# Need to know if I should try to rush my biopsy



## aliciap1214

I had a recent thyroid ultrasound that showed "Multiple complex nodules in both thyroid lobes that have internal blood flow". They are all pretty small, ranging from 2.6 x 2 mm to 5.4 x 14 mm. The impression stated by the radiologist is as follows:

1. Upper limit of normal-sized both thyroid lobes with multiple subcentimeter hypoechoic/complex nodules.

2. The largest nodule in the left isthmus measures 7 x 6 mm. This is an ill-defined solid nodule with internal blood flow.

3. New right cervical lymph node measures 5.4 x 14 mm.

4. Left cervical lymph node measures 5.3 x 12.5 mm, previously measured 4.6 x 14 mm.

These findings led my PCP to order a CT Scan, and it turned up the following findings:

A 2.9 x 2.3 x 3.1 cm, round fairly well-circumscribed, slightly heterogeneous mass situated inferior to the left thyroid lobe probably enhances, although no precontrast study was obtained. The appearance is similar to the adjacent thyroid gland, although not reliably contiguous in any plane. This mass was probably present in retrospect on the prior MRI of the cervical spine and overall not significantly changed in size.

The superior extent of the mass is situated at the clavicular heads and is approximately 2 cm of retrosternal extension. The airway may be slightly deviated to the right, but there is no other significant mass affect on the surrounding structures. Differential considerations would include thyroid mass or parathyroid neoplasm, considered less likely. No other abnormal enhancement and no pathologically-enlarged cervical lymph nodes. The remaining soft tissues, include portions of the bone, are grossly unremarkable. No lytic or sclerotic bony lesions are detected.

My concern/question is as follows:

My Endocrinologist stated that she wanted my thyroid biopsy to be done by the first week of January, but put it through as "routine", so now it has been put off until 1/21/2010. Is this O.K. in light of the second mass that turned up in my CT Scan? And should I have the thyroid biopsy before the mass biopsy? I guess I'm both confused and a little scared.

Alicia :confused0033:


----------



## aliciap1214

I guess persistence pays off. My thyroid biopsy has been moved up to next Monday (12/28/09). I am still concerned about the "mass" (its biopsy hasn't been scheduled yet). If anyone has had anything similar and has any thoughts, etc., I'd be very grateful for your input.


----------



## Andros

aliciap1214 said:


> I had a recent thyroid ultrasound that showed "Multiple complex nodules in both thyroid lobes that have internal blood flow". They are all pretty small, ranging from 2.6 x 2 mm to 5.4 x 14 mm. The impression stated by the radiologist is as follows:
> 
> 1. Upper limit of normal-sized both thyroid lobes with multiple subcentimeter hypoechoic/complex nodules.
> 
> 2. The largest nodule in the left isthmus measures 7 x 6 mm. This is an ill-defined solid nodule with internal blood flow.
> 
> 3. New right cervical lymph node measures 5.4 x 14 mm.
> 
> 4. Left cervical lymph node measures 5.3 x 12.5 mm, previously measured 4.6 x 14 mm.
> 
> These findings led my PCP to order a CT Scan, and it turned up the following findings:
> 
> A 2.9 x 2.3 x 3.1 cm, round fairly well-circumscribed, slightly heterogeneous mass situated inferior to the left thyroid lobe probably enhances, although no precontrast study was obtained. The appearance is similar to the adjacent thyroid gland, although not reliably contiguous in any plane. This mass was probably present in retrospect on the prior MRI of the cervical spine and overall not significantly changed in size.
> 
> The superior extent of the mass is situated at the clavicular heads and is approximately 2 cm of retrosternal extension. The airway may be slightly deviated to the right, but there is no other significant mass affect on the surrounding structures. Differential considerations would include thyroid mass or parathyroid neoplasm, considered less likely. No other abnormal enhancement and no pathologically-enlarged cervical lymph nodes. The remaining soft tissues, include portions of the bone, are grossly unremarkable. No lytic or sclerotic bony lesions are detected.
> 
> My concern/question is as follows:
> 
> My Endocrinologist stated that she wanted my thyroid biopsy to be done by the first week of January, but put it through as "routine", so now it has been put off until 1/21/2010. Is this O.K. in light of the second mass that turned up in my CT Scan? And should I have the thyroid biopsy before the mass biopsy? I guess I'm both confused and a little scared.
> 
> Alicia :confused0033:


Oh, my gosh!! I am scared with you but in truth 1/21 is not that far away. Plus, you can always call and have yourself put on a "cancellation list" but you would have to be ready at a moment's notice.

