Total Thyroidectomy for Multinodular goiter?

[brejim]

I am deciding whether or not to have a total thyroidectomy. I have multinodular goiter and the dominant nodules on each lobe keep growing. On left is 1.5cm and the righ 2.5cm and also many smaller ones. I had an FNA on the dominant ones. Left side benign. Right side non-diagnositc. I have high homocysteine levels due to the MTHFR genetic mutation and was wondering if the medication I would have to be in would increase my homocysteine even more?

[leimalove]

Doctor,
I have got multinodular goitre with the nodules being particularly pronounced in the right thyroid lobe which shows degenerative change...but the left thyroid though without much nodules, but with only degenerative change, has retrosternally extended downward to the thorax region, displacing trachea to the left. Left lobe FNAC suggests colloid goitre. The nodules on the right were very near to the blood vessel so FNAC wasn't done on right lobe, but right lobe hurts a bit when I press it, left lobe doesn't hurt. Some doctors suggest that only the left lobe should be removed for I was diagnosed with SLE about 20 years back and am still on minimal dose steriods.. Other docs suggests that total thyroidectomy should be done. Which should be done?Hemithyroidectomy or total thyroidectomy?Please help.
Leimalove

[Mark Lupo, M.D.]

The homocysteine issue shouldn't play a role in the decision.
Would consider a second opinion and repeat FNA on the right to clarify the need for (and extent of) surgery.  For benign nodules that are not causing compressive symptoms we usually don't do surgery unless >4-5cm.