# tests for GD



## kitemom (Aug 19, 2010)

Good evening, 
I am curious how one might be diagnosed with GD. Is there a particular test that is ran or is it your labs that show the disease? I'm wondering if my endo checked me for this or if it may have been overlooked. I have a mutinodular goiter and a dominant 3.6cm complex mass along with a hyperthyroidism diagnosis. Nothing has been said to me about GD, but I'm wondering it it could possibly be GD causing all these problems. Just reading up and trying to educate myself. My biggest fear is that it might be cancer. Any thoughts on this. Thank you all very much!!!

kitemom


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## Andros (Aug 26, 2009)

kitemom said:


> Good evening,
> I am curious how one might be diagnosed with GD. Is there a particular test that is ran or is it your labs that show the disease? I'm wondering if my endo checked me for this or if it may have been overlooked. I have a mutinodular goiter and a dominant 3.6cm complex mass along with a hyperthyroidism diagnosis. Nothing has been said to me about GD, but I'm wondering it it could possibly be GD causing all these problems. Just reading up and trying to educate myself. My biggest fear is that it might be cancer. Any thoughts on this. Thank you all very much!!!
> 
> kitemom


I am sorry you are fearful but you are wise to consider the possibility of cancer for hyperthyroid, Grave's and Hashimoto's patients have been known to have cancer. It would seem hyper and cancer are bed fellows.

It would be a good idea to get a radioactive uptake scan (check for suspicious nodules) and also labs for TSI (thyroid stimulating immunoglobulin) which if present in any amount is the reason for hyper. Thryoglobulin Ab would be a good test too because increased amounts could mean cancer.

Was that a sonogram you had? Or an RAIU???

There is hyperthyroid and then there is Graves' as per Dr. Robert Graves (you can Google this guy.)

Criteria for Graves' is, Exophthalmos, Goiter, Pretibial Myxedema and Thyrotoxicosis.

And what treatment modality has the doctor suggested? Did you doctor comment?


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## kitemom (Aug 19, 2010)

Good morning Andros, 
Thank you! As for cancer, I appreciate your honesty. Based on the fact that I have hyperthyroidism, such a large mass, and a nodule, or two, or possibly the mass not taking in iodine, does that increase my odds that their may be malignancy??? I am hoping for the best but preparing for the worst. 
I already had an ultrasound and uptake scan. If you don't mind I will share the findings. I'm looking for any answers I can get, truths, opinions, thoughts. 
Sonogram shows an abnormal, complex, mixed solid and cystic right thy. lesion filling most of the right gland. The lesion measures 3.6cmx2.6cmx1.6 c. There is a large central cystic area with low level echoes and a solid capsule. There also are at least two mild subcentimeter hypoechoic nodular areas in the inferior pole of the the right thyroid a few millimeters. The left thyroid demonstrates 3 adjacent, well marginated and smooth hypoechoic solid nodules with the largest measuring 1 cm in the superior pole. The lower pole left thyroid nodule measures .7cm. The isthmus is normal. 
Thyroid uptake at 6 hours was 14.5% and at 24 hours was 29.7%. The right thryoid gland is normal in size and contour with a small to moderate sized, discrete, photopenic nodular area in the upper pole of the gland. The remainder of the gland is unremarkable. On the left side, there is significant decreased thyroid activity with two small areas of nodular residual acitivity. 
As for labs, I don't see a TSI or Thyroglubin Ab unless they go by some other name and I'm overlooking it. I will read up on the criteria for Graves.........not sure about all the lingo listed. 
At first my endo recommended TT due to hyper, size of mass, and nodules not taking in iodine. He referred me to to a teaching hospital an hour away. And he mentioned that if it is cancer they may be able to treat me there. I was pretty upset with this news since I had just had 4 surgies. He left me a message stating I may not need surgery, and he wanted to talk to me, but he won't be back in town til the end of the month. 
What would you all do if this were you? I'm thinking surgery................I don't know that I want to keep all of this inside me. But I will hear the doctor out on my options. Thanks for all your help. Do you think I could possibly have Graves? 
I know we are all in this boat together or we wouldn't be on this board, so I hope and pray each of you find a way to be strong, fight hard, and feel better!!!!

kitemom


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## Andros (Aug 26, 2009)

kitemom said:


