# Wondering about thyroid nodules



## Monokera (Aug 20, 2013)

About a month ago, I'd had difficulty swallowing, and had a visible lump in front of neck that moved when I swallowed. Lymph nodes under my chin were swollen, and the ones along either side of thyroid were prominent and hard (though not visible). I saw a dr who ordered blood work and an US. thyroid levels were normal. When I had the US done, the tech tried to reach the radiologist immediately but he was unavailable, so I was told 2 days for results. I'd received a call from the dr that same day saying that I had multiple nodules, -most- of which seemed innocent, but they required followup with my regular dr.

I saw my regular dr, and he wouldn't tell me what the US said when I asked. He just said that I had multiple solid nodules and was referring me to a specialist and would likely have samples taken with a needle. He also said there was a thickening over thyroid. He didn't have time to explain.

Is a GP obligated to say if there is something concerning described on an US? Does anyone have any idea what he could have meant by a "thickening over the thyroid"? How much should I be worrying, if at all? If there was any risk at all for cancer, would that mean I would see a specialist sooner rather than later (being in Canada)? I'm too young for cancer, but am a little worried considering I'm waiting on pathology for an ovarian cyst as well.


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## joplin1975 (Jul 21, 2011)

If you were in the States, you absolutely would have every right not only to know what was seen on the u/s but to have a hard copy of the radiologists report that describes what s/he saw. I don't know what the laws are in Canada but I call tell you I'd ask for it and don't leave until they get it from you.

Solid nodules are concerning and do require additional follow up...that said, many, many people have nodules and the vast majority are benign.

How much should you be worrying? I wouldn't get too worked up about it. Even if it IS cancer, its very treatable and you should be just fine. It sounds like you have some other health issues and stress never helps, so see if you can get into the specialist (do you know what kind?) as soon as possible, but don't lose sleep over it.


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## Andros (Aug 26, 2009)

Monokera said:


> About a month ago, I'd had difficulty swallowing, and had a visible lump in front of neck that moved when I swallowed. Lymph nodes under my chin were swollen, and the ones along either side of thyroid were prominent and hard (though not visible). I saw a dr who ordered blood work and an US. thyroid levels were normal. When I had the US done, the tech tried to reach the radiologist immediately but he was unavailable, so I was told 2 days for results. I'd received a call from the dr that same day saying that I had multiple nodules, -most- of which seemed innocent, but they required followup with my regular dr.
> 
> I saw my regular dr, and he wouldn't tell me what the US said when I asked. He just said that I had multiple solid nodules and was referring me to a specialist and would likely have samples taken with a needle. He also said there was a thickening over thyroid. He didn't have time to explain.
> 
> Is a GP obligated to say if there is something concerning described on an US? Does anyone have any idea what he could have meant by a "thickening over the thyroid"? How much should I be worrying, if at all? If there was any risk at all for cancer, would that mean I would see a specialist sooner rather than later (being in Canada)? I'm too young for cancer, but am a little worried considering I'm waiting on pathology for an ovarian cyst as well.




Solid raises concern so go ahead and have the biopsies.

Joplin has given you a very accurate and realistic portrayal about your concerns.

If there is a risk, I am sure they will whisk you right along. Please let us know when you are scheduled for that biopsy. We have a wonderful and very supportive group and we would like to be here for you.


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## Velcro (Jul 26, 2013)

Try not to stress about it. It is very common for it take a bit to get you into a specialist to check them. Even after my FNA and they are semi-suspicious (unsure), they are waiting 4 months and redoing the FNA to see if they can get better answers. My ENT said that even if it is cancer, it is so slow growing that waiting a few months is no big deal. And like Joplin said, most are benign. They are being cautious because they are solid.


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## Velcro (Jul 26, 2013)

I am more worried that you have a GP that "didn't have time" to explain. He should have made the time!


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## Monokera (Aug 20, 2013)

Thanks for your replies everyone!

My GP said he was in ER the night before. And I know he was in the clinic the day before too. Our area seriously over works the doctors  This dr also generally has extra patients each day, since he's one of the best.

I'm wondering if it is possible to exhibit signs of thyroid issues, despite thyroid tests being normal. Although I haven't seen the values to know how normal, or if it is my normal or not.

I'm wondering too if my losing weight is normal or not. I've been losing since around when I started with the swollen lymph nodes and lump on throat. I'd only lost a few pounds, but had seemed to be almost normal for a few days at some point after my surgery. I eat normally, if not more, and also meal replacement drinks with meals. I'm now about 5 lbs less than I was 3-4 weeks ago, and I don't have much to lose. Surprised my GP didn't notice actually.

I wonder if I can find a way to bypass having to see the dr again to get a copy of the US.

Oh, the specialist I'm being referred to is specialized in "internal medicine". Wondering too why not something more specific, being near that major city!


