Multinodular goitre

Hi, I developed a toxic multi nodular goitre after having a 50% thyroidectmy, and I'm a little worried as im currently working overseas.

I visited my specialist in the UK last year and have recently visited a doctor here......the two pieces of advice are conflicting and wondered if any of you have or have had this condition and are willing to discuss it with me.

As I'm currently not sure what to do or whom to believe.

Many thanks in advance 😊 x

12 Replies

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  • Newcastle2013, it's generally assumed that MNG carries very low risk of being malignant but the last link suggests the incidence is higher than previously supposed. I would request a fine needle aspiration biopsy if you haven't already had one done.

    mythyroid.com/toxicmultinod...

    yourhormones.info/endocrine...

    thyroid.org/patient-thyroid...

  • Thanks for the info, its interesting to read of the change in opinion.

    I had a fna about 5yrar ago and was ok.

    My problem is the difference in medical systems between countries....my one remaining gland is 4times the size of an average gland and my uk doctor was happy to leave it my German doctor wanted to send me straight to a surgeon and said I should have been on meds for 20years my uk Drs said i didn't need any...so I'm confused. Who do u believe x

  • Newcastle, I think you need an FNA now to determine whether there have been any cell changes. If the FNA is benign and the goiter isn't impacting on other nearby organs or cosmetically upsetting you there seems no need for surgery.

    UK don't treat hypothyroidism until TSH is >5, sometimes >10. If your German doctor thinks you should have been on hormone replacement for 20 years it's either because he thinks replacement may have shrunk the goiter and/or their TSH requirement is lower for commencing treatment. I would be happy with the German protocols on either.

    It's just occurred to me that we get members from all over the world but I don't recall any German thyroid patients asking for help. Perhaps Germany treats thyroid better than the UK does?

  • Newcastle, what meds would the German doctor have had you on? I replied assuming you were hypothyroid after your partial thyroidectomy but doesn't a toxic nodule make you hyper?

  • My levels are just above normal. He didn't say which meds just thyroid hormone replacement drugs (although I'm not Fluent so he may have)

  • Newcastle2013, replacement is for hypothyroidism so you aren't hyperthyroid then.

  • Newcastle2013, replacement is for hypothyroidism so you aren't hyperthyroid then.

  • I got my results today I have a tsh of 0.02, t3 3.6 pgml and t4 1.2 pgml (both free).....he Said meds were no good, today and mentioned surgery or radio iodine therapy as an option but would monitor every 3months. Is the above standard or over cautious ? Thanks x

  • Newcastle, do you have the lab ref ranges for FT4 and FT3 (the figures in brackets after your results)?

  • The only other figures are a guess research range (?) ft3 2.3-4.2 and ft4 0.9-1.8

  • Newcastle, If the ranges are right you are neither hypo nor hyper despite the suppressed TSH.

    I don't think your doctor is being over cautious. His recommendation is surgery or RAI to ablate the thyroid and goiter. If you don't want to do either he wants to monitor you every 3 months.

  • Neither, my levels were within range last year. He said thyroid meds would have prevented the goitre developing and will slow its progress....like I said I'm confused as it contradicts the info I've. Already received.

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