7cm nodule

[Alley27]

Hi everyone. Would you say that a 7cm nodule needs removing? I went to see an ENT consultant last week. He put a camera up my nose and said, after he had finished his exam...that's OK.

This morning I had another call from the hospital asking me to go for an ultrasound and fine needle biopsy...

Now call me daft, but I thought he said everything was alright. I thought that if there is anything wrong he would have seen it, on the screen. I have agreed to go for the ultrasound but, there is no way on God's earth that I am letting them shove a needle in my throat. I had 3 of them done over 2 weeks 10 years ago and they were awful.

I have a diagnosis of hashimotos from 10 years ago, followed 3 months later, by a diagnosis of autoimmune liver disease, so you can imagine my frustration.

I have lived with nodules since I was around 21 years old. This one however is much bigger. My thyroid panel keeps coming back within normal range but they did tell me my tsh was 10, this time whatever they mean by that.

I told them about this new nodule when it was 2cm 4 years ago and all I ever seem to get is we will wait and see.

I will go for the ultrasound tomorrow and as the consultant told me that's OK, I am not having anything intrusive done. My reason is that, covid is on the rise again, I am immune compromised and I do not want anything piercing my body that I am not used to.

I know they clean the rooms but, I don't know who was in that room before me or who the consultant has touched before me. A very valid argument for someone who is immune compromised.

My other thoughts are, why all of a sudden, do they feel that its urgent, when I was told, that it is OK.?

I tried to speak tomy gp about it too, to ask if any reports have been sent from ENT and you guessed it, I could not get an appointment, not even a phone call.

Not a happy lady at the moment .. does anyone have any suggestions about questions for me to ask tomorrow please as this has been dropped on me out of the blue,after being told that it's ok.

thanks in advance xx



[SlowDragon Administrator]

If your TSH is over 5 and you have hypothyroid symptoms you should be prescribed levothyroxine

If TSH is over 10 you must be prescribed levothyroxine

Starting levothyroxine - flow chart 

gps.northcentrallondonccg.n...

standard starter dose levothyroxine is 50mcg

Bloods should be retested 6-8 weeks after each dose increase

Dose levothyroxine is increased slowly upwards in 25mcg steps over 6-12 months until TSH is always below 2

Most people when adequately treated will have TSH around or under one. Most important results are always Ft3 followed by Ft4

When were vitamin D, folate, ferritin and B12 last tested

What vitamin supplements are you currently taking

As you have Hashimoto’s have you had coeliac blood test done

Are you on strictly gluten free or dairy free diet

[Alley27 in reply to SlowDragon]

Thank you for your reply. The first thing I did was check previous posts.

I am on a gluten free diet. I had to have private blood test done for food intolerance and gluten was my worst reaction.

My TSH is always fluctuating it was 5 three months ago. Unfortunately with my gp you have to ask permission in writing for access to your test results. I am in the process of asking.

I'm not looking forward to Tomorrow...my main issue is that the ENT told me it was OK, those were his exact words.

I will not be having the biopsy for numerous reasons...the main being my suppressed immune system but also, being told that everything is OK.

Thank you for taking time to answer

[SlowDragon Administrator]

Suggest you reread post and replies from a year ago

healthunlocked.com/thyroidu...

And similar 2 years ago

healthunlocked.com/thyroidu...

[PurpleNails Administrator]

Has it grown larger recently?

How are your thyroid results?

 If you previously had a fine needle & found it difficult you can refuse.

The scan might indicate a feature they recommend to investigate so decide after seeing what they say. 

Ask them what they can tell you, but often, to save time, they will often say report goes to doctor.

Make sure you get a copy of the report.

I have a nodule just over 5cm.  The ENT did a nasoendoscopy & said it “wasn’t too squashed in there” 

Unless it’s affecting your breathing, swallowing or voice there’s no necessity to remove it.

My nodule hyper functions, but I take medication to control it rather than a surgery or ablative treatment.  

If you have Hashimoto’s the function will already be reduced.  

Are you adequately replaced.  If your thyroid is still struggling to produce hormones it can swell, this will make the nodules swell too.

[greygoose]

this has been dropped on me out of the blue,after being told that it's ok.

From an ENT point of view, I expect it was OK. He wouldn't have been able to see the nodule.