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## bigfoot (May 13, 2011)

"Normal" on a test doesn't mean optimized for *you*. We are all different. Especially when it comes to hormones, including thyroid. Losing weight when you're not trying and haven't adjusted your diet is something to pay attention to. Like folks have mentioned, I wouldn't freak out, but stay diligent and on top of things (which you are already doing!).

As far as Canada goes, I have no idea what the laws are like up there. I will say we appear to be sliding in the direction of socialized medicine here, but I digress. Regardless of your country, I would have to believe that a patient gets access to their own medical records. You deserve a copy of your labs, as well as of that ultrasound. Since the doctor has reviewed them with you already (however brief that was), I can't see why there would be a problem in getting your records. Might even just go down to the office in person and politely ask (or demand). Sometimes standing there in the office makes things happen quicker.

Weird that you are being sent to an internal medicine doc and not to an ENT doc.


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## Monokera (Aug 20, 2013)

I wonder if it's just easier to get in to see someone in internal medicine, and then referred to more specialized if further action is needed after FNB


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## Monokera (Aug 20, 2013)

I am seeing a different dr in the clinic tomorrow about odd migraine I had the other day ... but main reason really is to get copy of the ultrasound. Is there anything anyone can suggest I ask about it, given that it is a GP who doesn't know me?


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## Monokera (Aug 20, 2013)

DR visit was useless, but I did get a copy of my results. There sure isn't a lot to go on with this!!

Multiple solid thyroid nodules. Largest to right of centre in the isthmus measuring 1.8cmx1cm. the second largest is in lower aspect of left lobe measuring 1.6cm. There are smaller nodules upper pole left of 0.8 and 1.1cm in the upper pole right of 1.2cm and 1.1cm

Impression: multiple solid thyroid nodules. The largest is 1.8cm and is to the right of centre in the isthmus. Based on size, ultrasound guided biopsy recommended.


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## Velcro (Jul 26, 2013)

So when is he sending you to the internist? Definitely need a biopsy.


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## Monokera (Aug 20, 2013)

No appointment has been booked. I'm wondering what's going on here!

And handwritten on the results is "TCI" underlined, and the date that I saw dr - not sure what that means.


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## joplin1975 (Jul 21, 2011)

TCI usually means "To Come In"...as in a follow up appointment is needed. In your case, that biopsy definitely needs to be done.


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## Monokera (Aug 20, 2013)

From my limited knowledge ... my results don't indicate malignancy, although higher risk than other results

But should I be mentally preparing myself for it, just in case? Does that even make sense? LOL

Betting those things are why I have troubles swallowing and voice gets hoarse easily if I talk a lot

Does positioning of nodules have any correlation with symptoms?


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## joplin1975 (Jul 21, 2011)

You simply can't tell malignancy from an u/s. You have solid nodules. Solid nodules are a red flag. Yes, solid solitary nodules are usually more concerning, but there are many, many of us who have had multiple solid cancerous nodules. So, at this point, I think just about everything is on the table. Which doesn't mean you should expect cancer, but it could happen, yes.


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## Velcro (Jul 26, 2013)

It's like anything else. If you had a weird spot on your skin that just didn't look right, wouldn't you want for them to biopsy and check it? You're hoping it's not cancerous, but you have to rule it out. Your nodules may be just fine, but solid is a "just don't look right".


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## Monokera (Aug 20, 2013)

Hmm I think it was silly of me to ask about preparing for possible malignancy.

Thank you for your replies everyone.

I decided to call the internist that I'm referred to, to see how long before I got an appointment booked- and it had been booked and sent to my dr to inform me. But she told me the date and time thankfully. A little under 3 weeks from now, and then go from there.


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## Octavia (Aug 1, 2011)

Not silly at all... it's okay to want to check things out! Just don't get too carried away thinking about worst-case scenarios.


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## Andros (Aug 26, 2009)

Monokera said:


> DR visit was useless, but I did get a copy of my results. There sure isn't a lot to go on with this!!
> 
> Multiple solid thyroid nodules. Largest to right of centre in the isthmus measuring 1.8cmx1cm. the second largest is in lower aspect of left lobe measuring 1.6cm. There are smaller nodules upper pole left of 0.8 and 1.1cm in the upper pole right of 1.2cm and 1.1cm
> 
> Impression: multiple solid thyroid nodules. The largest is 1.8cm and is to the right of centre in the isthmus. Based on size, ultrasound guided biopsy recommended.


Okay; as I mentioned, Solid is not a good word for nodules. You may benefit by bypassing everyone and going straight on to ENT.


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## joplin1975 (Jul 21, 2011)

Agreed, not silly at all. I hung on to all the stats before I got my results. Meanwhile, my husband kept telling me not to worry what everyone else dealt with, it's what happens to me that matters. It's very true.


