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Multinodular goiter

Hi everyone
I have multinodular goiter since 2002 and im hypo..  in 2004 had a FNA and it wasnt cancer.
I am on medication i take 100 mcg levothroid a day..   the meds are meant to shrink the nodules true?
I just had a ultrasound scan a few weeks ago and they said, that my goiter has grown bigger and i have more cysts 5mm-10mm and  nodules at 1.3cm
Dont know why my goiter keeps growing..  and i have hypo sytoms too, brain fogs, depression, tiredness, etc etc..  i feel terrible..
I have endo on the 12th July..
Thanks Tempy
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Avatar universal
Both your hypo symptoms and the continued swelling of your thyroid could indicate that you are undermedicated.  Many times doctors stop treating patients once their lab values are "in range".  However, many people have to be higher in the ranges to feel well and have their symptoms alleviated.  You should have antibody testing (TPOab and TGab) to see if you have Hashi's.  The continued swelling of your thyroid could be due to that and/or that you are undermedicated and your thyroid is being forced to try to work harder than it can to produce hormone.
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Avatar universal
Thanks for all your help..
Im having my bloodtest next week.. so will post them on here..
I kinda got scared  a bit because every year i go to ultrasound theres always a increase of my goiter and i have more cyts and nodes grow bigger .. i just wanted to know why..
I take 100cmg levo a day, its iodio intake,  someone else said i could have Hashi's too
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Avatar universal
The "multinodular goiter" is very vague term itself; it has many meanings.
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Avatar universal
I was not being dismissive at all...I'm beginning to resent the fact that it's damn near impossible to present an alternate opinion on this forum without having a guilt trip laid on me for being "dismissive" or "frightening to newbies" or whatever.  I just know that the multinodular goiter diagnosis is about as vague as they come.  In fact, correct me if I'm wrong, but I think when you were first on the forum, you were having trouble researching your toxic nodule because you kept coming up with information about simple nodules.  It IS confusing, and I was just trying to further qualify.  You mention Plummer's Disease, but how many newbies are going to go off and research it to find out what it is?  Plummer's is relatively rare (compared to Hashi's, for example), so many of us don't know what it is.  The only reason I do is that I did some research on it after you told me it was your diagnosis.

No, I'm saying that IFa person has a good diet to begin with (not assuming that they do), then I don't think dietary changes are going to have the same impact as they will for a junk food junkie (it's all relative, and I'll leave the evaluation of the quality of the diet to the reader).  I'm merely pointing out that we're all different and don't want anyone who might not be as lucky as you (to have diet changes work so well) avoid medical treatment in what might become (or already be) a dangerous situation. Your comments could be interpreted as "if you have 'multinodular goiter', then all you have to do is take some iodine and other minerals" by somone who isn't quite as immersed in thyroid issues as we are.  

My objection to your comments is partly a matter of timing...newbies can only absorb so much, and someone who hasn't even had an antibody test could get very confused.  "Multinodular goiter" applies to many of us with Hashi's, Graves', Plummer's, and sometimes people just get nodules for no apparent reason.  I think it's very important to pin down the cause of the "multinodular goiter", since it is such a generic term, before making specific recommendations.

I'm sorry that you feel like I was "pulling rank" on you, Mac.  I wasn't.  I've made it quite clear that I don't think a lot of the star system and wish it would go away.  I actually spent a fair amount of time on that response and rewrote it a couple of times so it wouldn't offend...obviously without luck.  As I said, I'm very happy that it's worked so well for you...and I think it could work for a number of people, but not everyone, and perhaps a diagnosis is in order before confusing the issue.

I've learned that if someone wants to take offense to something you've said, they will find a way to do it (just look at the righteous ingidnation lawyers can whip up when trying to discredit a witrness).  I'm sorry, but I think that's what you've done here.  I should be allowed to express my opinion as well as everyone else.  If you don't agree with something I said in response to you, then counter it again, but don't try to shut me up with a guilt trip for wanting to add the other side of the argument to balance the advice.

I've learned a lot in the time I've been on the forum...how I say what I say...when I say what I say...what I say.  It's a continually evolving process.  I think it will be sad for me and you and the forum if we can't help each other offer better and more timely responses.

I'm very sorry that you felt "dismissed".  I did try very hard to be inoffensive.  However, I stand by the content of the comments I made and thank you for your input and the opportunity to further clarify my position...I'll work on my delivery (and I mean that very sincerely).
Helpful - 0
649848 tn?1534633700
COMMUNITY LEADER
I had no intention of being combative or dismissing your comments; nor were all of my comments directed at you.  

I did google Plummer's and toxic multinodular goiter, which is how I know they are both related to hyperthyroidism, rather than hypo, at least in the beginning.  It seems that no matter how one starts out with thyroid issues, whether it be hyper/hypo, Graves, Hashi's, Plummer's, etc -- it seems that we all end up hypo in the end.  The trip to "hypoland" and on to wellness is different for all of us; and what works for one, certainly doesn't work for all.