Oh, dear..........we have a fellow here w/ retrosternal and it sounds like both of you will be considering surgery. The good news is it sounds self-contained. Thank goodness for that.

Are you having trouble breathing and/or swallowing?

We are here for you....................


----------



## aliciap1214

I really appreciate your reply, Andros. I actually was able to snag a cancellation spot for this upcoming Monday (12/28), so I am very relieved in that area. I'm still facing another biopsy for the "mass", so that may get pushed out a bit.

I am very new to all this, and a bit confused, because I was told in 2006 that my single nodule was gone, and now in 2009 I've been told it has now become "multiple complex" nodules. Is it normal for a nodule to come and go?

In answer to your question, if having Asthma/VCD (vocal cord dysfunction) would be considered as "trouble breathing", then yes. I did read that Asthma-like symptoms are sometimes associated with thyroid issues. As for trouble swallowing ... No, but ever since the Endocrinologist did her exam (on the 18th), I now have a constant feeling of a lump in my throat, and it sometimes gets pretty sore (after eating).


----------



## Andros

aliciap1214 said:


> I really appreciate your reply, Andros. I actually was able to snag a cancellation spot for this upcoming Monday (12/28), so I am very relieved in that area. I'm still facing another biopsy for the "mass", so that may get pushed out a bit.
> 
> I am very new to all this, and a bit confused, because I was told in 2006 that my single nodule was gone, and now in 2009 I've been told it has now become "multiple complex" nodules. Is it normal for a nodule to come and go?
> 
> In answer to your question, if having Asthma/VCD (vocal cord dysfunction) would be considered as "trouble breathing", then yes. I did read that Asthma-like symptoms are sometimes associated with thyroid issues. As for trouble swallowing ... No, but ever since the Endocrinologist did her exam (on the 18th), I now have a constant feeling of a lump in my throat, and it sometimes gets pretty sore (after eating).


Whoooooooooohoo about the appt.; good for you!! I have never heard of nodules coming and going, no. I have heard of them being engorged and therefore larger and or smaller depending on what is going on.

And yes, I consider the above "trouble breathing!"


----------



## aliciap1214

I had my biopsy yesterday (12/28/2009), and already got my results back; the nodule is benign. Yay!!!! Now I just need to find out what the "mass" is, and what my doctor plans on doing about it. I'm going to ask if they can please remove it as it is "retrosternal", which makes me concerned what will happen in the future if it is not removed.


----------



## Andros

aliciap1214 said:


> I had my biopsy yesterday (12/28/2009), and already got my results back; the nodule is benign. Yay!!!! Now I just need to find out what the "mass" is, and what my doctor plans on doing about it. I'm going to ask if they can please remove it as it is "retrosternal", which makes me concerned what will happen in the future if it is not removed.


That is the most wonderful news of all. And, please..............do let us know what the doctor has to say about possible surgery. I agree w/you on this issue.

Hey..............Happy New Year!!! Starting out w/ good news!


----------



## aliciap1214

Thank you, Andros. I spoke with my PCP on 12/30/09, and she gave me an immediate referral to the otolaryngology surgeon. She said there is always a chance that the biopsy gave a false negative, and the mass should come out. She also told me that they may, once they get in and see the number of nodules I have, just go ahead and remove my thyroid. I have an appointment set for 1/21/10 with the surgeon. So, we'll see! I'll let you know as soon as I know more.

I do have a question that maybe you might be able to answer having been on this forum for so long ....

Ever since I had my thyroid exam on 12/21, my throat and my neck has been bothering me. My head feels like it is too heavy (I know that sounds a bit weird), and I've had nearly constant bad headaches; plus I feel like I have a lump in my throat. Has this ever happened to anyone else .. where their symptoms worsen after a thyroid exam? Starting to wonder if it is just stress, and possibly all in my head.


