# Please give me your opinion.



## g1961 (Nov 14, 2010)

Thanks you for looking at my post. PLEASE let me know your thoughts, experiences and opinions.

I am looking for any ideas to shrink my goiters and reduce my TPOAb. Has anyone tried alternative methods? If so PLEASE list your success or failure.

I am going to start with accupuncture tomorrow morning. I want to try and increase my thyroid function, in theory I hope to reduce the size of the nodules? I know there are different types of goiters and according to my Dr. there isn't any way to shrink mine? I am willing to try anything reasonable before resorting to thyroidectomy surgery. I don't want have any regrets.

;-)

--------Detailed diagnostic information below-------------
I was recently diagnosed with multinodular goiter and thyroiditis. The suggested treatment is totaly thyroidectomy. I would like to exhaust alternative treatments before having surgery. Any suggestions would be appreciated.

First Ultra Sound Findings (at hospital): The left thyroid lobe is enlarged and measures 5.5x1.7x2.5 cm. There is a dominant mass identified within the left thyroid lobe which measures 3.2x1.5x2.4 cm. This is a heterogeneous mass with internal cystic areas. There is peripheral hypervascularity. This mass is seen in the midportion of the left thyroid lobe. Fine needle aspiration should be considered. No additional left thyroid masses are identified.

The right thyroid lobe measures 4x1.4x1.3 cm. There are 3 small isoechoic nodules within the right thyroid lobe. The largest of these measures 9x7x4 mm and is seen in the midportion. There is a 6 mm nodule in the upper pole. There is a 5 mm nodule in the midportion. No extra thryroidal nodules or fluid collections are identified.

FNA: 
CYTOLOGY REPORT:
Speciment Type: Left thyroid.

Final Diagnosis:
Negative for malignant cells
benign nodule consistent with nodular goiter with cyctic changes

Microscopic Description:
The smears, cytospins and cell block show clusters and sheets of bland follicular cells, some with oncocytic changes and flame cells, reactive cyst lining cells.

First Lab tests by primary care doctor:
Glucose: 110 (70-125)
Cholesterol: 199 (<200)
Triglycerides: 103 (<200)
HDL (Good Chol): 40 (>45)
LDL (Bad Chol): 138 (<130)
T4: 6.65
TSH: 3.52
CBC: Normal
Liver: Normal
Kidney Function: Normal
Vitamin D, 25-Hydroxy
LC/MS/MS
Vitamin D, 25 OH Total = 25 Out of Range (30-1000 ng/mL)
Vitamin D, 25 OH, D2 = 5 In Range
Vitamin D, 25 OH, D3 = 20 In Range

Second lab tests by specialist:
FRT4: 0.71 ng/dl Ref Range (.62-1.58)
TPOAb: 657.0 IU/mL Ref Range (0-9.0)
TSH: 2.44 uIU/mL Ref Range (.34 - 5.60)
TotT3: .92 ng/mL Ref Range (.62 - 1.62)
Thyroglobulin Autoantibodies Result 21 U/mL Ref Range (<60)

2nd Ultra Sound by specialist:
left thryoid lobe completely occupied by a large thryoid nodule which is partially cystic and solid. It measures 2.24 x 2.34 cm. Right thyroid lobe appeared heterogenous with the presence of a least one dominant thryoid nodule measuring 1.38 x 0.70 cm and is isoechoic and solid.

Specialist Recommendation:
Given the presence of thyroid antibodies and the formation of thryoid nodules involving the right lobe, I have recommended a total thryoidectomy and thyroxine replacement therapy postoperatively.

I have been referred to an allergist to further evaluate possibility of allergies as the cause of some symptoms.


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