Concerned about test results

[patches1982]

I guess my question is what to think of these tests results. I am scheduled to see an Endocrinologist in November. Just need some piece of mind so I don't go crazy.

So here is goes I am 27 year old female and have had hypothyrodism for approximately 10 years. Currently I take 112mcg of levothyroxine.  I had blood work done 10/5/2010 and the readings were all within normal range. The TSH came back at 1.310uIU/mL. My T3 Uptake was 34%, and the T4 Free was at 1.61 ng/dL.

At the office visit they also asked for an ultrasound. I had one done in 2006 which showed nothing, but never saw the report. This one I have the report stating. The right lobe measures 4.9x1.0x1.8 cm and the left lobe was 4.2x0.9x1.9 cm. Within the right lobe of the thyroid gland there is a heterogeneously hypoechoic nodule within the inferior anterior aspect of the gland which measures 1.6x1.0x1.2 cm. This lesion does not appear to be hypervascular and does not contain abnormal calcifications. No nodules present on left side.

The impression was: Hetergeneously hypoechoic right lobe thyroid nodule as described. This lesion is amenable to percutaneous image guided biopsy.

If you could tell me what you think I should do, or what this could mean such as Hashimoto's, thyroiditis?
I know you get this a lot and just would like any help possible.

[patches1982]

also forgot to mention my ldl was high and my hdl was low as it always is I believe he said it was 36, and said i have a metabolic issue cause my waist was bigger then my hips, and said he may want to do adrenal tests after this thyroid thing is over.. is this a good idea in my case?

[patches1982]

Ok so the doctor did a few tests on me
My thyroid antibodies came back negative.
However, he did find that I am insulin resistant, as my sugars were 109, and something about my IR being 2.9. he also said I have a vitamin D deficancy. With another test showing i have a lot of inflammation in my body.

I am scheduled for FNA this Friday. Very worried about this test as I am screamish when it comes to needles. I have read a lot and think I know what to expect, but the question still is for one nodule with ultrasound guidance how long will it take and is the lidocaine even worth it?

[Mark Lupo, M.D.]

I-123 is not necessary and would be a waste of time/money.
Ultrasound by the endocrinologist with possible FNA is the next step.
90-95% of these are benign.

[patches1982]

The primary physician ordered the Ultrasound, but not a I-123 they just told me to go see an endocrinologist. Is the I-123 necessary or would a FNA be equally as good? Just exhausted from the stress of it all.. Thanks for the answer was very helpful. IS there a likely hood more toward Benign or is there not enough evidence at this point?

[Mark Lupo, M.D.]

This is likely part of hashimoto's but based on described size of 1.6cm, this needs further evaluation and possible FNA biopsy to confirm it is benign.  I-123 nuclear scan is NOT indicated.  The next step is to find an endocrinologist who does his/her own ultrasound to look at your thyroid and determine if FNA is needed.