----------



## Andros

aliciap1214 said:
 

> Thank you, Andros. I spoke with my PCP on 12/30/09, and she gave me an immediate referral to the otolaryngology surgeon. She said there is always a chance that the biopsy gave a false negative, and the mass should come out. She also told me that they may, once they get in and see the number of nodules I have, just go ahead and remove my thyroid. I have an appointment set for 1/21/10 with the surgeon. So, we'll see! I'll let you know as soon as I know more.
> 
> I do have a question that maybe you might be able to answer having been on this forum for so long ....
> 
> Ever since I had my thyroid exam on 12/21, my throat and my neck has been bothering me. My head feels like it is too heavy (I know that sounds a bit weird), and I've had nearly constant bad headaches; plus I feel like I have a lump in my throat. Has this ever happened to anyone else .. where their symptoms worsen after a thyroid exam? Starting to wonder if it is just stress, and possibly all in my head.


I feel you are in very competent hands. Whew; what good news.

Yes, if your thyroid organ was palpitated, pressed upon or if you took radioactive iodine; this could cause an inflammatory process. Many of us cannot stand anything around the neck for this very reason.


----------



## soladeo

Since having a number of thyroid exams, along with an ultrasound, I've noticed my neck to be sore, and feel as if I have a lump in my throat. I also have to clear my throat a lot. This didn't happen in previous exams (I've had thyroid nodules for 5 years), so it's good to know I'm not just imagining things.


----------



## aliciap1214

You're not imagining things, Soladeo. I had my exam on 12/21 and I'm still feeling a lump in my throat, plus my neck has been hurting; so much so that I've been fighting headaches every day.


----------



## Andros

aliciap1214 said:


> You're not imagining things, Soladeo. I had my exam on 12/21 and I'm still feeling a lump in my throat, plus my neck has been hurting; so much so that I've been fighting headaches every day.


Remind me about your upcoming appt. w/ the otolaryngology surgeon. Just wanted you to know I am thinking of you.


----------



## aliciap1214

Thank you, Andros. Just to let you know, the appointment has been pushed up to 1/15 (which I'm thrilled about). Also, my Endocrinologist ordered PTH and Calcium testing, which leads me to believe she thinks I have a benign Parathyroid tumor. Either way, I'll be glad to have whatever it is, removed.


----------



## Andros

aliciap1214 said:


> Thank you, Andros. Just to let you know, the appointment has been pushed up to 1/15 (which I'm thrilled about). Also, my Endocrinologist ordered PTH and Calcium testing, which leads me to believe she thinks I have a benign Parathyroid tumor. Either way, I'll be glad to have whatever it is, removed.


And/or the thyroid tissue is encapsulating the parathyroids and by the way, do know that they can put your parathyroid gland in your shoulder or near the clavicle if they should have to be removed and they are healthy. Did you know that?

Glad you have been bumped up on that appt..


----------



## aliciap1214

O.k., now I am completely confused, and starting to get scared again. My PTH and Calcium came back normal, which means my parathyroid is not being affected by the mass. I was hoping the mass was a benign parathyroid tumor, and thus could have it removed, and be done with it; but unfortunately it is not.

Has anyone heard of someone having a benign parathyroid mass that is NOT affecting parathyroid levels and/or calcium levels? Is it even possible?


----------



## aliciap1214

Andros said:


> And/or the thyroid tissue is encapsulating the parathyroids and by the way, do know that they can put your parathyroid gland in your shoulder or near the clavicle if they should have to be removed and they are healthy. Did you know that?
> 
> Glad you have been bumped up on that appt..


I did read about that, but hadn't thought about it lately. Thank you for reminding me.


----------



## Andros

aliciap1214 said:


> O.k., now I am completely confused, and starting to get scared again. My PTH and Calcium came back normal, which means my parathyroid is not being affected by the mass. I was hoping the mass was a benign parathyroid tumor, and thus could have it removed, and be done with it; but unfortunately it is not.
> 
> Has anyone heard of someone having a benign parathyroid mass that is NOT affecting parathyroid levels and/or calcium levels? Is it even possible?


I am glad your tests came back in normal range. Re the mass. I would have no idea but as previously stated, I suspect that the thyroid tissue is wrapped around the parathyoid glands. This happens a lot.

So...............the doctor has suggested what?

Don't be scared; I am keeping you in my thoughts and prayers.


----------



## aliciap1214

Update .... Spoke with the surgeon yesterday. He said the mass definitely has to come out, and that it is most likely causing the pressure feeling I have (and neck issues). He also said he will try to not remove any of my thyroid as the nodule biopsy came out benign. Not sure how I feel about that ... I know trying to regulate thyroid medication can be difficult .. but should I keep my thyroid if it has gone from one nodule to many complex, hypoechoic with blood flow?

I guess it's not up to me anyway ...


