# cold nodule(s)bloodtest normal, lots of symptoms



## jerseygirl (Jun 30, 2010)

Hi!

Glad to find this forum. I learned a lot from all of you!

I am 42 years old and feel like cr*p for at least a year and a half.
I am usually a very active person. Lots of exercise and general healthy living.
When all my symptoms started (I will list them later) the first thing i thought I was in early menopause. My periods were always quite heavy but they were getting worse. Lots of clots (sorry..)and aprox. 7 days.
After a visit to a ob/gyn who did a d&c and a general check I was sent home.

My other main symptoms are:
extreem exhaustion (sleep >9hrs a night and still need a nap in the afternoon)
shakyness and nervousness (almost like I am vibrating)
heart palpatations
heartbeat low (about 60 in rest)
sometimes heartbeat 75-85 in rest when heart is pounding
dry eyes and itchiness around them
weight is fluctuating plus and minus 3.5 kg
NO libido
depression (I take AD) 
tinnitus 
throat is often irritated (like there is something in it
joint pain (esp. ankles and hips)

After the OB/GYN I went back to my GP who did several blood tests (on my request)
TSH 1.2 (0.38-5.5)
Free T3 4.4 (3.5-6.5)
Free T4 12.6 (10.5-20)
Antibodies TSH receptor <0.9
B12 686 (ref 150-650)(I take iron/B12 supplements)
blood pressure 135-80/ 116-78

Was send for a ultrasound were they found 2 nodules. One small and another one 1.5 cm.
Last week I did an uptake scan and today I got the results in:

"The four hour uptake of activity is 9% (within normal limits)
Scanning shows a concave margin to the inferior pole of the right thyroid gland which could indicate the presence of a cold nodule or cyst in this area. the requisition implies that there is a previous ultrasound though I do not see one in patient's files here. Follow-up ultrasound correlation would be necessary otherwise."

These are the questions for my GP on Monday:
Why didn't they sent the ultrasound to the hospital?
Second of all why was there only an scan after 4 hours?
I think I need a fine needle biopsy to determine if those nodules are cancerous.
I want my blood tested again (last test was March'10).
A test to determine if some of the symptoms could be from menopause
A referral to a endocrinologist.

Does any of you have any advice or comments?
I feel like I am drifting between hyper and hypo but my tests say otherwise.
I hope my post make sense. i have a hard time concentrating and English is not my 1st language.

Thanks,
~Jerseygirl


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## jerseygirl (Jun 30, 2010)

Any one who can say anything about all this?
I am sick and tired about being sick and tired!
I read that you can do a adrenal test. How does that work?


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## Andros (Aug 26, 2009)

jerseygirl said:


> Hi!
> 
> Glad to find this forum. I learned a lot from all of you!
> 
> ...


Welcome. I agree with you 100%; something is afoot. Solid nodules are most definitely are suspicious for cancer.

Your basic thyroid panel is odd also in that both the FT4 and FT3 are below mid-range. You can bet something is going on.

You may find this information helpful..................(you do need FNA)

http://radiographics.rsna.org/content/27/3/847.full


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## hillaryedrn (Dec 14, 2009)

Yes, "cold" nodules are suspicious. I would definitely request a FNA to see what it shows. Good questions you already have laid out there. Does your insurance require you to have a referral? If not, I'd just go ahead and find an Endo on your own. Can't hurt! Let us know what you find!!


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## jerseygirl (Jun 30, 2010)

Thanks for your comments!
My husband will go with me tomorrow. I am not letting my GP send me away with nothing:evilgrin0036:
I will keep you updated.


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## Andros (Aug 26, 2009)

jerseygirl said:


> Thanks for your comments!
> My husband will go with me tomorrow. I am not letting my GP send me away with nothing:evilgrin0036:
> I will keep you updated.


Good to hear from you and glad hubby is going w/ you so at the very least, he can be a witness. Take your whip too!

Hope to hear from you sometime tomorrow.


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## jerseygirl (Jun 30, 2010)

Finally we are getting somewhere!
My GP was really concerned when he measured my blood pressure and felt my pulse.
My blood pressure went up and down and back up again. Strange! And my heartbeat was pretty bad yesterday. Lots of skipping beats and pounding.
So, he gave me beta-blockers to make me feel a little better and right away he phoned the surgeon for a FNB. He tought it would be a good idea also to do another thyroid blood test. Yahhoo, I didn't need my whip! 
But seriously, I was really relieved that he finally noticed some of my symptoms.
I keep you all updated.
Thanks!


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## Debbie from Milwaukee (Apr 18, 2010)

Sorry for you for the symptoms, but glad to hear that your body "misbehaved" on cue for the doc to see. Isn't it odd that docs will so often put a patient's reported symptoms in the backseat to what they can observe through their labs and exams? When you finally get a physician who gives equal weight to symptoms and tests, then you know you have found a good one!