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## Velcro (Jul 26, 2013)

Nope not silly. I'm a planner. So for me, preparing for the worse (work, groceries, who's feeding the cat) and hoping for the best is just who I am.


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## Monokera (Aug 20, 2013)

Yes that's how I am as well. I deal with things by planning and doing. When I can't do anything with the worry, that's when it gets bad.

I'm really glad I found this forum. It also helps seeing I'm not alone, and getting a better "real life" perspective on things


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## Monokera (Aug 20, 2013)

Just saw specialist and he booking me for biopsy. He said I didn't need any more blood work even though it seems all that's been tested is tsh. My value for tsh in december was 0.62 and when I first went in about lump on throat it was 0.36. Range is 0.3 to 6.2 . Dr said nothing i've been experiencing is related to the nodules. Said my weight is fine at 116 lbs. I really didn't feel like pushing for anything. And really wonder why I had to book a day off work to just be seen and have the biopsy booking sent off.


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## Velcro (Jul 26, 2013)

I'm glad they are scheduling you for the biopsy. I know the feeling. It's so annoying to take off work and then say, "Just wanted to see how you are doing?" Ugggghhhh.


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## Monokera (Aug 20, 2013)

I have my biopsy yesterday. It was awful for me! Whe she put in the freezing, that was ok, but at some point it felt like the needle went through something with a lot of resistance, and I nearly passed out. Other than that, the experience was ok, but my anxiety was bad then. The biopsy dr was good. I had to take it slow getting up cause my bp and sugars dropped too with my reaction. After I was good to go, I left, walked to where I was going, and then had to lay down due to a sudden very visual migraine. Man! But still makes sense to me.

How long should I expect my throat to be sore, raspy talking?


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## joplin1975 (Jul 21, 2011)

It's had to tell -- everyone's reacts so differently. I'd take some kind of anti-inflammatory (e.g., Advil) and ice your neck. I get you'll feel better very soon.


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## ChrisP (Oct 29, 2013)

I'm a little late, but welcome! It's great news that you skipped over all of the un-necessaries and had your biopsy so quickly! Like others said, solid is not a good word for nodules, and I'll be thinking of you while you wait for your results. :hugs:


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## Andros (Aug 26, 2009)

Monokera said:


> I have my biopsy yesterday. It was awful for me! Whe she put in the freezing, that was ok, but at some point it felt like the needle went through something with a lot of resistance, and I nearly passed out. Other than that, the experience was ok, but my anxiety was bad then. The biopsy dr was good. I had to take it slow getting up cause my bp and sugars dropped too with my reaction. After I was good to go, I left, walked to where I was going, and then had to lay down due to a sudden very visual migraine. Man! But still makes sense to me.
> 
> How long should I expect my throat to be sore, raspy talking?


Hope you grabbed that ice; it should have helped. When do you think you will have the results of the biopsy? Keeping my fingers crossed for you!


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## Monokera (Aug 20, 2013)

I almost wish that they would have done a full thyroid panel before doing biopsy. Well, any panel other than tsh and cbc! Still having trouble with throat after biopsy.

My results appointment is at the end of the month, but I might call the office earlier since they should have results wednesday. I get the feeling that he won't do anything if it is not cancerous, since I have never had full panel done, despite being symptomatic. treat the patient, not the numbers!!! Just because the number isn't coloured, doesn't mean it's "normal" ... er long day /rant off


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## Andros (Aug 26, 2009)

Monokera said:


> I almost wish that they would have done a full thyroid panel before doing biopsy. Well, any panel other than tsh and cbc! Still having trouble with throat after biopsy.
> 
> My results appointment is at the end of the month, but I might call the office earlier since they should have results wednesday. I get the feeling that he won't do anything if it is not cancerous, since I have never had full panel done, despite being symptomatic. treat the patient, not the numbers!!! Just because the number isn't coloured, doesn't mean it's "normal" ... er long day /rant off


No matter how this turns out, you will need numbers. TSH, FREE T3 and FREE T4. Wishing the best for you!


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## Monokera (Aug 20, 2013)

I was not too happy with results. Dr said benign nodules. I asked composition and he said follicles. He did run bloodwork when I asked, but then called me the next day saying all results normal and no antibodies. I was told at least 3 days for the one test result so how did he have all in 24 hrs? He said all is well he will see me in 3 months.

When I had mentioned my tsh was low normal he said that low was actually lower than test parameter and I was well above at 0.6 and 0.38 tsh. He did not give numbers when he called. He said nothing to treat nodules either.


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## thumper54 (Sep 2, 2013)

Hello. While benign is good, you may feel better actually seeing the results. Were you able to get a physical copy of the labs and the ultrasound report? Many doctors say normal when you fall into the "normal range", but that doesn't mean it's your normal. If you get those results and post them here it will help. (Also post the ranges of the labs). Are you still having symptoms? If so, what are they?


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