Thyroid Nodule to be concerned or not?

[pastorman1]

Hello all!
I am a 54 year old male. During regular physical in 11/2015 my TSH level was little high so my Dr. wanted me to come back in two weeks for more specific Thyroid labs. Also, my cholesterol came back very high. When those came back my TSH had increased to 3.5, which according to new guidelines is high? Because of that I was scheduled for Thyroid Uptake and Thyroid Ultra Sound 1/5/2016. The uptake came back normal but the US shows a solitary 5mm Heterogeneous Solid Hypoechoic nodule in the left lobe that was Indeterminate. My family Dr. has put me on 25mg of Levothyroxine and wants me to come back in 3 months to do labs again.
Over the past 6-8 months I have been very tired, cranky - (my wife says moody), joint pain, some weight gain, but not overly amount, a sore throat that would last less than 24 hours and waking up every night around 3:00 am and not going back to sleep.
Anyway, my concern is that my family Dr. sent me to an ENT who gave me about two minutes and told me not to worry about and if needed get another US in a year. Should I have asked my family Dr to have sent me to see an endocrinologist?
Thanks for the input.

[1Kel12]

For what it is worth, my TSH was "only" 4 when I was finally diagnosed - I was very sick at this point. I was over 3 for sure starting 2 yrs prior, the same time as certain odd symptoms started which I assumed were "just aging".

I also did not have good experiences with Endo's, and I do not take levo (NDT in my case) but I think you may not want to wait so long for labs, just in case you need an increase. My understanding is 6 weeks is a good time frame, but ask around.

Good luck, Kel

[pastorman1]

                                        Actual              Reference Ranges
T4,Free, Direct                         1.13          .82 - 1.77
TSH                                          3.5            .450 - 4.5
ALT (SGPT)                               44            0-44
Thyroid Peroxidase TPO Ab     10            0 -34
Triiodothyronine, Free, Serum   3.2          2-4.4

[pastorman1]

Thyroidgnobulin Antibody   <1.0        Range  0.0 - 0.9
using Beckman Coulter Methodology

All Labs done by LabCorp

[Barb135]

Hi there... You don't necessarily need to be seen by an endo, as not all endos are good thyroid doctors.  The biggest thing you need is to have your doctor start checking the actual thyroid hormones, Free T4 and Free T3, instead of just TSH, which is actually a pituitary hormone, not a thyroid hormone.

You also should ask to be tested for thyroid antibodies to determine if you have Hashimoto's Thyroiditis, which is the most common cause of hypothyroidism.  The antibody tests you need are Thyroid Peroxidase Antibodies (TPOab) and Thyroglobulin Antibodies (TgAb)... You need them both, since they are both markers for Hashimoto's; some of us have one or the other, some have them both.

Hashimoto's is an autoimmune condition in which the body has determined that the thyroid is foreign and produces antibodies to destroy it.  The disease is progressive, in that the antibodies continue to destroy thyroid tissue until there is no longer any healthy tissue... ultimately, the thyroid will produce nothing on its own and you will be completely dependent on replacement hormones.  This means that your dosage will, most likely, have to be increased, periodically, over time...

Nodules are very common with Hashimoto's and are, typically, nothing to be concerned about, unless they have unusual characteristics or are very large.  Yours is very small and apparently, there were no unusual characteristics of concern.

[pastorman1]

See below