# advise!! normal blood with nodules and symptom



## aderjane (Sep 11, 2012)

am a new member to this board, a long time lurker... unfortunately not new to the thyroid hell. My story (the short version): 11 years ago a doc told me one of my T levels were high in a routine blood test. Looking back I did have symptoms but wrote them off as "just my crazy life with 3 small kids". I had an uptake scan done and they found a hot nodule. The nodule would take me in and out of hyperT. No treatment was offered. Fortunately things would settle on their own with some help for diet/exercise. I repeated testing the following year or two and same story. None of the docs at that time told me there was a connection between hyperT and heart problems or damage! I have been to docs for heart palps and even a cardiologist for chest pain. Both were told about my hot nodule and neither connected the two.... first doc said she couldn't find anything so.... nothing. The cardio actually told me my heart was weak and that I should push it and build endurance. 
Anyway....fast forward to two months ago. I began experiencing moderate to severe symptoms (heart palps, elevated HR, leg pain, itchy skin, insomnia, brain fog and so on) and this time they were not going away. So I decided to get medical attn. My new doc seems to care (did all my labs) and is sending me on to an Endo. My labs are as follows:

9/4/2012
Antinuclear Anitbodies: negative
RA latex turbid: <10.0 range 0-13.9
*Antistreptolysin: 315.6 range 0-200****HIGH*
C-Reactive Protein, quant 2.2 range 0-4.9

CBC, all normal (platelets/monocytes on the low side of normal)

Metabolic Panel, all normal

Thyroid Antibodies
TPO ab 12 range 0-34
Antithyroglobulin <20 range 0-40

TSH .859 range .450-4.5
sed rate 4 range 0.32

ULTRASOUND
Findings: rt lobe 48x10x29mm and lft lobe 44x13x26mm. Isthmus 4mm

There is a rt upper pole 4x4x2mm cyst, a rt midpole 3x3x2mm cyst. there are two other right-sided cysts; 4x5x3mm and 5x3x6mm

There is a left thyroid ill-defined solid slightly hypoechoic nodule 8x7x6mm in the superior left thyroid.

There is a posterior left thyroid nodule or posterior to the thyroid nodule, solid but with some internal echogenicity 7x9x7mm "on image 21"

There is a complex cyst with septations and mural nodule 12x17x8mm in the superior left thyroid.

There is an ill-defined heterogeneous echogenic nodule in the mid thyroid 13x16x10mm

9/11/2012 
UPTAKE/SCAN
Findings: normal in size and homogeneous uptake and distribution with no discrete hot or cold nodules
4 hour tuv= 15.9 % range 5-15
24 hour tuv= 32.7 % range 10-30

"Normal size with slightly elevated uptake values"

9/27/2012
Free T3 3.1 range 2.0-4.4
Free T4 direct 1.12 range .82-1.77
TSH .509 range .450-4.5 ****

What I need advice about??? 1. Do hot nodules go cold? 2. Any insight you have! I have an Endo appt Oct 11 and want to walk in to this appt with a brain full of my own info so that I am prepared =) 3. Should I stop taking vitamins/minerals/herbs until I see endo? 4. Concerned about cancer =(
thanks in advance, Amy


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## Andros (Aug 26, 2009)

aderjane said:


> am a new member to this board, a long time lurker... unfortunately not new to the thyroid hell. My story (the short version): 11 years ago a doc told me one of my T levels were high in a routine blood test. Looking back I did have symptoms but wrote them off as "just my crazy life with 3 small kids". I had an uptake scan done and they found a hot nodule. The nodule would take me in and out of hyperT. No treatment was offered. Fortunately things would settle on their own with some help for diet/exercise. I repeated testing the following year or two and same story. None of the docs at that time told me there was a connection between hyperT and heart problems or damage! I have been to docs for heart palps and even a cardiologist for chest pain. Both were told about my hot nodule and neither connected the two.... first doc said she couldn't find anything so.... nothing. The cardio actually told me my heart was weak and that I should push it and build endurance.
> Anyway....fast forward to two months ago. I began experiencing moderate to severe symptoms (heart palps, elevated HR, leg pain, itchy skin, insomnia, brain fog and so on) and this time they were not going away. So I decided to get medical attn. My new doc seems to care (did all my labs) and is sending me on to an Endo. My labs are as follows:
> 
> 9/4/2012
> ...












Words such as complex, solid, ill-defined, septations (separated) are causes for suspicion of cancer.

A mural nodule means there are solid components in your cyst.

So, press for FNA or better yet, press to just go on to ENT. Methinks you have cause for concern.

And I am sooooooooooooooooooo glad you are here for we have many cancer survivors who spend an inordinant amount of time helping others who come here.

