry related to the thyroid. You also need to check the thyroid supporters and mimics. Ferritin, vitamin B12, and vitamin D. If these are low they aggravate you thyroid state and thyroid symptoms. I think you have someone wanting to work with you, but they may be a bit aggressive. I am assuming since you haven't had the uptake scan yet that you have not had a biopsy either. With out the scan, a complete blood chem and thyroid panel, and fine needle biopsy of any nodes, I would wait on surgery. If the scan shows a slew of hot and dead nodules and you FNA the nodules and they are questionable.. yank it. Get it out. But cover your bases first.

    Sincerely,
    MG
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    Old 01-07-2008, 08:33 AM   #5
    lesiablueeyes
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    Re: do toxic nodules ever go away on their own?

    I am anemic that is the ferritan that you mentioned right? My periods are crazy I am scheduled for an endometrial biopsy on thursday due to the irregular periods. Dr doesn't believe they will find anything but I am 41 and she wants to be certain she believes it is all thyroid related but it is all so much to think about. My nerves are all over the place. I have panic attacks but really trying to hold it together here. No dr has said the word Cancer but anytime I have test like this I am terrified.

     
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