Incidental 'Large Complex Leision' found during MRI

[Kermit78]

Hi. I had an MRI scan for some nerve issues in my arm & neck. During the scan they found I had a 'large complex leision' on the left lobe of my thyroid with 'smaller leisions' on the right lobe and a 'tracheal deviation'. I am now absolutely petrified as to what it could be.

I have had 2 cousins on my paternal side who have had thyroid cancer and 2 relatives on my maternal side who had large goitres removed.

I have a GP appointment on Thursday to discuss as MRI report suggested further investigation is needed.

My anxietyis sky high at the moment with this ... I know everyone is different but just wondering what I can expect of GP appointment and what may happen next?

Thanks in advance.

[PurpleNails Administrator]

Ask your GP for an ENT referral because it’s quite likely your GP will have no idea what follow up is necessary unless is clearly specified in instructions.

You might need further scans & possibly fine needle aspiration of the legion or if the tracheal deviation is significant they may consider looking at surgical options.

Do you have breathing issues?

While a referral being arranged ask if they will carry out some “blood tests”.

Hopefully they will have an idea about what tests that should include, but thyroid function should be included. That’s TSH, FT4 & FT3. Often if TSH is in range nothing further is tested, there are private options if you can’t get a complete test. Sample taken by DIY fingerprick & posted to lab, results available online.

Do you have any thyroid symptoms - the main hypo vrs hyper symptoms can be seen here

thyroiduk.org/signs-and-sym...

Try not to worry.

[Kermit78 in reply to PurpleNails]

My GP ordered blood tests whilst I was awaiting the face to face appointment. Looking on my NHS app record my TSH level was normal so looks like they've not done any if the other tests. I know at the beginning Iof the year the level was suggestive of hyperthyroidism but when it was repeated 3 months later I was just back into the normal range so nothing was done. Ironically the symptoms I experience are more prominent with hypothyroidism which makes no sense!

[PurpleNails Administrator in reply to Kermit78]

TSH is a pituitary hormone and its a poor indicator of thyroid levels. Low TSH occurs for many reasons.

Recommend you look at arranging a private test. There are lots of options from basic function (TSH FT4 & FT3) or more complete.

If you can afford a more comprehensive option it would be worth while. Medichecks advanced includes TPO & TG antibodies to rule out any autoimmune issue effecting the thyroid. CRP inflammation marker & key nutrients (folate,ferritin b12 & vitamin D). Low nutrients can mimic a lot of the hypo symptoms.

See link of companies, some have discount codes available.

thyroiduk.org/testing/priva...

Symptoms can be very varied, I had hyper missed for a long time but had some quite typical hypo symptoms.

In early stages of thyroid issues, especially autoimmune it’s also common for levels to fluctuate or for the ratio of FT4:FT3 to be abnormal which can result in a mix of symptoms. Nodules can also occur alongside autoimmune.

Was anything else tested recently? eg Blood count, Bone group, Urea/Electrolytes, CRP, Liver Function Tests.

[Kermit78 in reply to PurpleNails]

All my bloods came back normal: HbA1c, Serum TSH level, liver function test, bone profile, U&Es, CBC and WBC differential.

[mistydog in reply to Kermit78]

We don't do "normal" here, better to give actual results with ranges. If you haven't got copies of the results you can ask for them.

[Kermit78 in reply to mistydog]

These are my TSH results, like I said, it came back as 'normal'.

Historical levels

[SlowDragon Administrator in reply to Kermit78]

beginning Iof the year the level was suggestive of hyperthyroidism but when it was repeated 3 months later I was just back into the normal range so nothing was done. Ironically the symptoms I experience are more prominent with hypothyroidism

This is typical for early stage Hashimoto’s

[Anthea55]

Before you go to your appointment make a list of your questions. Start making the list soon and add to it as you think of other questions.

Then print it out - maybe an extra copy for your GP. This will help you so you don't come away thinking you forgot some things.

With your family history of thyroid problems it's definitely worth getting your thyroid tested as PurpleNails has suggested.

Come back here any time you need help.

[SlowDragon Administrator]

For full Thyroid evaluation you need TSH, FT4 and FT3 tested

Also both TPO and TG thyroid antibodies tested at least once for autoimmune hypothyroidism (hashimoto’s)

Hashimoto’s frequently starts with transient hyperthyroid results and symptoms

Hashimoto’s will change how thyroid looks in MRI or ultrasound

Very important to test vitamin D, folate, ferritin and B12 at least once year minimum

About 90% of primary hypothyroidism is autoimmune thyroid disease, usually diagnosed by high thyroid antibodies

Autoimmune thyroid disease with goitre is Hashimoto’s

Autoimmune thyroid disease without goitre is Ord’s thyroiditis.

Both are autoimmune and generally called Hashimoto’s.

Low vitamin levels are extremely common when hypothyroid, especially with autoimmune thyroid disease

20% of autoimmune thyroid patients never have high thyroid antibodies and ultrasound scan of thyroid can get diagnosis

In U.K. medics hardly ever refer to autoimmune thyroid disease as Hashimoto’s (or Ord’s thyroiditis)

Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins

Testing options and includes money off codes for private testing

thyroiduk.org/testing/

Medichecks Thyroid plus antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins

bluehorizonbloodtests.co.uk...

Only do private testing early Monday or Tuesday morning.

Link about thyroid blood tests

thyroiduk.org/testing/thyro...

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

Symptoms of hypothyroidism

thyroiduk.org/signs-and-sym...

Tips on how to do DIY finger prick test

support.medichecks.com/hc/e...

Medichecks and BH also offer private blood draw at clinic near you, or private nurse to your own home…..for an extra fee

[Kermit78 in reply to SlowDragon]

Many thanks for taking the time to give me such a comprehensive reply. x

[SlowDragon Administrator in reply to Kermit78]

Come back with new post once you get results

[Kermit78]

Thank you. Im Shropshire based x

[Gillybee24]

with your family history I urge you to ask for a needle biopsy Your GP must refer you to a specialist for advice as Fruitless suggests then you will know if it’s a benign or cancerous tumour when the results of the biopsy is back

I have a very large thyroid full of nodules Carbimazole has reduced my TSH and we are ‘watchful waiting’ No family history

[Batty1]

You need to see Endocrinologist.