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Thyroid Question


~Naomi~
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I recently had a CT scan of the neck looking for something that turned out to be not an issue, but on the report it talks about the thyroid a little. Says symmetrically small thyroid (why the need to mention size?) and says there's a small (5.9mm) nodule. The Dr. who ordered this scan called and said everything was normal - I didn't have the report when we had that conversation. It says on the report that this nodule "requires sonographic characterization." Doesn't that mean the radiologist thinks it should be looked at more closely? I did a little online looking and am confused - seems these are very common, usually benign, but also read they should be looked at - even small ones. Anyone know anything? And would a "small" thyroid mean anything?? Thanks.

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I don't know anything about nodules or small thyroid but based on what the radiologist said I would go for another opinion. I am wondering why you were originally sent for this scan, and have they done a TSH and most importantly antibody tests for the thyroid and a Free T3 (not just T3) and a Free T4(not just T4). Do you have any symptoms of thyroid issues? A great site that I found helpful is Medhelp. I have Hashimoto's (autoimmune form, hypothyroid). They have very knowledgable lay people and if you run your scenario by them they will give you things to think about or check into. You will probably find others with similar conditions. Along with a holistic/M.D. and this site I recently feel like I've gained more knowledge to finally start the right balance of medication since I've remained extremely symptomatic of hypothyroid inspite of sometimes being in the textbook norm on testing. Oh if you go to that site I suggest going on the thyroid community forum where you can ask questions.

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**** Naomi,

I have had thyroid issues and know a little bit. For me my thyroid was large which is a sign of a complication of some type of thyroid issue. So small can usually mean nothing since people can have different sized thyroids within a certain range. Usually nodules should be looked at, but most people acquire nodules after a certain age and it can be typical. But always always get a second and even third opinion.

I was unfortunately the one who found my own nodules on my CT scan, it was overlooked by two docs. I even told them I was having trouble swallowing. They always felt my neck and said they couldn't feel anything. Also, my TSH was completely normal. But during a CT scan of my lungs it fortunately and accidentally picked up a scan of my thyroid. The CT doc forgot to put the enlarged thyroid and nodules in the summary, so no one ever saw the results. Doctors mostly just look at the summary at the end of the paper work. One and a half years later I went through all of my tests with a fine tooth comb because no one could find out why I was so sick. At the time, two years ago I was 45 years old, 5'6" and weighed 110 pounds. I looked like I wasn't long for this world and I wasn't. I could not stand up without my heart rate going to 200 and my blood pressure was very erratic. I knew someone missed something. That's when I found on that old CT scan from over 1 year ago, that I had 2 enlarged thyroid lobes and a nodule. So I brought it to my primary docs attention and he reluctantly gave me an ultra sound and told me that it was surely nothing. Even after the ultra sound showed abnormal results my primary doc was reluctant to give me an endocronology referral because my TSH was still normal. He insisted what I had going on with my thyroid was normal. Anyhow, I was persistent and got the referral. It took a few months to get to the Endocronologist, and after a 45 minute consultation and feeling around my neck, I was told... don't worry about it! He said, the chance of me having cancer was 5% and if by the end of summer I wanted a biopsy, to do that, but to not give it a second thought because he was 95% sure it was nothing. I went with my gut since it was almost February, and him wanting me to wait 8 months was not an option since I was seriously sick. So I ignored what the endocronologist said and went straight to the diagnostic center to give the radiologist my ultra sound and CT results for a second opinion to the endo doc. I told the radiologist my short version of this story, he left for about 3 minutes and came out and yelled, who is your doctor, I'm calling him right now. He was so angry!! He said you need to fire your doctor, and he needs to quite his job, this is thyroid 101! You have a very enlarged thyroid lobe that can be toxic or an autoimmune disease and your other lobe is calcified which makes your chance of cancer at 85%. He said, I hate to scare you, but you should be scared, your doctors don't know what they are doing. And also he told me that the endocronologist wrote the biopsy for the wrong thyroid lobe. And then he looked and saw that it was on a CT scan over a year ago, he blew up and said, I'm calling your doctor right now. He said, I'm keeping these and you need to go get a referral for a biopsy right now. I went back to my primary doc, again I was met with resistance and he said, and I quote, "I wouldn't listen to some idiot radiologist over an endocronlogist," and he refused to give me a biopsy. I had to call my insurance company to get the referral. After the biopsy I had surgery ASAP. So to sum it up, I had to have 2 surgeries, that's another story. Anyhow, the first surgery was for cancer which unfortunately had spread to my parathyroids and had to be removed also, and the second lobe was exactly what the radiologist thought, it was toxic. So every time my thyroid was secreting thyroxine, it was poisoning me. People couldn't believe the difference in me just a few hours after the last surgery. And I could stand up without my heart rate going through the roof. That was huge. Also, the reason they couldn't feel my thyroid poking out of my throat was because it was actually growing in towards my throat not out, like most lobes and nodules do. Also, abnormal results were only found in a not so typical thyroid test, thyroidglobulin. Anyhow, sorry this is so long, but the moral of this story is, you have to be your own advocate. Go for second and most of all third opinions! As mad as I was at those doctors who kept brushing me off, I'm soooooo grateful for the angry radiologist. Also, the endo doc is no longer an endocronologist here and I never saw him again. But also to relieve your fears Naomi, I think small is better, but you should get a second and third opinion on the nodule, although they can be normal, just double check. And my husband has had nodules for a few years and so far they are normal. ;)Let me know how you come out.

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Maiysa - oh my goodness, what a story!! You found your own nodule??? How crazy (and how smart you are). I'd love to meet that angry radiologist - he sounds great! So glad you made it through all that. So I should ask for an ultrasound - is that the idea?

Paona- I posted a message at that board you told me about -we'll see if anyone knows anything.

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Oh, you are so sweet Naomi, but I should have been a lot smarter and checked those records a long time ago. :) Anyhow, yes, you should at least ask for an ultra sound. They are so easy and no prep at all. The just rub the ultra sound over the area. Also, you would need to see an endocronologist possibly. Is your TSH okay? Are you having any thyroid symptoms?

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Naomi - do you have any symptoms of hypothyroid or hyperthryoid? Many people out there have "normal" test results and find out that they still feel miserable. I'm reading a lot of different books on thyroid and finding that doctors need to be treating to the symptoms and not just test results. The only problem is that a lot of symptoms of thyroid issues are also symptoms of dysautonomia!

Brenda

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My symptoms fit lots of things - that's what makes this so tricky. Doctors keep thinking it's my thyroid, so it's been tested over and over. I had to ask them to STOP checking it! lol. Anyway, like you said I doubt most Dr's would treat for a thyroid condition, if you don't have the numbers to back it up.

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