Help understanding ultrasound results

[FallenSky]

Hi, I hope this is the right place to post! For a couple of months now I have had the feeling of something being stuck in my throat, food getting stuck, breathlessness and wheezing when laying down. I'm also extremely fatigued. I have rheumatoid arthritis and my rhuematologist noticed I have a goitre. I had blood tests which showed normal thyroid levels and an ultrasound and have just had the US results. From what I can understand U2 is good so I'm not sure what is causing my symptoms. I can't see the gp for another week so I was wondering if anyone knew what, if any, next steps would be? Thank you.

US Thyroid. Clinical details: Enlarged thyroid gland, possible nodule.. No previous images are available for comparison.. Findings: The right thyroid lobe is larger than the left. The right thyroid lobe measures 76 x 34 x 51 mm and the left thyroid lobe measures 56 x 23 x 29 mm. There is tracheal deviation to the left. No retrosternal extension. Normal vascularity.. On the right, there is a spongiform type cystic nodule measuring 63 x 27 x 52 mm (U2).. On the left, there is a spongiform nodule measuring 16 x 12 x 14 mm (U2).. There is a spongiform nodule on the isthmus measuring 8.2 x 5.6 mm (U2).. Both the submandibular and parotid glands appear unremarkable.. No abnormal lymph nodes in the right or left cervical chain.. Conclusion: Benign multinodular thyroid (U2). The right thyroid lobe is larger than the left and contains a dominant nodule measuring up to 63 mm.. If the patient is symptomatic, an ENT referral is recommended

[SlowDragon Administrator]

I had blood tests which showed normal thyroid levels

What exactly was tested

Please add actual results and ranges

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

Also both TPO and TG thyroid antibodies tested at least once

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

Have these been tested …if not request they are

What vitamin supplements are you taking

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

Post all about what time of day to test

healthunlocked.com/thyroidu...

Testing options and includes money off codes for private testing

thyroiduk.org/testing/

Medichecks Thyroid plus BOTH TPO and TG antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes BOTH TPO and TG antibodies, cortisol and vitamins

bluehorizonbloodtests.co.uk...

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

Only do private testing early Monday or Tuesday morning.

Tips on how to do DIY finger prick test

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

[FallenSky in reply to SlowDragon]

Hi, thank you for the information. The bloods I had done were -

TSH - 0.47 (0.35-5.00 mU/L)

Free T4 - 13.7 (9.0 - 22.0 pmol/L)

I haven't had any vitamin levels checked since 2021.

I take 5mg folic acid daily due to the methotrexate I take for rheumatoid arthritis.

[SlowDragon Administrator in reply to FallenSky]

So next step is to get full thyroid including BOTH TPO and TG thyroid antibodies and all four vitamins tested

[milkwoman]

The US report indicates you have two thyroid nodules with the one on your right lobe being quite large (as nodules go).

I suspect your GP will refer you to an Endo who will want to have that nodule biopsied (a very simple procedure called an FNA - Fine Needle Aspiration). I’ve had three FNAs in the last 10 years on a growing nodule my Endo has been watching (and my concerning nodule is currently much smaller than yours). So far, all three FNA results show my nodule is benign but we will continue to watch.

With the size of your nodule I’m not surprised you are having difficulty swallowing and breathing at times. It’s very likely the nodule is pressing on your trachea. Please push to have it further checked out.

[FallenSky in reply to milkwoman]

Thank you. I'm glad yours are showing as benign so far, I hope it stays that way for you. I was wondering if there was a chance the nodules would go down by themselves but seems unlikely? It's really frustrating that my GP surgery won't allow me to speak to a different GP whilst mine is on annual leave so I appreciate the information I'm getting here.

[Digger0]

As the US report says, if you are having problems (which you are) the next step is referral to ENT. See nhs.uk/conditions/goitre/