The main point of my post was that we don't even know tempy's lab results or specific issues, other than that she's hypo, taking levo, with multinodular goiter and "some" part of that is growing.  We don't know whether the goiter is growing or whether the nodules are growing.    

If I remember correctly from way back, your nodules were toxic; there's a huge difference between toxic multinodular goiter and simply multinodular goiter.  A diagnosis of "multinodular goiter" can mean different things for each of us.  I have a multinodular goiter, by my nodules are not toxic; that makes my disease a lot different from yours, even if I didn't have Hashi's.

I don't believe that we should make specific recommendations until we know the individuals latest labs and a bit more history, including past courses of treatment, etc.  I'd hate to think someone might take advice that doesn't specifically fit their situation.  

There are some people for whom drastic diet changes or different med(s) might do wonders; there are others for whom it will do nothing.  In my personal case, my doctor has advised me NOT to go gluten free and try to make a lot of changes in my diet.

All of our goals is help people, and you are absolutely correct - we all go by our own experiences because that's what we know best.  As goolarra said, "we need to make sure we are comparing apples to apples".



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1144849 tn?1395455166
I was obviously speaking to my experience, and said "If you do not have antibodies". So if she does have hashis or graves or something other than Multinodular Goiter then her issues are more complex.  As I have mentioned in other posts,  I no longer comment on any issue that do not relate to me (even though I have may know the answer, because others have posted the answer a hundred times) and what I have been through.  We all agree that the data that  tempy1122 gave us is a little vague.

Barb, It is true that the onset of Plumber's disease usually brings on Hyperthyroidism and the autonomous nodules producing hormone on their own tends to make us Hyper, however over time we tend go Hypo. In the middle stages many of us flip back and forth daily, and with diet changes. I have been more HyPO than HyPEr over the last year. I can recite volumes of studies and post dozens of links about Plumber's , it's pathology and it's relationship to patients presenting with Hypo symptoms, but I do not think that is necessary since we do not know enough about the status of this person ( if you are interested you can Google Plummer's disease and hypothyroidism)  I will leave it at that and continue to share my experience with anyone that posts questions about Multinodular Goiter when they do not specify Hashi or Graves.  

I think I qualified my statements. I do not disagree with any advice anyone has given here, but I ask that you please do not discount my statements from my own experience and treatment. I assure you that I am not alone with my course of treatment. However unconventional you may feel it is. There are many who have been able to improve, or even correct their thyroid function by determining the root causes (for them) besides heredity. I try and reach people who still have their thyroid, who have "fairly normal" FT3 and FT4 but low TSH and have been diagnosed via Ultrasound and labs, so that I can share my experience in the hopes that they might want to try some similar path first, because they have nothing to lose, even those who have other thyroid disease have nothing to lose by getting their hair analyzed and work with natural common sense to correct any deficiencies etc.  It is a little difficult to try these steps and gain success once you have RAI or have your thyroid removed.

goolarra, I agree that  “Multinodular Goiter” Is a fairly ubiquitous term and is used generically by physicians and patients alike to mean many things, that is why I specifically referenced Plummer's disease and my experience.  In the same breath you have dismissed everything that I have said, based on what you know about me, but assume this person with the question, is the picture of health and wonderful eating habits. I resent your dismissive attitude.

My goal continues to be, to help people with questions who’s comments are similar to my experience and they have prefaced their question with a diagnosis of Multinodular Goiter.  

-Mac
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Avatar universal
I'd like to see FT3, FT4 and TSH, TPOab and TGab, too.  It sounds like you are undermedicated.  Just because your numbers are "in range" does not mean that they are adjusted correctly FOR YOU.

Mac, I'm so happy to hear that you are doing well.  However, what works for one does not work for another.  You may have had a lot of success with diet and lifestyle changes because your diet prior to diagnosis was so poor (I think you've admitted this).  On the other hand, I doubt that someone who leads a healthy lifestyle and eats a well balanced and diversified diet to begin with is going to see the dramatic changes from a new diet that you've seen.  As with everything else, if there is a dietary deficiency (or bad habits), then it has to be corrected, however, if it ain't broke, fixing it probably won't change much.  Also, you have a toxic nodule - much different from our Hashi's nodules.  "Goiter" and "nodule" are very general terms and can arise from very different conditions and require very different treatments.  If tempy has Hashi's and doesn't have a "toxic" nodule, then you do not share the same disease ...I realize that you might have been talking in more general terms (i.e., "we both have thyroid disease"), but tempy may not understand that.