----------



## Andros

aliciap1214 said:


> Update .... Spoke with the surgeon yesterday. He said the mass definitely has to come out, and that it is most likely causing the pressure feeling I have (and neck issues). He also said he will try to not remove any of my thyroid as the nodule biopsy came out benign. Not sure how I feel about that ... I know trying to regulate thyroid medication can be difficult .. but should I keep my thyroid if it has gone from one nodule to many complex, hypoechoic with blood flow?
> 
> I guess it's not up to me anyway ...


Boy, that is a confusing statement. I think it is going to be a whole different story when he gets in there.

When is the surgery? Maybe he can save part of your thyroid; he will have to have a looksee.

Let me know when this event is taking place.


----------



## aliciap1214

Yes, it is very confusing. I don't really understand how he can determine the thyroid is fine from just biopsying one nodule; esp. when there is a 3 cm mass behind it. Anyway, I'll post the surgery date as soon as it's set. Thanks, Andros.


----------



## Andros

aliciap1214 said:


> Yes, it is very confusing. I don't really understand how he can determine the thyroid is fine from just biopsying one nodule; esp. when there is a 3 cm mass behind it. Anyway, I'll post the surgery date as soon as it's set. Thanks, Andros.


I still suspect the mass to be thyroid tissue. Harumph. Well, no matter what, I am here for you and so are the other posters. Hang in there. Soon we "will" find out.

It is not a matter of who is right and who is wrong, rather............it is all about getting you well.


----------



## aliciap1214

UPDATE:

I had my surgery on February 25th, and it went very well. The mass (goiter) turned out to be much larger than the surgeon expected (extended from behind the left lobe of my thyroid down into my chest wall). He removed a small portion of the left lobe of my thyroid to get to the goiter, along with the nodules, and was also able to get all the goiter (which was benign, thank God).

Since the surgery I have noticed that my neck pain (in the T6, 7 and 8 area) has dissipated. So I have much to be grateful for.

As for the surgery itself ...

I would say the worst part of it was trying to swallow for about the first three days. It reminded me of when I had strep throat in my twenties. However, it wasn't so bad that I needed to take anything stronger than 500 MG of Extra-Strength Tylenol. The only other semi-annoying thing was the neck compression bandage as it forced me to keep my neck stable, and caused some neck strain (I was very, very happy to remove it after three days), but that's about it. So for those who may be facing this surgery, please rest assured that it is not a difficult surgery, and you will be on the mend very quickly. As a matter of fact, I could have returned to work after 1 week, but took two because of lower back issues (from being on the operating table 3 hours).

Thank you, everyone (esp. Andros) for your help and support.

Alicia


----------



## Andros

aliciap1214 said:


> UPDATE:
> 
> I had my surgery on February 25th, and it went very well. The mass (goiter) turned out to be much larger than the surgeon expected (extended from behind the left lobe of my thyroid down into my chest wall). He removed a small portion of the left lobe of my thyroid to get to the goiter, along with the nodules, and was also able to get all the goiter (which was benign, thank God).
> 
> Since the surgery I have noticed that my neck pain (in the T6, 7 and 8 area) has dissipated. So I have much to be grateful for.
> 
> As for the surgery itself ...
> 
> I would say the worst part of it was trying to swallow for about the first three days. It reminded me of when I had strep throat in my twenties. However, it wasn't so bad that I needed to take anything stronger than 500 MG of Extra-Strength Tylenol. The only other semi-annoying thing was the neck compression bandage as it forced me to keep my neck stable, and caused some neck strain (I was very, very happy to remove it after three days), but that's about it. So for those who may be facing this surgery, please rest assured that it is not a difficult surgery, and you will be on the mend very quickly. As a matter of fact, I could have returned to work after 1 week, but took two because of lower back issues (from being on the operating table 3 hours).
> 
> Thank you, everyone (esp. Andros) for your help and support.
> 
> Alicia


Alicia.................I am falling over with joy! Thank God it was benign and yes, yours was substernal so you had quite the surgery there and I am amazed that you feel so great!! And quite happy about it also!arty0045:

I am glad you took 2; you deserve it and you do need to give time to heal and get that anesthetic out of your system also.

Are you one thyroxine at this time? If so, what and how much? When do you go for follow-up?

