# Help! Thyroid ultrasounds - insist on FNA or not?



## enserfud (Jul 1, 2014)

Hi! Hopefully I'm posting this right. I'm new to this forum and hoping for advice from others who have been through similar situations with their thyroid. Obviously I know this is not medical advice but I would appreciate any insight. thanks!

I surprisingly found out I have thryoid nodules in Nov during a CT scan of my chest. I had an ultrasound and my general practioner recommended a FNA. I live close to Boston and felt more comfortable going to one of the big hospitals there so scheduled my FNA there. When I got there though, the dr said that she didn't feel as though a FNA was needed and that it'd be ok to wait six months to get another ultrasound. My second appointment was rushed and she said she still felt as though everything was okay and no FNA was needed but now I'm concerned that maybe I should get one. I know the dr is the expert but I've freaked myself reading too much about this and it seems as though people with ultrasounds similar to mine always get FNA. I'd really rather NOT have a needle in my neck but I'd much rather have that than cancer!

I'm going to try to post both ultrasound reports and hopefully some of you can take a look and let me know if you think I should insist on getting the FNA? The thing I'm most worried about on the report is a 2.5 cm dominant complex nodule with calcification.

First ultrasound report:










or link if that doesn't work: http://tinypic.com/r/wcejxs/8

Second ultrasound:










or link if that doesn't work: http://tinypic.com/r/hskenb/8

By the way, my TSH is normal (1.2) but they didn't do any further antibody tests. I've had other autoimmune issues in the past - including alopecia areata 4 years ago, eczema, and severe allergies (I get allergy shots).

Any help would be so appreciated!!!


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## Andros (Aug 26, 2009)

SUGGESTED TESTS
TPO (antimicrosomal antibodies) TBII (thyrotropin-binding inhibitory immunoglobulin), Thyroglobulin and Thyroglobulin Ab, ANA (antinuclear antibodies), (thyroid hormone panel) TSH, Free T3, Free T4.

You can look this stuff up here and more.........
http://www.labtestsonline.org/
(Copy and paste into your browser)

Trab
http://www.ncbi.nlm.nih.gov/pubmed/17684583
(Copy and paste into your browser)

Complex and calcified definitely dictate the wisdom of an FNA. Others may agree. And since your GP recommended that you do...............??? Please make other arrangements to have it done.

How are you feeling? Any clinical symptoms?

It would be good to have antibodies' tests. Listed above for your convenience.

Welcome to the board.


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## enserfud (Jul 1, 2014)

Thanks, I have anxiety and have gained about 15 lbs over the past year but I don't have any throat discomfort. My GP isn't a specialist so I thought seeing an endocrinologist in a leading hospital would be better but I think just to put my mind at ease, I'll try insisting on the FNA. Thanks!


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## joplin1975 (Jul 21, 2011)

Yes!!!! To the ultrasound, that is. Especialliay of the dominant nodule on your left lobe.


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## Octavia (Aug 1, 2011)

If I'm reading your report correctly, it says you have a 2.5 centimeter dominant nodule. That absolutely calls for an FNA...no doubt about it.


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## enserfud (Jul 1, 2014)

Yes, I think you read my report correctly - I indeed have a 2.5 cm complex dominant nodule with calcification. What confuses me is why a leading endocrinologist would take this so lightly. I know drs are way more knowledgeable than stuff I read online but she said seeing the calcification was a GOOD sign -- that the nodule was old and the cyst was breaking apart (or something like that) and that's what caused the calcification BUT everything I've read online seems to say calcification is a red flag. I want to trust my dr -- she's very well respected in her field -- but my health is on the line.

I also asked her about testing more than just TSH. Since my TSH was normal, she said there's no need for further testing because regardless of what the other numbers are, she said they wouldn't treat someone with normal TSH.

I kind of suspect hashomitos (which is the lesser evil than cancer of course!). Last year my TSH was borderline low - .47 and this year it was 1.2. I know it's not a huge difference but those are just two numbers. I wonder how often it fluctuates? My weight certainly fluctuates a lot even though my diet remains pretty consistent. I could practically open a boutique in my closet since my clothes range from a size 4 to a size 12 (my current size). Also, since I had alopecia areata, often get eczema, and have some of the worst allergies my allergist has ever seen (I get 8 allergy shots a week!). Oh boy... I'm a mess 

I tried a gluten free diet for 3 weeks and got a lot more energy and felt overall more healthy. When I reintroduced gluten, I began to feel terrible again. Today I just went for lab work to test for celiac. I'd like to know if I have celiac, but regardless, I'll probably eliminate gluten again because I did begin to feel better.

I know I'm just rambling random facts now and I apologize for that. I'm just trying to make sense of this. Doctors always seem to dismiss me as being "just fine" but I feel like there may be a puzzle that needs to be put together. I appreciate you guys looking at my lab reports. If anyone else has insight, I'd be very much appreciative.

Thanks so much for your time!


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## Andros (Aug 26, 2009)

A huge thump on the head to that doctor. I think she skipped many classes!

Hugs,


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## jenny v (May 6, 2012)

Yikes, find a new doctor! With a nodule that big, not to mention calcification, an FNA should be a no brainer.


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