# Please give me your ideas.



## 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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## Christinals (Sep 9, 2010)

I wish I had answers for you here.

I went to an ENDO, had an inconclusive FNA and they wanted me to take Synthroid and diagnosed me of having Hashimoto's. I wasn't convinced, and wanted to know more about my nodule. While waiting for an appointment with another ENDO, I went to a naturalist to see what he thought. He said I was suffering from what he thought to be "Hashitoxicosis" and wanted me to take a giant list of supplements and did all sorts of allergy testing that led to even more testing. Before taking the supplements I wanted to see what the next ENDO said....now the new ENDO sent me to have RAIU - showed possibly thyroiditis and "it will heal on it's own". I am now waiting for my FNA results. Hopefully Monday/Tuesday. Still stuck in limbo! I tell you this long _pointless _story because if you aren't happy with a Doctor's recommendation, continue your search until you feel comfortable that you have exahsted all of your options. Surgery is permanent, and I understand you are not ready to go there. That being said, when looking at nodules, isoechoic & solid is not something you want to see.

How long ago was your FNA?

I will be interested to see what other's say about reducing antibodies. I too have antibodies. TPO Ab - 320 (<35) & TGAB 1,283 (<41). Mine have only gotten slightly worse over time, but I have not been on any medication or supplements to "help" the situation.

Sorry so long. lol
I wish you the best and hope your search for alternatives proves a positive experience and you get answers that you can share with all of us!

There will be more to chime in here soon! Hang in there!:hugs:

-Christina


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## McKenna (Jun 23, 2010)

Hi and welcome!

First off....how do you feel? Are you having symptoms of either hypo or hyper thyroid?

Did your doctor comment on your low Vit D? Or suggest you start on replacement thyroid meds now? I see a recent Free T4 (which is low, BTW) but I don't see a recent Free T3. Did you have one done?

The nodule on the left lobe is very large. Did anyone suggest a RAIU (radioactive uptake scan) to see what it's doing? (hot or cold)


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## Andros (Aug 26, 2009)

g1961 said:


> 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.
> 
> ...


Hello and welcome to the board. Okay, the word solid does not bode well; FNA should be done.

Then there are two words that raise suspicion which are "oncocytic change." (http://www.humanpathol.com/article/S0046-8177(97)90278-1/abstract

You are asking for opinion and mine is that you should not fool around. I think you should have it out. That is my humble opinion.

Furthermore, if you only have had sonograms instead of a RAIU (radioactive uptake scan), there could be a lot more going on that the sonogram did not pick up. Sonograms are good but have areas of limitations. Both human and technology oriented.

Once again, welcome. You "will" get varying opinions and that is good. We are not narrow-minded here.


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## lavender (Jul 13, 2010)

I have read your post and honestly do not know how much help I can offer you because I do not know a whole lot about nodules. I know it is your body and you have to do what feels right to you. Surgery and the thought of loosing a major gland that affects the way your whole body functions is pretty scary and it is a pretty big decision. I am not aware of any med or alternative treatment that will shrink a nodule.

I see tons of ads on-line for some miracle cure to fix your thyroid naturally, but I am pretty wary as most of it seems to be someone's scam for making a buck off of desperate people. Having desperately spent a ton of money on a "wholistic" doc who sold me pricey supplements while dismissing some real medical issues, I would be hesitant to recommend this approach to anyone.

I have also seen some chat rooms full of people angry that their docs took their thyroids from them who are now trying to piece their lives together without a thyroid. I actually wanted my thyroid out, but when I post on those sites, they assume I have been similarly mis-treated, even when I tell them otherwise. And I feel doubtful about the advice they are giving when I can not find any good medical or scientific evidence to back it up.

I believe that treatments such as acupuncture, massage, chiropractic, herbal medicine, energy work, therapy, a natural whole food organic diet, etc are all beneficial steps for anyone to take to improve their health. I use several of these methods myself. But I do not see them as a substitute for western medicine, and at times, procedures as radical as surgery.

I know that for myself, I had to take a look at how bad I felt. I knew there were people out there who claimed that my thyroid issues could be healed naturally, but I also knew that I was too sick to employ those methods. I got in touch with my inner sense of myself which told me my thyroid was sick and that I needed it to be removed in order for my body to heal. This was not an easy path, and now I am learning how to live without a thyroid, which is not as simple as many doctors seem to believe it is.