You are welcome; I did not do much. Just a shoulder to lean on.:winking0014:


----------



## aliciap1214

Hi Andros,

My follow-up with the surgeon is on the 25th. As for thyroxine .. they haven't put me on anything, yet. I guess they figure they took so little of my thyroid that it isn't necessary. However, I will follow up with my PC if I start to feel any different. At the moment I feel fine. Any signs I should be looking for, just in case?

Take care,

Alicia


----------



## Andros

aliciap1214 said:


> Hi Andros,
> 
> My follow-up with the surgeon is on the 25th. As for thyroxine .. they haven't put me on anything, yet. I guess they figure they took so little of my thyroid that it isn't necessary. However, I will follow up with my PC if I start to feel any different. At the moment I feel fine. Any signs I should be looking for, just in case?
> 
> Take care,
> 
> Alicia


How much thyroid do you figure you have left? The entire right lobe and part of the left?

Gaining weight, edema, dry skin, hair falling out (bear in mind anesthetic may cause some of this), constipated, feeling cold, feet and ankles hurting,other joints hurting....................can't get enough sleep. Lethargic. But it's too soon, like I say, some of the above symptoms could just be from what you have gone through.

Lab tests will tell when you go on the 25th.


----------



## aliciap1214

I had my appointment about a week and a half ago with my Endocrinologist, and she send me for a loop! She said, "oh, you had your surgery? Well, you should have had the entire thyroid removed."

She went on to explain that the mass could return, along with the nodules, and that I will most likely have to be put on thyroid medication anyway (something the surgeon was trying to avoid). She then scheduled me for lab tests and an ultrasound (to see how much thyroid I actually have left. The surgeon did state that he only took a small amount so he could get to the mass (goiter) behind it. However, his surgical notes also mentioned a "thyroid mass" that he removed. The Endocrinologist was confused as to whether he simply meant a nodule, or an actual separate mass).

My ultrasound is set for tomorrow morning, and the lab work results are already in:

T4 FREE: .73 (12/21/09 it was .82)
T3 FREE: 2.85 (no prior tests to compare to)
TSH 3rd Gen: 2.34 (12/21/09 2.11)

I dropped a little in my T4 count, and yet went up in my TSH. Does that mean I'm becoming hypothyroid?

I have been noticing that I never feel rested, no matter how much extra sleep I get. I'm tired (lethargic) all the time. Plus I'm having trouble concentrating (focusing), my hands are cold all the time, and I'm slightly irritable. Fortunately I'm not constipated, which surprises me as I struggle with that from time to time. The other thing I've noticed is that I just don't feel well lately. It's kind of hard to put a finger on it, except to say that I'm slightly nauseated, but not so much so that I don't want to eat. Oh, and yeah, I'm losing hair; not in clumps, I just notice hair in the tub after I shower (more than usual), and in my hands after I put gel in my hair.

I'd say the biggest issue, however, is how tired I am. For the last couple of days, after going on my daily walk, I felt weak and winded.


----------



## Andros

aliciap1214 said:


> I had my appointment about a week and a half ago with my Endocrinologist, and she send me for a loop! She said, "oh, you had your surgery? Well, you should have had the entire thyroid removed."
> 
> She went on to explain that the mass could return, along with the nodules, and that I will most likely have to be put on thyroid medication anyway (something the surgeon was trying to avoid). She then scheduled me for lab tests and an ultrasound (to see how much thyroid I actually have left. The surgeon did state that he only took a small amount so he could get to the mass (goiter) behind it. However, his surgical notes also mentioned a "thyroid mass" that he removed. The Endocrinologist was confused as to whether he simply meant a nodule, or an actual separate mass).
> 
> My ultrasound is set for tomorrow morning, and the lab work results are already in:
> 
> T4 FREE: .73 (12/21/09 it was .82)
> T3 FREE: 2.85 (no prior tests to compare to)
> TSH 3rd Gen: 2.34 (12/21/09 2.11)
> 
> I dropped a little in my T4 count, and yet went up in my TSH. Does that mean I'm becoming hypothyroid?
> 
> I have been noticing that I never feel rested, no matter how much extra sleep I get. I'm tired (lethargic) all the time. Plus I'm having trouble concentrating (focusing), my hands are cold all the time, and I'm slightly irritable. Fortunately I'm not constipated, which surprises me as I struggle with that from time to time. The other thing I've noticed is that I just don't feel well lately. It's kind of hard to put a finger on it, except to say that I'm slightly nauseated, but not so much so that I don't want to eat. Oh, and yeah, I'm losing hair; not in clumps, I just notice hair in the tub after I shower (more than usual), and in my hands after I put gel in my hair.
> 
> I'd say the biggest issue, however, is how tired I am. For the last couple of days, after going on my daily walk, I felt weak and winded.