As long as your GP (or the next doc down the line) is doing more blood tests, why don't you ask for a full panel of tests for both autoimmune conditons of Grave's and Hashimotos's (I think they are TSI, TPOab, and TGab)? Of course, I imagine you are most anxious to get the FNB done and the results back. Keep us informed at the support forum here. Whatever your results, I'm sure there will be people here who have gone through similar and can keep coaching you about what questions to ask. Wish you well through this difficult time!


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## Andros (Aug 26, 2009)

jerseygirl said:


> Finally we are getting somewhere!
> My GP was really concerned when he measured my blood pressure and felt my pulse.
> My blood pressure went up and down and back up again. Strange! And my heartbeat was pretty bad yesterday. Lots of skipping beats and pounding.
> So, he gave me beta-blockers to make me feel a little better and right away he phoned the surgeon for a FNB. He tought it would be a good idea also to do another thyroid blood test. Yahhoo, I didn't need my whip!
> ...


This is very encouraging. Please let us know when you are scheduled for FNB and also the results of your blood test with ranges if you care to share.

Glad he gave you a beta-blocker. Many of us have heart damage. Keep the whip handy but glad you did not need it this time. Having your husband along was a great coup, I am thinking!


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## hillaryedrn (Dec 14, 2009)

That's wonderful news!! Please do let us know how the FNA goes!


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## jerseygirl (Jun 30, 2010)

I have some test results in. My GP decided to take some tests to see how far away I am from menopause. FYI I am 42 years old.
Is there anyone who can say anything about the results? I tried to get some info online but those hormones can be darn confusing 
When the blood was taken I was on day 4 of my cycle.

Estradiol 143 pmol/l
mid follicular 110-184
ovulatory peak 550-1650
mid luteal 550-845
post menopausal up to 220 
hypogonadal up to 220

C-reactive protein 0.2 (ref <5.0)

FSH 17.3 IU/L
follicular/luteal <9.0
midcycle 4.0-20.0
postmenopausal 20-135

LH 8.2 IU/L
follicle/luteal <13.0
midcycle 14-100
postmenopausal 15-65

I am waiting for my Free T3 and Free T4 to come in.
Thanks!


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## McKenna (Jun 23, 2010)

Hi Jerseygirl,
I don't understand a thing about your results, but I wanted to say hi and tell you that you're not alone. I have been dx with Hashimoto's and I have a 1.5 cold nodule that I had a FNA of last week. My results were inconclusive.
I hope you get some answers soon, for everything. It's hard when you don't feel well.


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## jerseygirl (Jun 30, 2010)

Thanks McKenna, that's very sweet of you....
So what are they doing now? Are they keeping a close eye on your nodule?

Do you know, or anyone else for that matter, know if your thyroid function can be influenced by a cold nodule?
Mine is 'inwards' and 1.6 cm takes up a lot of space in such a tiny organ. Now, it's 'cold' so it's not active thyroid tissue. My thyroid was of a regular size but if those 1.5 cm are not working you should say that that thyroid lobe is not working properly! 
I hope my other test results are in soon. I am very curious to see how they turn out...


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## McKenna (Jun 23, 2010)

They are not doing anything yet. My ENT comes back from vacation next week and I'm going to talk to him then. There were some weird notes in the description that I need to ask him about. I really don't want it in there, even if he suggests to watch it.

When my ENT showed me the ultrasound, he explained that the whole upper left pole of my thyroid had turned into the nodule.


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## jerseygirl (Jun 30, 2010)

O darn!! The t3 and t4 were canceled because they needed some written consent or something from my family doctor. If he could send it within a week they could use the blood from the draw I did last week. I phoned my doctor and he is on a holiday....DARN!! I don't mind going in for another draw but I was so happy I could go right that day because I felt so crappy!
I am scheduled for a FNB July 29 so that is not too bad....
Yesterday I had a really good day. Today not that great to be honest.
Irritated throat and it feels like it's burning. My ears are ringing like crazy and tired...so freaking tired it drives me nuts! I want to do soo many things but sometimes I can't make myself do them....
Sunday my back hurt like crazy! I never have a backache and it was such an unusual spot! I remember when I had an pneumonia it hurt in the same place. My back just below my shoulder blades, my ribcage. I couldn't even stand up at one time. Just felt like somebody knocked the wind out of me.
It freaks me out because I want to know if something is seriously wrong if you know what I mean....

It's one big waiting game....

Thanks again for listening to my complains and worries...:hugs:


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## jerseygirl (Jun 30, 2010)

FNB is scheduled for the 29th of this month. I am thinking of phoning back my surgeon though. Why do a FNB if I want that nodule out anyways? It's giving me a whole bunch of symptoms and I don't want to walk around with a 1.5 cm lump in my throat. Benign or not benign.
Tuesday i will see my GP again and I will discuss this.
Anyone an opinion about this?


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## McKenna (Jun 23, 2010)

You might want to check how your insurance works, if you would be able to "skip" the FNA and go straight to surgery.

