# ultrasound results... please help me make sense



## propel (Jul 20, 2015)

Hello all,

I am new to this board. I have been on a brand new thyroid journey for the past two months, which landed me in for a thyroid ultrasound last week. I see my doctor to discuss my ultrasound findings tomorrow, but I an frankly nervous and tired of waiting. I was hoping to get a little insight in the meantime. Thank you in advance for sharing your knowledge with me, and I wish you all the very best.

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Thyroid gland slightly enlarged, with the right lobe measuring 5.1 x 2.2 x 1.9 cm in dimensions and the left lobe measuring 5.6 x 1.4 x 2.0 cm in dimensions. The isthmus measures 3.8 mm in thickness.

There is a tiny hypoechoic nodule in the right side of the isthmus, which measures 3 mm.

There is a dominant complex nodule containing solid and cystic components within the right lobe, which measures 1.6 x 1.2 x 1.4 cm in dimensions.

There is a hypoechoic nodule in the upper pole of the right lobe which measures 1.3 x 0.8 x 0.9 cm

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## joplin1975 (Jul 21, 2011)

You have two good-sized nodules on the right side of your thyroid. Hypoechoic means that the tissue is not "reflecting" the u/s waves at the same speed as the surrounding tissue. That is usually an indication of some kind of damage or irregularity. It can be from autoimmune disease or it could be indicative of cancer. Complex means part cystic and part solid. Solid nodules are more associated with cancer, but there's no way to say cancer vs no cancer without a biopsy.

The nodules have to be larger than 1cm to biopsy, so yours meet that criteria. Have they discussed that with you yet?


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## propel (Jul 20, 2015)

Thank you so much for your response. The radiology report says that biopsy (FNA) is recommended on the larger two, but I am meeting with my doctor tomorrow to get his take on things.

Do you have any suggestions for questions I should ask my doctor? A bit more background:

I am a 36 y/o femaile. I have had a lot of hypo and hyper thyroid symptoms for some time now, despite normal or borderline normal blood tests. My gyno decided to go ahead and try me on low dose thyroid hormone meds nearly two months ago since my symptoms were so typical of thyroid (low body temp, fatigue, suddenly irregular periods, some hoarseness, skin problems, racing heart, nervousness etc... Since I have researched hyper/hypo thyroidism, it is like my body shifts back and forth between the two at times, but is usually hypo. He started me on armour, and then I had a lot of dizziness and anxiety during the time for my period. So, he took me off armour but switched my to levothyroxine because the armour had helped some of my symptoms, such as low temp and skin rashes.

I have also had gastro symptoms for about a year now, and my doctor referred me to a surgeon for a colonoscopy. When I had the consultation with the surgeon, he recommended we ultrasound my gallbladder. I asked him to ultrasound my thyroid in addition, because things have felt odd in that area. So, he agreed to it.

And now, here I am...


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## propel (Jul 20, 2015)

I also wanted to add...

The levothyroxine seems to maybe? help a little, but I am having horrible symptoms right now again surrounding the time for my period. I don't even know if I should be on thyroid meds. I don't know if they are making some things worse, while making others better. I am a bit lost.


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## joplin1975 (Jul 21, 2011)

I know those feelings well. 

Do you have the exact blood tests, the results and the reference ranges? That would be helpful.

It's very likely you have antibodies that are causing you to flip flop from hyper to hypo. Some of those antibodies can make it very difficult to stabilize on meds.

A biopsy would be an excellent idea. I hope you will strongly consider getting the FNA done. If you have cancer, chasing down the right dose and medication is really a secondary issue.

Even without thyroid cancer, I think you might want to consider a surgical consult and it makes sense to find a surgeon who could do both the biopsy and sugery, if needed. The symptoms you describe sound like you either have or are heading towards an advanced case of autoimmune disease. That, again, can cause the stabilizing on meds tough.


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## propel (Jul 20, 2015)

I can't tell you how comforting it is to just talk to someone about this. I am going through so many things right now that I don't understand at all. I am trying to educate myself as much as possible right now, and I really appreciate the info you provided me with. I will seriously look into all of it. The doctor that ordered my thyroid ultrasound is a general surgeon. I see him in the morning. I will do the biopsies for sure.

The last blood test I had (about 3 months ago) is below, but I don't know the reference ranges. I will call to try to get those:

Free t4: 1.0
TSH: 1.16


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## jenny v (May 6, 2012)

Get a biopsy for sure! Those two nodules are big enough to do it and it sounds like you are flipping back and forth between hyper and hypo, which makes it hard for the medicine to work (I went through the same thing).


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## propel (Jul 20, 2015)

I had biopsies on the largest two done yesterday. Awaiting the rusults is difficult.

I am also quite nervous because due to the biopsy site of one, I see how incredibly close to my voice box one of them is. I am a professional voice user, so regardless of the outcome on the biopsy, I think I should see an ENT about this soon.

You mentioned that the same thing (hypo to hyper) happened to you. Would you mind sharing more about your experience?

Thank you for replying.


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## joplin1975 (Jul 21, 2011)

I had an advanced case of Hashimoto's, antibodies related to Grave's Disease and thyroid cancer. I had my thyroid and ten lymph nodes removed. I also had a treatment of radioactive iodine.

Finding the right dose of medication was a journey, but I fell better now than I have in years. I had no voice issues.


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## propel (Jul 20, 2015)

Wow, You have been through a lot. Thank you for sharing. I am so glad you are feeling better and on a good path with your medication.


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