I hope you can find a solution that feels acceptable to you and helps your body heal.


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## g1961 (Nov 14, 2010)

I truley appreciate everyone's opinion and response. I believe we all learn from each other and without your help I might not be capable of asking some very important questions and making an educated decision.

I currently feel good despite this annoying lump in my throat feeling...below is a list of my "complaints"!

I use massage and Low Level Laser Treatment (LLLT aka cold laser) to treat muscle and nerve problems from a car accident around 4+ years ago. I also have used accupuncture. I am prescription pain medication free ;-).

I just finished my first treatment of accupunture along with a massage and lllt. I have read about clinical studies for "lllt to reduce the TPO(ab's)". I couldn't find anywhere lllt has been used to treat goiters. I am relying on the premise reducing the TPO(ab's) may reduce the size of the goiter????

All of my test results have been within the last month. I have a variety of health issues (I consider annoying since they are not life threatening):

Insomnia(falling asleep and staying asleep), 
Restless leg syndrom, 
Depression (I call medical since I do not lack self worth, hehe!), 
migraines with and without ora's (the ones with ora's occur rarely and only last a few hours but the ones without ora's can last months. I have seen several doctors for this without any success. I am also very sensitive to weather fronts, 
Cold sensitivity, I am always cold and wear layers of clothes, 
Raynaud's Syndrome, 
Atypical Acid Reflux, 
Hoarsness (for many years mostly starting in fall - spring), 
dry cough, 
radiating pain to ear (after flying in March, saw ENT but pain still persits).
On/Off fatigue. 
Diagnosed with Fibromyalgia in my 30's - (I always felt this might be wrong, I joke science hasn't caught up to me yet!)
I think this is all but I tend to dismiss somethings as bumps and bruises life throws my way.

Medicine I currently take: Vitamin D Supplement, Nardil (30mg), Temazapam(30mg), Neurontin(300mg).

I am seeing an allergist in Dec. My Endocrynologist wants to make sure my syptoms are thyroid related vs allergy before any surgery.


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## lavender (Jul 13, 2010)

I am honestly having a hard time following your posts because similar issues are posted in several different threads. Is there any way of combining them?


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## g1961 (Nov 14, 2010)

Lavender, my apologies for posting the way I did. I thought I would get different opinions from the different boards. I am not an experienced member so I wasn't expecting to see the same people post replies on each board. I would be happy to combine my threads but I do not see from the FAQ's I can do that?


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## McKenna (Jun 23, 2010)

> I am relying on the premise reducing the TPO(ab's) may reduce the size of the goiter????


My understanding is that a goiter and nodules are two different things. Goiter is swelling of the thyroid whereas nodules are lumps, cysts, and tumors. The nodule you have in the left lobe is very big, since the report says that it occupies almost the entire lobe. This is why I mentioned the RAIU scan. Even if you deal with potential allergies as a cause to your symptoms, the nodules need to be addressed, IMHO.

I have Hashi's (confirmed by final path report) and a lot of the same symptoms you have. Plus, I had hashitoxicosis with both hyper and hypo symptoms and test results and a large solid nodule with inconclusive FNA results. I opted to have my thyroid removed and so far, so good.

It's not an easy decision and you will hear conflicting advice. In the end, you have do decide for yourself. But I will say that if you are looking at awful symptoms, a potential cancer or the nodules growing, it is better to have it out. And I'm definitely against a lobectomy (hemithyroidectomy).


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## lavender (Jul 13, 2010)

g1961 said:


> Lavender, my apologies for posting the way I did. I thought I would get different opinions from the different boards. I am not an experienced member so I wasn't expecting to see the same people post replies on each board. I would be happy to combine my threads but I do not see from the FAQ's I can do that?


I think one of the moderators can combine them. I am not sure that you can. I am just not sure how to ask them to do this, so I posted.


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## g1961 (Nov 14, 2010)

McKenna - I believe you are correct about the goiters and nodules.

I often see the terms intertwined. i don't have my endocrinologist's report in front of me to verify his wordings. I'm wondering if I paraphrased his findings incorrectly when entering my post????

I get very confused by these terms:
i.e. FNA diagnosis: 
benign nodule consistent with nodular goiter with cyctic changes.


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## McKenna (Jun 23, 2010)

I do think doctors, nurses and other medical professionals use goiter to describe a thyroid with nodules. I know that if a thyroid is swollen (as can happen in Hashi's), the swelling can go down. But I don't really know of nodules significantly shrinking. ???? That was my point in pointing out the difference in goiter/nodules.