My FNA came back inconclusive, and the ENT who did it told me he was comfortable watching it for a year. No thanks! He said he would take out the left lobe if I could not sleep at night not knowing what it was. I decided to get a second opinion this week and the new surgeon said he used to think doing a lobectomy was ok, but has since changed his mind after doing hundreds of thyroidectomys. His reasons were 1. if it comes back cancer he would have to go back in and remove the other side, that means more scar tissue to get through and more complications. 2. nodules can still grow on the lobe that's left, so I would still need to be monitored. I scheduled a TT with him for Sept.

About the back pain...I have had terrible back pain mostly between my shoulder blades and upper back onto my shoulders for a few months since this all started. I'm convinced it's b/c of whatever I'm going through. And I get ringing in my ears occasionally too, when I feel nervous and edgy which I'm sure is from a hyper phase.


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## Andros (Aug 26, 2009)

jerseygirl said:


> FNB is scheduled for the 29th of this month. I am thinking of phoning back my surgeon though. Why do a FNB if I want that nodule out anyways? It's giving me a whole bunch of symptoms and I don't want to walk around with a 1.5 cm lump in my throat. Benign or not benign.
> Tuesday i will see my GP again and I will discuss this.
> Anyone an opinion about this?


It's not a bad idea to do the FNB as that will help the surgeon know what he/she is dealing with.


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## jerseygirl (Jun 30, 2010)

Thanks for the replies guys.

Next week I will undergo the biopsy as scheduled. We will go from there.

The last week and a half I feel worse. The shaking and the fatique is worse and my throat hurts. I am noticeably hoarse now and I know it is not a cold. The pain is deeper in my throat. I am concerned because that probably means the nodule is getting bigger. That's why I asked my doctor for another ultrasound. He said we better wait for the biopsy. All the waiting makes me even more anxious!
I just picked up my new blood results which I will share with you:

TSH- 1.2 (ref 0.38-5.5) was 1.2 back in April
Free T3 4.5 (ref 3.5-6.5) was 4.4
Free T4 13.9 (ref 10.5-20.0) was 12.6

As you can see things didn't change much. So confusing. I have all these symptoms and still my blood tests all come back within the range.
Can a nodule give you all these symptoms and leave your blood all normal?
I am afraid it is cancer because of my hoarseness and throat issues...
*Sigh*....such a long road...I hope I can get some answers soon and start feeling better...


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## Andros (Aug 26, 2009)

jerseygirl said:


> Thanks for the replies guys.
> 
> Next week I will undergo the biopsy as scheduled. We will go from there.
> 
> ...


Cancer must be ruled out. Sadly the hoarsness and so one are listed as possible symptoms of cancer. I am keeping you in my thougths and prayers.

What day is the biopsy?

Just so you know; we all care...................a lot. And we are here for you at all times.hugs2

Your docs are on top of this so keep the faith.


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## jerseygirl (Jun 30, 2010)

Last week Thursday I saw the surgeon. First I spoke to her assistant for almost an hour. Lot of questions and such. After that the surgeon poked her head around the corner and asked if I could come back after lunch (hour and a half later) because she was behind on her schedule. I agreed. I thought by myself that then she can take the time to do what she needs to do.
An hour and a half later I saw her for 5 whole minutes!! She felt my thyroid, asked if I had an ultrasound done because it was not in my file. She didn't find my blood results either and send me away with the message that somebody will contact me next week so I can make an appointment for the biopsy. With a little luck we have the results somewhere in the middle of August. She wasn't able to do it there because she didn't have the equipment. Duh!! Didn't she know that beforehand? I was really annoyed. A: nothing was done today and I had prepared myself for that biopsy and B: my file was not in order. When I phoned my GP the assistant said that everything was send by email and all the reports and tests were attached. I phoned the surgeons office to tell her that and O, yeah...here they are:confused0064:.

So today I phoned the office myself to make an appointment for the biopsy. The assistant couldn't find a note from the surgeon about an appointment. So I said well I NEED to get a biopsy done asap because I am already waiting for more then a month. Appears that the surgeon is away until the 10th. O and we are not able to see you before the end of October anyways because we have a waiting list! 
This drives me nuts!!! She tells me in my face that we probably will have the results the middle of August while she knows that she will be away!! And the whole thing about missing stuff in my file and such doesn't give me a good feeling at all so I phoned my GP to find me another surgeon. He didn't phoned me back yet....
God...does this ever end? 
To end with a good note: I read a lot about Wilson's low temperature syndrome and measured my temperatures for a few days in a row. My temp is consistently low (average 36.3 and my basal was 35)so I went to my GP and asked him for T3 Cytomel.
I start with 5 mcg for a day or 2 and work my way up to 25mcg. I will continue taking my temp and heart bpm.
Fingers crossed. I hope I will get some relief because all this starts to drive me bonkers!!!


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