Hemithyroidectomy or total thyroidectomy?

[MrsAlice]

Hi all

just like most female on my paternal side of the family, after giving birth in my late 20s I developed thyroiditis (?Hashimoto's, I have extremely high levels of TgAbs, but normal TPOs). I have a goitre (not massive) and on recent ultrasound a U3 nodule (as well as a U2). FNA biopsy has confirmed this as indeterminate U3, therefore surgery is the way forward. Normal TFT I shall add, I have been on thyroxine (50) for a few years as I was hypo symptomatic and found a very forward-thinking endo in my local hospital. I am now 34 years old.

In my family, my grandmother/aunties ended up having the whole of their thyroid taken out due to multinodular goitre/suspicious nodules. On the scan report (ultrasound 1, to check the goitre), only the above 2 nodule were reported, however the doctor who performed my FNA biopsy (ultrasound 2, ten days later) said that there are "several". So I have 2 questions:

1. Why were these "several" not reported?

2. I am only being offer a hemi at this point - could the consultant consider a complete thyroidectomy if I asked him to, since it looks as if there are "several" nodules and they're only going to grow and develop further?

Many thanks for your input!

[greygoose]

1. Why were these "several" not reported?

Because the majority of nodules are no big deal. Almost everyone has some. And, for the most part, they don't cause any problems. Even people without thyroid problems are likely to have nodules.

2. since it looks as if there are "several" nodules and they're only going to grow and develop further?

Not necessarily. Not all nodules grow or develop. The majority of them do nothing at all. But, you could ask the consultant what he thinks. He has experience of these things.

[MrsAlice in reply to greygoose]

Thank you!

[greygoose in reply to MrsAlice]

You're welcome.

[SlowDragon Administrator]

That’s a very small dose levothyroxine

TG antibodies likely to reduce with increase in levothyroxine

What are your most recent thyroid and vitamin results

TSH, Ft4 and Ft3, vitamin D, folate, ferritin and B12

Important vitamins are at good levels on levothyroxine and B12 at good levels before any anaesthetic

.

[MrsAlice in reply to SlowDragon]

Thank you for your reply - B12, folate and ferritin all ok (ferritin not massively high, always struggled with it, just finished another course of supplementation). T4 and T3 ok, as is the TSH, which is 1.2 so I dont think they'd be inclined to increase the thyroxine?

[SlowDragon Administrator in reply to MrsAlice]

What are actual results and ranges

Many people only feel well with Ft3 at least 50-60% through range, Ft4 swill usually be higher at 70-80% through range on just levothyroxine

Essential all four vitamins are OPTIMAL

What are actual vitamin results

Low vitamin levels tend to lower TSH

[Hedgeree]

Hi Mrs Alice,

When I had a FNA on a nodule the person doing the scan said many people have nodules on their thyroid and they cause no issues and are not even aware that they have them.

My nodule had suspicious cells so I ended up having a partial or hemithyroidectomy. I'm still at the early stage of titrating my levo dose and doing ok.

I would keep as much thyroid intact as I could.

Best wishes.

[MrsAlice in reply to Hedgeree]

Thank you!