Since it is the weekend; you may not hear much until Monday but don't despair. You will get information, support and the help you need w/this.

Always trust your instincts. Your body "is" speaking to you!

And to answer your question, a nodule can change. It sure can. And a hot nodule is no guarantee there is not cancer although it is not common. Nonetheless, why not be sure?

Did you have a recent strept infection?

Are you now on a beta-blocker for your heart? You should be if not. You are very hyper. Have you been placed on anti-thyroid medication?

This might be worth reading.

http://www.ncbi.nlm.nih.gov/pubmed/12876418
The above on hyper and cancer was rare in 2003 but not so rare now. Probably due to better diagnostics or poorer environmental factors or both.


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## aderjane (Sep 11, 2012)

I am not on any meds. I have asked for a beta blocker from my pcp and she says I need an appt. So will make that appt, hopefully Monday. 
I have not had a recent infection/illness that I am aware of. My doc pointed that out as well and I am baffled why that antibody it high =0/

Are ENT's the docs that will do the FNA? So you think I should bypass the endo??
THANKS so much for your input!!!


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## Andros (Aug 26, 2009)

aderjane said:


> I am not on any meds. I have asked for a beta blocker from my pcp and she says I need an appt. So will make that appt, hopefully Monday.
> I have not had a recent infection/illness that I am aware of. My doc pointed that out as well and I am baffled why that antibody it high =0/
> 
> Are ENT's the docs that will do the FNA? So you think I should bypass the endo??
> THANKS so much for your input!!!


Yeah.........................I think you would get a better opinion from and ENT and he/she would then order FNA if there is suspicion to do so and I think there is. You can never be too inquisitive when it comes to one's health.

That is really strange about that antibody test. Really strange. You don't think the lab maybe got the bloods mixed up with someone else.? Is the doc going to re-run that test?

If the vial is dropped or otherwise mishandled, that can skew a test as well.

Do not delay that appt. for a beta-blocker!!! This is really important.


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## aderjane (Sep 11, 2012)

it states on my lab report "***verified by testing sample a second time***" or something to that effect (report not with me) re: strep antibody. I should have had them test it again when they did my last T3 and T4. I have made an appt with an ENT for next week and keeping the endo appt just in case. I will wait to see what ENT says. xxfingers crossedxx THANKS again Andros


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## aderjane (Sep 11, 2012)

I forgot to mention.... I have a pea sized lump near my collar bone...is there any thyroid connection with that area?


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## Andros (Aug 26, 2009)

aderjane said:


> it states on my lab report "***verified by testing sample a second time***" or something to that effect (report not with me) re: strep antibody. I should have had them test it again when they did my last T3 and T4. I have made an appt with an ENT for next week and keeping the endo appt just in case. I will wait to see what ENT says. xxfingers crossedxx THANKS again Andros


Oh, you are wise! I am sooooooooooooooooooooooo glad you are seeing ENT!! Thank goodness.

Please let us know the outcome of that visit when you can.

Keeping you in my thoughts and prayers plus crossed fingers!!!


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## greatdanes (Sep 25, 2010)

aderjane said:


> am a new member to this board, a long time lurker... unfortunately not new to the thyroid hell. My story (the short version): 11 years ago a doc told me one of my T levels were high in a routine blood test. Looking back I did have symptoms but wrote them off as "just my crazy life with 3 small kids". I had an uptake scan done and they found a hot nodule. The nodule would take me in and out of hyperT. No treatment was offered. Fortunately things would settle on their own with some help for diet/exercise. I repeated testing the following year or two and same story. None of the docs at that time told me there was a connection between hyperT and heart problems or damage! I have been to docs for heart palps and even a cardiologist for chest pain. Both were told about my hot nodule and neither connected the two.... first doc said she couldn't find anything so.... nothing. The cardio actually told me my heart was weak and that I should push it and build endurance.
> Anyway....fast forward to two months ago. I began experiencing moderate to severe symptoms (heart palps, elevated HR, leg pain, itchy skin, insomnia, brain fog and so on) and this time they were not going away. So I decided to get medical attn. My new doc seems to care (did all my labs) and is sending me on to an Endo. My labs are as follows:
> 
> 9/4/2012
> ...


It's been so long since I researched nodules heavily but I believe they have to be 1-2cm before they biopsy. I had 2 nodules that were solid and hypoechoic. The research pointed to a higher % of cancer, but the chances of it NOT being cancer were higher....still meaning less likely. Mine were discovered almost 4 yrs ago. Research says that solid ones don't shrink, but low and behold one of mine disappeared, and the other one has stayed the same size for 3 1/2 yrs. All you can do is keep an eye on them. I get an u/s once a yr.


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