What you wrote here:


> 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.


Is why I think you should have a RAIU as part of your decision making process. The left lobe being "completely occupied" by a large nodule can mean that side is not producing hormone, in the case of a cold nodule. Or producing too much hormone, in the case of a hot nodule.


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## lavender (Jul 13, 2010)

Seems the posts can't be combined. I'll get over it with my fuzzy brain.

Gosh, a lot of what you describe sounds very familiar to me. I was Diagnosed with Fibromyalgia a few years back, but was never convinced that the docs weren't just giving me a label so that they could stop looking into anything else to either diagnose or treat. I can't take pain meds, and don't like the way anti-depressants make me feel. So, no drugs for me! I have been managing pain with massage, therapy, meditation and mentholated herbal salves for several years now, but basically, I live with pain all day, every day. I have never heard of Low Level Laser Treatment, but now I am intrigued.

I will tell you that most of my pain disappeared for a month after my thyroid was removed, and this gives me some hope that managing my thyroid levels will help lower my pain levels. I have seen glimpses of studies of Fibromyalgia being treated with T3, and am hoping to find a doc who may be willing to discuss this with me.

Back to your nodules. I will have to second and third those who have recommended RAIU. It is a more helpful test than ultrasound. It seems like a lot of docs do ultrasound, but my endo said it was a worthless test, and just sent me in for RAIU. I think it could help clear up some of the confusion about your nodules.

It also may be helpful to ask your endo or get a second opinion as to why he is recommending surgery? Is he concerned about cancer? Not to scare you, but would that change your course of action if it were a possibility?


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## g1961 (Nov 14, 2010)

*lllt is very controversia*l. I _think_ it is relatively _new_. From my experience, it feels like the knots just melt away!! I know there are different quality of units, they are incredibly expensive. If your insurance covers chiropractic care - check if there is a chiropractor in your area who has a unit. See if they will show you how it works. 1-2 minutes on an area and the difference is something you have to experience.


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## g1961 (Nov 14, 2010)

I talked to my endo last night about having an RAIU. He said they are only done for hyperthyroidism and it wouldn't tell me anything more about my nodules.


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## Andros (Aug 26, 2009)

g1961 said:


> I talked to my endo last night about having an RAIU. He said they are only done for hyperthyroidism and it wouldn't tell me anything more about my nodules.


That is totally absurd. You have been given the fluff-off!

And what does this endo purport as the next step for you?

Keep on reading that path report. Total thyroidectomy is recommended.


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## McKenna (Jun 23, 2010)

Oh wow, that's terrible!
Can you go to your family doctor and have him/her order it?


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## g1961 (Nov 14, 2010)

I felt a little bewildered last night...

BUT it wasn't as bad as my primary care physician's recommendation. She prescribed .025 synthroid expecting it to shrink the nodules in 3 months. I was too stunned to lol! Scary, these Dr's are highly regarded in my area! I'm glad I found this website. I'm learning to ask the right questions.

My next step is to get an appointment with another endo.

Thanks again!


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## lavender (Jul 13, 2010)

g1961 said:


> *lllt is very controversia*l. I _think_ it is relatively _new_. From my experience, it feels like the knots just melt away!! I know there are different quality of units, they are incredibly expensive. If your insurance covers chiropractic care - check if there is a chiropractor in your area who has a unit. See if they will show you how it works. 1-2 minutes on an area and the difference is something you have to experience.


Insurance does not cover chiropractic. I do see a chiropractor, and she has done some sort of ultrasound thing to my back before. The first time it felt like it helped a little, and the second time, it did nothing whatsoever. I have to pay extra for it and have not done it again. I don't think she uses lllt.


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## lavender (Jul 13, 2010)

g1961 said:


> I felt a little bewildered last night...
> 
> BUT it wasn't as bad as my primary care physician's recommendation. She prescribed .025 synthroid expecting it to shrink the nodules in 3 months. I was too stunned to lol! Scary, these Dr's are highly regarded in my area! I'm glad I found this website. I'm learning to ask the right questions.
> 
> ...


your Free T3 and Free T4 are low, so the synthroid may help you feel better. I can't tell you if it will shrink the nodule.

I think it's absurd that they are refusing to send you for RAIU. My endo told me it was a requirement before surgery and would not even refer me to the surgeon until I had mine done.


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