For starters, the endo needs to call the surgeon and clarify before he/she makes statements. That's my feeling and there should be nothing to prohibit "YOU" from calling the surgeon to clarify.

Usually w/ hypo, the FREES do go down and the TSH goes up. Sad there is no range available for the FREE T3 because that would help me tell a lot more. But, I do think you are leaning towards hypoland now.

Please, please let us know about the ultra-sound tomorrow morning. I will hang out here all day waiting to hear.


----------



## Andros

aliciap1214 said:


> I had my appointment about a week and a half ago with my Endocrinologist, and she send me for a loop! She said, "oh, you had your surgery? Well, you should have had the entire thyroid removed."
> 
> She went on to explain that the mass could return, along with the nodules, and that I will most likely have to be put on thyroid medication anyway (something the surgeon was trying to avoid). She then scheduled me for lab tests and an ultrasound (to see how much thyroid I actually have left. The surgeon did state that he only took a small amount so he could get to the mass (goiter) behind it. However, his surgical notes also mentioned a "thyroid mass" that he removed. The Endocrinologist was confused as to whether he simply meant a nodule, or an actual separate mass).
> 
> My ultrasound is set for tomorrow morning, and the lab work results are already in:
> 
> T4 FREE: .73 (12/21/09 it was .82)
> T3 FREE: 2.85 (no prior tests to compare to)
> TSH 3rd Gen: 2.34 (12/21/09 2.11)
> 
> I dropped a little in my T4 count, and yet went up in my TSH. Does that mean I'm becoming hypothyroid?
> 
> I have been noticing that I never feel rested, no matter how much extra sleep I get. I'm tired (lethargic) all the time. Plus I'm having trouble concentrating (focusing), my hands are cold all the time, and I'm slightly irritable. Fortunately I'm not constipated, which surprises me as I struggle with that from time to time. The other thing I've noticed is that I just don't feel well lately. It's kind of hard to put a finger on it, except to say that I'm slightly nauseated, but not so much so that I don't want to eat. Oh, and yeah, I'm losing hair; not in clumps, I just notice hair in the tub after I shower (more than usual), and in my hands after I put gel in my hair.
> 
> I'd say the biggest issue, however, is how tired I am. For the last couple of days, after going on my daily walk, I felt weak and winded.


Pathologist said a "mass!" Here is your original report.......

The superior extent of the mass is situated at the clavicular heads and is approximately 2 cm of retrosternal extension. The airway may be slightly deviated to the right, but there is no other significant mass affect on the surrounding structures. Differential considerations would include thyroid mass or parathyroid neoplasm, considered less likely. No other abnormal enhancement and no pathologically-enlarged cervical lymph nodes. The remaining soft tissues, include portions of the bone, are grossly unremarkable. No lytic or sclerotic bony lesions are detected.

And his guestimate was either thyroid or parathyroid mass.

I personally think you are going to be okay. He got the mass out. Let's take it one step at a time. I think if you talked to the surgeoun yourself, it would be reassuring to you.


----------



## hillaryedrn

I'm glad you've had the surgery!! That is odd that the endocrinologist thought the surgeon would be taking out the entire thyroid, yet that isn't what happened. I would most definitely get that clarified. Have you had the ultrasound yet? What did it show? How are you feeling now? Still tired and drained? If you have at least half of your thyroid left, you "shouldn't" need to go on replacement meds, but it is possible. Keep us informed!!


----------



## aliciap1214

Thank you, Andros and Hillary.

I haven't had the ultrasound yet, as it's scheduled for tomorrow morning. I usually don't get the results right away (so Andros, please don't hang around for it ). I promise to let you know as soon as I hear something.

As for the "mass" ... Yes, the pathologist did say "mass", but the indication my Endo got was that the surgeon removed something _additional_ to the one mentioned in the report. I did tell her what the surgeon told me (that he removed a large goiter and some of the nodules), but she still thought there was something else involved. Oh, one other thing, the initial cold slice biopsy done during my surgery turned up "lesions" - something else my Endo brought up to me. She is concerned that I could still develop cancer. Oh well.

