# Is this an abnormal ultrasound?



## kme8908 (Mar 29, 2017)

This fall, after experiencing a myriad of typical "thyroid" symptoms I decided to go to my doctor to have some labs run. My doctor was on an extended vacation so I ended up visiting her NP. The NP said that my symptoms definitely warranted lab work, and an ultrasound because I have both a palpable (and visible) lump on the front right side of my neck and STRONG family history of Hashimoto's. She only ran TSH, which was normal 1.79 (0.40-4.50). Ultrasound results were:

Findings:

Thyroid gland is normal in size. The right thyroid lobe measures 5.2 x 1.7 x 2.0 cm. The left thyroid lobe measures 4.6 x 1.5 x 2.0 cm. The thyroid parenchyma is diffusely heterogeneous with increased vascularity. There are no discrete nodules. The isthmus is 3 mm thickness.

Impression:
Diffusely heterogeneous and hypervascular thyroid gland.

Because of normal TSH and no nodules no follow-up testing was done, and NP said that ultrasound findings were normal.

My symptoms did not go away, but not knowing enough about how the thyroid works I wrote it off, thinking I was just experiencing fatigue from lack of sleep/etc. After doing a bit of googling it seems that these results may not actually be normal... Is this true? Is it worth going back to my PCP and asking for more tests? Which tests should I ask for?

I would appreciate any guidance!


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## Lovlkn (Dec 20, 2009)

Welcome to the board! Joplin1975 is the expert on ultrasounds and will chime in shortly.

If you have the opportunity and can order labs on your own ( depends on which state you live in) I would suggest testing Free T-4 and Free T-3 to get an idea of where your free and unbound thyroid hormones are. TSH is diagnostic but since you are symptomatic and have a lump on your thyroid those tests would reveal the actual levels.

Next would be antibodies, TPO and Thyroglobulin.


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## joplin1975 (Jul 21, 2011)

Lovlkn said:


> Welcome to the board! Joplin1975 is the expert on ultrasounds and will chime in shortly.


Things I'd never think I'd be called. 

Is your ultrasound normal? No. Normal thyroids do not have heterogeneous echotexture nor are they hypervascular. Both are physical characteristics seen on diseased thyroids. I also believe your thyroid is a bit larger than normal. Again, also common with diseased thyroids.

Is there anything, based on your ultrasound alone, that should be done? No. The only time there are really any "action items" as a result of an ultrasound is if they find nodules, which they didn't.

That all said, it certainly "looks" like you have autoimmune thyroid issues (again, based only on the u/s) and you sound symptomatic. So you should really push for the testing Lovlkn mentioned.


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## kme8908 (Mar 29, 2017)

Lovlkn said:


> Welcome to the board! Joplin1975 is the expert on ultrasounds and will chime in shortly.
> 
> If you have the opportunity and can order labs on your own ( depends on which state you live in) I would suggest testing Free T-4 and Free T-3 to get an idea of where your free and unbound thyroid hormones are. TSH is diagnostic but since you are symptomatic and have a lump on your thyroid those tests would reveal the actual levels.
> 
> Next would be antibodies, TPO and Thyroglobulin.





joplin1975 said:


> Things I'd never think I'd be called.
> 
> Is your ultrasound normal? No. Normal thyroids do not have heterogeneous echotexture nor are they hypervascular. Both are physical characteristics seen on diseased thyroids. I also believe your thyroid is a bit larger than normal. Again, also common with diseased thyroids.
> 
> ...


Thank you both so much for your response. I have a doctor's appointment on monday and I will inquire about this testing. I think that the original NP that I saw did not really know what she was doing, and I regret not being more proactive in the beginning...


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