# PLEASE Give me your opinion.



## 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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## greatdanes (Sep 25, 2010)

Hello, and welcome. Much controversy surrounds the idea of being able to shrink nodules. Most research says doing so with meds is not likely. Some nodules shrink and disappear on their own. I myself have had two dissapear. Selenium is good(and has been proven) for lowering TPO(ab's). I've heard good results from accupuncture but have never tried it myself. Are you taking vit D supplements, your levels are low but I've seen much lower, which is the reason why i ask if you are taking them


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## GD Women (Mar 5, 2007)

Thyroid cancers typically present as a dominant solitary nodule. Did 
specialists do a biopsy of nodule. Some specialists advocating biopsy of nodules greater than 1 cm in size, whereas others advocate biopsy of nodules greater than 1.5 cm in size. There are multiple factors that influence this decision.
Most solid thyroid nodules generally will not shrink spontaneously and completely disappear due to damage of the thyroid. Patients with a hemorrhage into a thyroid nodule may commonly experience reduction in size of the expanded nodule once the hemorrhage resolves. Similarly, patients with a nodular variant of Hashimoto's disease may notice nodules gradually getting bigger or smaller. Nevertheless, the majority of solid nodules remain persistent and detectable for many years.

Either you can go by your present specialists or seek a second opinion.

No easy way out.


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## g1961 (Nov 14, 2010)

Thank you for your post.

I think any alternative treatment is controversial ;-).

I have had positive results in the past for both accupuncture and Low Level Laser Treatment (LLLT aka Cold Laser Treatment) after a car accident for muscle and nerve problems.

I have read online taking thryoid medication can possibly increase the size of the goiters? I don't know if there is any truth to this? I take as little prescribed medication as absolutely. I have read Selenium is good for reducing goiters and I plan on trying this, do you know how much is recommended?

Yes, I am taking Vitamin D supplement. One pill a week for 8 weeks. I only have to remember to take it!!!!

What types of goiters did you have? I didn't know they could disappear. Amazing! Did you do anything causing two of them to dissappear?


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## greatdanes (Sep 25, 2010)

g1961 said:


> Thank you for your post.
> 
> I think any alternative treatment is controversial ;-).
> 
> ...


Hi again. My nodules were discovered two yrs ago when i was considered ''subclinically hyper''(TSH slightly low). I had 2 cysts and two nodules, both nodules were solid and hyperechoic. I had an u/s about two months ago, and only 1 nodule was found, and not even a cm. I rubbed lemon grass(akin to lemon balm) on my thyroid, as i had a friend with graves disease recommend i take it b/c she said it worked for her. I've used it both times i became aware there was an ''issue''. It is NOT recommended if you are hypo or have hashimotos b/c it could cause you to become permantly hypo...or at least I've read. The smell alone has such tranquil soothing effects! I researched it awhile back so I may be wrong but I remember reading that it shrinks mass's/cysts. It's also an anti-inflammatory, so it''may'' have played a role in shrinking my 2 cysts, and 1 nodule. Of course I've read varying studies that mention it's not uncommon for them to go away on their own, especially if they are cystic.

Yea I thought you were taking vit d. Selenium recommendation is 200mcg's daily. It's important taht you don't overdose or you'll have some adverse reactions.

PS, is the report that the nodule is benign, for one or both?


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## g1961 (Nov 14, 2010)

My primary care physician prescribed the first set of tests. The first US and FNA was done at the hospital and the second US by the endocrynoligist. I have two different opinions on the right lobe. The hospital said 3 small nodules and the endocrynologist said only one. The hospital did the FNA based on thier US report, only the left nodule was biopsied.

Thanks for letting me know. I will research it tomorrow while at work - hehe!

Its so nice outside for November I want to enjoy the last few hours playing with my dog.


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