I did do a bit of research today, and found some interesting posts on another site about taking a combination T4/T3 or Cytomel. From what I read (and there were a lot of entries), people with a TSH 2.01 to 3 experience hypo symptoms. Here's the link to what I read:

http://www.altsupportthyroid.org/tsh/tshexp3pr.php#2.01

So I have to agree with you, Andros, I may be heading in to hypo land. Personally, I think I've always been. As I've had a heck of a time losing weight, dealing with fatigue, cold hands, and tingling and numbness in my hands for years.


----------



## hillaryedrn

Well, the only solid clarification I can give you so far is that "lesion" refers to any different area. Could be a tumor, could be cancer, could just be a strange spot. I'm curious as to what your ultrasound will show and what your surgeon has to say!


----------



## Andros

aliciap1214 said:


> Thank you, Andros and Hillary.
> 
> I haven't had the ultrasound yet, as it's scheduled for tomorrow morning. I usually don't get the results right away (so Andros, please don't hang around for it ). I promise to let you know as soon as I hear something.
> 
> As for the "mass" ... Yes, the pathologist did say "mass", but the indication my Endo got was that the surgeon removed something _additional_ to the one mentioned in the report. I did tell her what the surgeon told me (that he removed a large goiter and some of the nodules), but she still thought there was something else involved. Oh, one other thing, the initial cold slice biopsy done during my surgery turned up "lesions" - something else my Endo brought up to me. She is concerned that I could still develop cancer. Oh well.
> 
> I did do a bit of research today, and found some interesting posts on another site about taking a combination T4/T3 or Cytomel. From what I read (and there were a lot of entries), people with a TSH 2.01 to 3 experience hypo symptoms. Here's the link to what I read:
> 
> http://www.altsupportthyroid.org/tsh/tshexp3pr.php#2.01
> 
> So I have to agree with you, Andros, I may be heading in to hypo land. Personally, I think I've always been. As I've had a heck of a time losing weight, dealing with fatigue, cold hands, and tingling and numbness in my hands for years.


You are symptomatic and have been. It is true; at a certain point, it is not all about TSH. The Free T4 and the Free T3 "must" be done ocassionally to get the patient absolutely on track.

Good link too! Glad you are researching. Your doctors need to know that they can't pull the wool over your eyes.


----------



## aliciap1214

I got my ultrasound results back, and also found some older lab test results. Here's what they all say:

Ultrasound:

lightly inhomogeneous thyroid gland which could be indicative of thyroiditis 
either current or remote. The thyroid gland is not particularly enlarged. 
There is no focal cyst or nodule.

Right lobe of the thyroid gland measures 4.5 x 1.2 x 0.8 cm. The left lobe 3.7 x 1.3 x 1.1 cm. There is no obvious cervical lymphadenopathy.

IMPRESSION:

DESPITE HISTORY OF MASS IN THE BASE OF THE NECK ON REPORTED CT SCAN OF 12/15/2009, THE THYROID GLAND IS HOMOGENEOUS AND NOT ENLARGED. THERE IS NO OBVIOUS LYMPHADENOPATHY AROUND THE THYROID GLAND AREA. CLINICAL CORRELATION RECOMMENDED.

-----------------------------

The above simply states that the surgeon removed the nodule, and took a very small portion of my thyroid gland. The prior size of my gland was:

Right lobe: 4.6 x 1.1 x 1.3 cm
Left lobe: 3.6 x 1.1 x 1.4 cm

All lab tests to date:

8/9/2006:
TSH: 1.39 mcIU/mL
FREE T4: 1.11 ng/dL
Anti-TPO: 60 IU/mL

2/8/2008:
TSH: .98 mcIU/mL
FREE T4: 1.11 ng/dL
Anti-TPO: < 1.1 IU/mL

5/8/2009:
TSH: 1.05 mcIU/mL
FREE T4: 1.03 ng/dL

12/21/09:
TSH: 2.11 uIU/mL
FREE T4: .82 ng/dL
Anti-TPO: <20

4/5/2010:
TSH: 2.34 mIU/L
T4 FREE: .73 ng/dL
T3 FREE: 2.85 pg/mL

From the above, I'd say I've been heading into hypoland since 2008. My Endo has only seen the last two lab tests, and doesn't feel I'm hypo yet. I'm going to fax all my lab test results to her office today, and see if she changes her mind. At the moment I'm supposed to wait until my next appointment (6/14/10), retest, and then possibly get started on meds on a test basis.


----------