I had a similar experience. Had all sorts of throat symptoms - continual cough, sore throats, felling of something blocking my throat, trouble swallowing, lose of voice, etc. The ENT specialist put the camera up my nose and told me there was absolutely nothing wrong with me! Finally turned out I had Hashi's/hypo with multiple nodules - small ones. So, there was something wrong with me after all! But, he couldn't see it from inside my throat.

[Alley27]

Hi and thank you all for your replies. My GP tells me that my bloods are within normal range.

I know that different lab's have different ranges though but at the end of the day, we are all different and not 1 box fits all.

I'm OK really, the issue is the word urgent when I was told everything is OK.

We will see how tomorrow goes. Thanks everyone

[SlowDragon Administrator in reply to Alley27]

You are legally entitled to printed copies of your blood test results and ranges.

The best way to get access to current and historic blood test results is to register for online access to your medical record and blood test results

UK GP practices are supposed to offer everyone online access for blood test results. Ring and ask if this is available and apply to do so if possible, if it is you may need "enhanced access" to see blood results.

Link re access

healthunlocked.com/thyroidu...

In reality many GP surgeries do not have blood test results online yet

Alternatively ring receptionist and request printed copies of results. Allow couple of days and then go and pick up.

Important to see exactly what has been tested and equally important what hasn’t been tested yet

TSH range is universal

If it’s your TSH that’s over 10 you must be started on levothyroxine immediately

If Ft4 is below bottom of range…..similarly started on levothyroxine

If you have had 2 thyroid test results where TSH is over 5, and high thyroid antibodies and symptoms you should be started on levothyroxine

That’s the guidelines….they are quite clear

[Sweeneythyca]

i don't want to be alarmist but I was being told I was fine and well, fit and young blah blah blah all the way up to a cancer diagnosis with multiple cancerous nodules and lymph nodes, discovered by FNA. Not the best experience but really the only way to rule it out, and done in a completely sanitised setting.

I can understand your concerns. Hope it all goes ok whatever you decide to do.

[Hedgeree]

Hi Alley27,

You may have already had your appointment so this may be of no use to you now.

I can understand your fears regarding being immunocompromised but the technician will be wearing surgical gloves that they will change between patients.

Also the device that is used to take the sample will have just been taken out of it's packaging (so sterile) and disposed of after.

The hospital local to myself is now again requesting that staff and all visitors including patients wear masks so you could get a proper mask N95 to wear during the process.

I've had two FNA's done on a 3.5 cm nodule and suspicious cells were found on the second.

It is scary and can be uncomfortable.

Best wishes with whatever you decide to do.

[radd]

Alley27,

Autoimmunity creates complex thyroid gland reactions whether its a goitre trying to improve inefficient hormone production that results in a jelly substance called colloid and cysts, nodules, etc, or blocking antibodies (TRAb’s) that shrink the gland away through mistaken under-use. 

FNA’s are given to determine the nodules health usually if they are fast growing or appear suspicious. I also suspect sometimes an FNA is offered because they simply don’t know what else to do with us. I refused mine many years ago as have no cancer family history and like you it was suddenly sprung on me with no explanation of why. Eventually Levothyroxine shrank the goitre/nodules, and assumed TRAB’s atrophied the gland anyway because now I have nothing left but a shrivel up pea.

Some members have goitres growing down into their windpipe creating breathing/eating difficulties, and a 7cm is significant but size isn’t always indicative of danger and doesn’t mean it’s not reversible. Thyroid cancer is rare but be aware there are forum members who have suffered it so the option for further investigation must be yours.

I hope your appointment goes well 😊

 

[Lilypocket]

Hi

Before having my needle biopsy this time the Dr prescribed topical anaesthetic which I put on about 40" before. Didn't feel a thing just the slightest movement but absolutely no pain. But it did set my mind at rest. I have had nodules for years and one in particular is growing.

Hope all goes well for your whatever you decide.

Take care.

[Alley27]

Hi everyone, I went to hospital for my ultrasound appointment today. I did not have the biopsy.

I have a total of 8 thyroid nodules. None of them smaller than 1.5cm. There are 3 that go down I to my upper chest and one that is behind the thyroid , so you can imagine my frustration in dealing with the radiologist or other medical staff about this.

My next step is speaking to the ENT consultant a out next steps.

The radiologist mentioned several available treatments if I decided to go down that path however, I am very limited, because I have autoimmune liver disease. Radiated iodine is out of the question due to the fact that it can cause injury to the liver.

We will see how things go, take care all xx