> Good morning Andros,
> Thank you! As for cancer, I appreciate your honesty. Based on the fact that I have hyperthyroidism, such a large mass, and a nodule, or two, or possibly the mass not taking in iodine, does that increase my odds that their may be malignancy??? I am hoping for the best but preparing for the worst.
> I already had an ultrasound and uptake scan. If you don't mind I will share the findings. I'm looking for any answers I can get, truths, opinions, thoughts.
> Sonogram shows an abnormal, complex, mixed solid and cystic right thy. lesion filling most of the right gland. The lesion measures 3.6cmx2.6cmx1.6 c. There is a large central cystic area with low level echoes and a solid capsule. There also are at least two mild subcentimeter hypoechoic nodular areas in the inferior pole of the the right thyroid a few millimeters. The left thyroid demonstrates 3 adjacent, well marginated and smooth hypoechoic solid nodules with the largest measuring 1 cm in the superior pole. The lower pole left thyroid nodule measures .7cm. The isthmus is normal.
> ...


I am sorry but you really should have the gland ablated (surgical removal) as you have too much solid "stuff" going on. I know you have been through it of late but let's just say this is only going to be one more time; the last of it.

You never know; the thyroid is such an important gland and could very well have contributed to your other troubles in part. And do not settle for RAI. This gland definitely has to wen it's way to the pathologist. The outcome will define your future on-going treatment plan.

{{{{kitemom}}}} Sending prayers and hugs,


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## Andros (Aug 26, 2009)

kitemom said:


> Good morning Andros,
> Thank you! As for cancer, I appreciate your honesty. Based on the fact that I have hyperthyroidism, such a large mass, and a nodule, or two, or possibly the mass not taking in iodine, does that increase my odds that their may be malignancy??? I am hoping for the best but preparing for the worst.
> I already had an ultrasound and uptake scan. If you don't mind I will share the findings. I'm looking for any answers I can get, truths, opinions, thoughts.
> Sonogram shows an abnormal, complex, mixed solid and cystic right thy. lesion filling most of the right gland. The lesion measures 3.6cmx2.6cmx1.6 c. There is a large central cystic area with low level echoes and a solid capsule. There also are at least two mild subcentimeter hypoechoic nodular areas in the inferior pole of the the right thyroid a few millimeters. The left thyroid demonstrates 3 adjacent, well marginated and smooth hypoechoic solid nodules with the largest measuring 1 cm in the superior pole. The lower pole left thyroid nodule measures .7cm. The isthmus is normal.
> ...


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

http://www.hopkinsmedicine.org/endocrine/graves/TopicAnswer.asp?QuestionID=22

http://www.thyca.org/thyroglobulin.htm Read this one ever so carefully. It is not just a diagnostic tool post surgery but pre-surgery as well.


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## kitemom (Aug 19, 2010)

Andros, 
I think I'm with you on the surgery. My guess is that the option my endo doctor may want to talk to me about is RAI, but not sure. I don't think I would take that path as there is just too much weighing on pathology. I am grateful for your thoughts and opinions 
I certainly have alot of educating to do for myself. I will definitely read the sites you have posted above, thank you, thank you!


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## Andros (Aug 26, 2009)

kitemom said:


> Andros,
> I think I'm with you on the surgery. My guess is that the option my endo doctor may want to talk to me about is RAI, but not sure. I don't think I would take that path as there is just too much weighing on pathology. I am grateful for your thoughts and opinions
> I certainly have alot of educating to do for myself. I will definitely read the sites you have posted above, thank you, thank you!


You are most welcome. It is my mission to serve and protect!!hugs3


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## kitemom (Aug 19, 2010)

Please tell me these readings will get easier to understand with time. I'm a little overwhelmed with all the jargon. I'm sure the more I read the more I will get familiar with everything, whew!!


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## Andros (Aug 26, 2009)

kitemom said:


> Please tell me these readings will get easier to understand with time. I'm a little overwhelmed with all the jargon. I'm sure the more I read the more I will get familiar with everything, whew!!


Yes; it will get easier. Plow into it. That's what I did many years ago and I am still learning every single day.

Here is a "helper" for you. Look up Dorland's Medical Dictionary on-line, book mark it and make good use of it.

We may not all be Einsteins but we sure don't have to be uninformed and educated as much as time and energy will allow. We all have a lot of unused brain cells.

Go for it.


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