Do you only get nodules with an overactive thyroid?

[beaton]

[helvella Administrator]

It isn't that simple:

Thyroid nodules are not expression of a single disease but are the clinical manifestation of a wide range of different diseases. Non-neoplastic nodules are the result of glandular hyperplasia arising spontaneously or following partial thyroidectomy; rarely, thyroid hemiagenesia may present as hyperplasia of the existing lobe, mimicking a thyroid nodule. Non-neoplastic thyroid diseases, such as Hashimoto’s thyroiditis or subacute thyroiditis may appear as thyroid lumps which are not true nodules but just the expression of the underlying thyroid disease.

thyroidmanager.org/chapter/...

The answer is basically, you can have nodules regardless of thyroid hormone levels.

Rod

[beaton in reply to helvella]

Thanks Rod,

My notes say,USS neck thyroid not enlarged diffusely hypoechoic and heterogenous.

There is a 6mm well defined nodule in the R. lobe and a further 1cm hypoechoic defined nodule in the L lobe. Neither displaying sinister sonographic features.

So no further action.

I've been on T4 for 3years and the endo changed the 'script to T4&T3.

But he was convince that I must have had an over active thyroid at some time.

[helvella Administrator in reply to beaton]

I respect that may be his experience. He could well be right. But very often certainty is only achieved by pathology.

And thyroid nodules are very much not things I know much about - hence the quote.

Rod

[beaton in reply to helvella]

Thanks Rod.

[Jackie]

Hi Tends to be with autoimmune thyroid disease, mostly is. I have Hashimoto ( Hypo) and sever enlargement and nodules but specialised radiology assumed I was hyper, may have been to do with being very underweight!

Best wishes,

Jackie

[beaton in reply to Jackie]

Thanks Jackie,I'm just trying to get my head round it all,begining to feel like a freak.

[Jackie in reply to beaton]

Hi just a thought If you had nodules found on an ultra sound, routine is to then have a biopsy , fine needle under ultra sound ,done by a specialised radiologist. Also ,in that case has your PTH been checked,? Parathyroid. ? First test is 3 blood tests must be done Am and together, PTH, calcium , and vit D. If all high or 2 high and D high for you. Then you have a nuclear scan and CT ( large teaching hospital) of the PTH.

It does take ages to be stable with often set backs. , frequent bloods and alterations in meds.

Best wishes,

Jackie

[beaton in reply to Jackie]

Hi Jackie,Thanks for that,I was not aware of any of this and shall bring it up with my GP.

\\\\regards,Beaton

[Jackie in reply to beaton]

Hi Problems with the site again. I will have another go! None of the GP`s at my practice knew that D test vital with the other 2. My Endo said ,no use without it.

Best wishes.

Jackie

[beaton in reply to Jackie]

Thanks Jackie, I am waiting to see if my 'script will be filled by the end of the week (T3) Then I shall make an appointment with my GP. I know he will not be offended when I tell him what you have said. Thought he might have called me in after the letter from the endo. but looks like it's up to me.

regards Beaton.

[Jackie in reply to beaton]

Good, T3 should help a lot. letters, half of them do not get read by the correct GP, If at all.Then i find they just give it a quick glance! That is why I find a copy essential!I always take my copy with me, just in case!

Best wishes,

Jackie

[beaton in reply to Jackie]

Thanks Jackie.

[merissa in reply to Jackie]

jacki, quick question, my nodules were found on ultrasound and it was suggested FNA, but later said no, I understand that a ultrasound is used to detect if a nodule is hot or cold but will not tell the consultant if any pathology is present, is this correct? you say that a FNA should be routinely followed, but in my instance this was not the case, I was told its just one of those things lol they r having a laugh, I may be blonde but I am not stupid. my PTH was elevated and vitamin D low hence my bone profile was abnormal, no futher investigations. Only a week to have my consultation.

kindest

merissa xx

[Jackie in reply to merissa]

Hi Merissa,

For the thyroid nodules, you should have had a needle biopsy under a specialised radiologist.I know this is routine and the only way of telling ,in the unlikely find that it is malignant and needs surgery. I am certain of this, as I needed a biopsy but can never have them because of my co-morbidities, basically biospy or treatment ,surgery ,chemo etc. would kill me so no point in killing me with a simple biopsy, which may be negative.. As I think you know ,I have a brilliant Endo and she believes patients should always be well informed.If PTH high blood test, then a vit D test and a corrected calcium test must be done AM together, 3 tests. Without all 3 useless. A PTH problem can cause calcium to suddenly rise and the D to rise for you, PTH of course, high. GP `s I see did not know this! They do now!If this comes back suspicious should always be followed by the Nuclear scan and CT of the PTH. Cancer of the pTH is fairly common, not too serious ,as one of those that is totally self contained but. of course, surgery essential.

You know I cannot be brief as I assume every one like me, wants all the facts!!!!

Get back to me if you need to.

Best wishes,

Jackie