"Nodule" and "goiter" are unfortunately general terms, and I think it's very important to qualify each before using it and make sure we're comparing apples to apples.
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649848 tn?1534633700
COMMUNITY LEADER
I'd be interested in seeing what your actual lab results are: TSH, Free T3 and Free T4; since you have hypo symptoms, it's possible that you might simply need an increase in med dosage.  It would be great if you could post both the lab results and the lab's reference ranges.  These ranges are lab specific so will need to come from your own report. They should be noted right beside the result.  

I would never recommend a T3 med, without knowing what your actual thyroid hormone levels are.  T3 is about 4 times stronger than T4 and should only be prescribed if hormone tests show that proper conversion from T4 to T3 is not taking place.

I agree that you need to get your antibodies tested.  That would be TPOab and TGab to confirm/rule out Hashimoto's. TSI would be done if there was a suspicion of Graves Disease.

I'm not real familiar with Plummers Disease, but from a quick bit of research, it's related to hyperthyroidism, not hypO. According to another bit of research, toxic multinodular goiter is also related to hyperthyroidism and occurs when the nodules produce hormone on their own.

A goiter is simply an enlarged thyroid, which could be caused by different things.  I wonder if the goiter (thyroid), itself, is growing or is it the nodules that are growing?  I, too, have multinodular goiter but I have Hashi's and my nodules are not toxic.

It is often recommended that those with Hashimoto's, not be treated with iodine; however, there are those who do well on it.

Since we are all different, I think it would be most important to know what tempy's current thyroid levels are, as well as knowing whether or not antibodies are present; then we can comment more fully on the question.




Helpful - 0
1144849 tn?1395455166
Hi tempy1122, I too have nodules and MultiNodular Goiter.  What you eat is critical to how well you will do. Have you been tested for Hasi or Graves antibodies?

I can feel that my nodules are being reabsorbed into my thyroid and are smaller then they were  last November, I have an ultrasound next month to prove or disprove my belief.

I don't know about nodules growing at 8% per year, perhaps that is with no treatment. I have read studies with Plumbers disease patients, that have nodules decrease with small doses of iodine and other mineral supplementation (as in my case). I can not feel my nodules anymore, and I can swallow normally, and I no longer have pain in my left throat.

If you do not have antibodies, and only have Multi Nodular Goiter to contend with, then your ability to correct this problem with a proper diet and some other natural supplementation is possible. I am living proof.  Last December my TSH was .2  now it is in normal range as are all of my other thyroid level. The brain fog, lack of energy depression etc are all gone for me now.  I have my life back.  I suffered for 7 years not knowing what was wrong with me, doctors giving me anti depressants etc.

I am sure I won't get any gold stars for my answer, but I would urge you to see a Naturopath, or a doctor that specializes in treating thyroid patients with proper nutrition and natural healthy common sense medicine. Fast food and processed foods are killing us at an alarming rate, not to mention thyroid disease, diabetes, heart disease etc.

I suggest all this to you because you and I share the same thyroid disease and I found a way to heal myself with the help of a Naturopathic doctor.  My endo has no words for my improvement and actually seemed somewhat disappointed that I will not be dropping by to give her money anymore.

I can give you specifics of what I have done if you are interested.

Let me know if this was helpful or not. There truly are some simple steps you can take to better your condition.

-Mac
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Avatar universal
The diameter of benign nodules grows  @ 8 % rate per year.
according to some studies keeping the TSH les then 1 (0.8 to 0.5) may slow down or even rverse growth of some nodules; however nodules composed of scar tissue and these of inflammatory origin are not reduced.
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Avatar universal
Get your TGab and TPOab tests for Hashimoto's disease. Most hypo cases in developed countries are due to Hashi, especially if you have a goiter and nodules. When the antibodies attack the thyroid, it swells, causing goiter. Also, consider the antibody attacks little explosions. Those explosions cause the thyroid tissue to erupt into nodules.

You are probably feeling poor because:
1. You are getting T4 treatment and not T3 treatment in addition. I take Cytomel, a T3 drug, in addition to my Synthroid (Levo) a T4 drug. 20 percent of T3 is made by the thyroid gland. If your thyroid isn't working properly, how do we know you are getting enough T3? Get your FT3 and FT4 levels tested. FT4 can be mid-range, but FT3 can be in the upper 1/3 if you are middle age/young and without heart problems.

2. Adrenal fatigue - Most hypothyroids are low in adrenals. As the thyroid breaks down, the adrenals kick in and do the job of the thyroid. The adrenals eventually become fatigued. Get the 24 hour saliva test for adrenals. All other adrenal tests do not measure throughout the day, and adrenal levels do change.

3. Many Hashis feel better by eliminating gluten. Read my journal. My thyroid swelling and antibody attacks have stopped since removing it.

Also, Selenium once a day (200 strength) will help control the swelling but not completely.

Take care...
:) Tamra
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