Barb135; Thank you for your reply!
To be more correct the doctor at Mayo said he could see more than the two nodules found at home, a big one and a smaller one plus many tiny ones. He showed me on the screen that the tissue looked like there were alot of "bubbles", and he said that was inflammation....
He writes in the report:
"She had left neck discomfort in the past , and back in 2015, she underwent an ultrasound. Outside reports document at that time a nodularity in the left lobe that was targeted by FNA and reportedly found to be benign . A repeat ultrasound was performed in March of this year, which is more detailed and describes a nodularity of 14 x 18 mm without calcifications in the left lobe. This was again biopsied and found to be benign. Her thyroid function has been normal and remains so today.
Impression, Imaging studies: Her neck ultrasound was reviewed. The thyroid parenchyma shows some microsystic changes on both sides. On the left side, there are two nodules that seem to be mainly spongiform, the largest one at 2 cm. There are no abnormal lymph nodes.
Multinodular thyroid with changes suggestive of Hashimoto's thyroiditis. At this point the patient is euthyroid, and these nodules are low suspicion. "
He did though tell me he strongly recommended a biopsy from the smaller nodule.
The reports from my local hospital in 2017 says:
"In left glandula thyroidea there is a nodule, 14 x 18 mm not securely encapsulated and with a little rough appaerance. Some minor low attenuated areas, but no cysts. No calsifications. I the lower part of the thyroid in relation to the nodule there is another smaller sized nodule of 1 cm, similar appearance. There is no increased doppler signal in the nodules. Right gland looks slightly enlarged. No pathologigal glands observed in the neck.
R: Nodules in the left glandula thyroidea, further testing required"
I find it a little strange that the doctor at home did not see the multinodular thyroid that Mayo has described. She even said that she didnt think the changes in my thyroid look like hypothyroid changes at all, and wasnt at all interested in hearing about what the doctors at Mayo had said or found.
When it comes to my thyroid function tests, here are my results:
-Aug 2016: TSH: 1.00 (ref: 0.24-3.78), Free thyroxine: 13,6 (ref 11.6-19.1)
-Nov 2016: TSH: 1,2 (ref 0.20-4.00), T4: 15,5 (ref (11-23), TPO: 34 (less than 100)
-Aug 2017: TSH: 0.96 (ref: 0.24-3.78), Free thyroxine: 14.7 (ref: 11.6-19.1)
-March 2018: -Tyreoglobulin 72 (under 30), TSH and free T4: normal. Tyreoglobulin antibodies and anti-TPO are both within normal range (range not noted in the results)
The ultrasound at your local hospital indicated a larger and a small nodule. The doctor at Mayo said he found "multiple nodules"... Multiple nodules is anything more than one - could be the same 2 your local hospital found or it could be more than that...
Do you have copies of both ultrasound reports so you can compare them to see what each found?
The biggest difference is that the doctor at Mayo recommended biopsy of he smaller nodule - typically biopsy isn't done on any nodule less than 1 cm unless it's suspicious for cancer - do you know how large that nodule is? In addition, the doctor at Mayo said he saw inflammation suggestive of Hashimoto's - that's not a reason to biopsy a nodule because a biopsy won't determine if you have Hashimoto's.
You can either go by the ultrasound results and say you have Hashimoto's, based on that. You said your thyroid blood work is all normal... did they do both antibody tests to confirm Hashimoto's? It's important to note, however, that some people are diagnosed with Hashimoto's even if they have negative antibody counts? If they didn't do antibody tests, that would be the next step. Many of us have Hashimoto's for years before there's enough damage done to our thyroid gland to cause thyroid hormone levels to go out of range.
You said the doctor at Mayo could "see signs of inflammation"; it's possible that whatever inflammation (or signs of) that he saw were gone by the time your doctor did her investigation or it's possible that she simply didn't see the same things. That's why we get second opinions - because it's not unusual for doctors to disagree with one another.
Thyroid uptake means you thyroid was absorbing iodine. This typically happens when we have hyperthyroidism, which isn't uncommon in the early stages of Hashimoto's. It's not unusual to alternate between hyper, hypo and normal in the beginning.
If you aren't comfortable with what your doctors are doing, you can call the doctor at Mayo and ask them to consult with your doctor or you can get a third opinion.
All of that said, are you still having the same symptoms you posted at the beginning of your question? Many of those are symptoms we see with hyperthyroidism. Some symptoms can cross over and apply to either hyper or hypo...
If you have copies of your current labs, it would be most helpful if you could post the results so we could see what they are. Even though they might be "in range" doesn't mean they're right for you. Be sure to post the reference ranges listed on the lab report since ranges vary lab to lab and have to come from your own report.