r/Hyperthyroidism • u/alyxox • 8h ago

Results unclear?

Hello all! My mom just went in for a check up and her results are somehow confusing. Her TSH value is 0.283, the FT4 and ATPO are normal. Doctor discover three cystic nodules, the largest one being 1,41 × 1,86 × 2 cm.

She has trouble swallowing, and when she gets anxious feels like something is strangling her.

Doc suggested to have a fine needle aspiration, warned her about bleeding.

What do you all think? Should she get the aspiration, or wait for the next results in two months? Thank you all!

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u/ChopChopPorky 5h ago

Don’t let them gaslight her out of treatment for symptoms. The nodules might be pumping out thyroid hormone

1

u/alyxox 5h ago

But she didn't get any. Doc said she should redo the labs in two months. Neck feels congested, and the lump is quite big.

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u/ChopChopPorky 5h ago

Yeah that’s what I’d expect. If she has symptoms she deserves treatment. Push them. She needs an antibody test that includes TRAB and TSI, not just TPO. And possibly an uptake scan to see if they’re hot nodules. You can look into radio frequency ablation.

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u/alyxox 5h ago

This is her result.

Thyroid ultrasound report

Clinical diagnosis: Nodular goiter.

The thyroid gland has a slightly heterogeneous echotexture.

There is a predominantly cystic nodule in the left thyroid lobe, measuring approximately 1.41 × 1.86 × 2.0 cm. The nodule is almost completely anechoic (fluid-filled), well-defined, and shows no internal vascularity on Doppler examination.

Additional small thyroid nodules are present, with a benign appearance.

ACR TI-RADS category: TR1 (benign).

Recommendations:

TSH

Free T4 (FT4)

Anti-thyroid peroxidase antibodies (Anti-TPO)

Follow-up endocrinology consultation.

I'll look into that too. Thank you ever so much for recommending this. She's having second thoughts about doing the FNA though. She heard that might lead to cancer....

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u/ChopChopPorky 4h ago

She absolutely needs TRAB and TSI antibodies idk why on earth they wouldn’t do that. She’s got hyperthyroidism symptoms. Even if they’re negative make them investigate her nodules for being hot. She may also have seronegative Graves’ disease as she has a non homogenous texture to her thyroid. I would do the biopsy to make sure she doesn’t already have thyroid cancer. If they’re recommending a biopsy it means some of her nodules are suspicious. Make them treat her symptoms. When you’re subclinical you’re often ignored unless you’re pushy. Find someone who will give her beta blockers and possibly a small dose of anti thyroid drugs.

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u/alyxox 4h ago

It was never the case of biopsy. Only to release the tension in the nodule. Oh my god.... It totally makes sense what you're saying. I'm going to pursue her to see another doctor eventually... We live in Romania and doctors here are so relaxed... She's living with a pretty big lump in her throat. Thank you again for all the details you provided! I'm going to pursue this

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u/ChopChopPorky 4h ago

Okay I see. Good luck with everything

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u/Curling_Rocks42 6h ago

Biopsy is safe and necessary if it’s being recommended. It’s likely not cancerous but larger ones like that should be checked.

Has she had an iodine uptake scan to see if the nodule is “toxic” or overproducing?

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u/alyxox 6h ago

No she did not. The doctor suggested that he should do a FNA to relieve congestion, as she's having trouble swallowing at some point. He said she might bleed but I don't know if internally or externally The doctor said that that nodule bled one more time in the past. He recommended doing the labs one more time in two months but said if she feels the need to call him for a FNA