Thyroid Nodule Results - Can Someone Help?

[Writermss]

Hi,
New here but have lurked on occasion. I have a 3cm thyroid nodule on one side and a 1.4cm nodule on other side of thyroid, both labeled "suspicious to indeterminate." I am exhausted ALL the time and sleep constantly. Moody, irritable, cold, tired. Occasionally get hot flashes in between being cold but that might be early menopause. : )  My TSH and free TSH tests are normal.

Nodules were discovered in 2010 and watched; several grew with margins changing shape; endo ordered biopsy in 2011 intended for 3cm nodule but sent in order for other side and surgeon/radiologist biopsied a .9cm non-suspicious nodule on the opposite side. I discovered the error (that's right - me, not the doctor!) when reading last year's report which suggested a follow-up this year. (Doctor admitted she'd made an error and apologized - hey - it happens.) Anyway, just had biopsy of the correct side and haven't heard from endo yet but primary care doc called to say "Great news! You have a benign cyst. We're all clear!"

I just want to confirm that that's what the report says. Considering how lousy I feel (I certainly don't FEEL like I'm "all clear!"), and considering that I underwent an unnecessary biospy a year ago, I want to make sure I understand every word of this report. Can someone please help? Here's what it says:

"The smears consist of an admixture of bland follicular epithelium. Innumerable hemosiderin-laden macrophages and abundant watery and inspissated (sic) colloid. The findings are most indicative of a benign colloid nodule with cystic degenerative changes. Diagnosis: Benign follicular nodule consistent with colloid nodule. Cystic."

a) what are cystic degenerative changes?
b) what does "most indicative" mean - are they hedging or does that imply certainty?
c) is there anything here that I need to worry about or are we definitely "in the clear." ?

Thanks again.

[Gibbon1]

>a) what are cystic degenerative changes?

What I read is that when nodules get bigger, the cells in the center will start to die off and be replaced with fluid and 'crud'  A cyst develops.

b) what does "most indicative" mean - are they hedging or does that imply certainty?

I read that as 'best answer'.  Mostly I think it's boiler plate.

>c) is there anything here that I need to worry about or are we definitely "in the clear." ?

Nothing is certain, but yes, in the clear.  Meaning it just has to be watched to make sure it doesn't grow.  If it causes problems you can have it drained, which is a bonus over solid nodules.

[goolarra]

Please post your thyroid lab results with reference ranges (they vary lab to lab and have to come from your own lab report).  Just because labs are in range does't mean you will feel well.

I'm no expert on pathology, so i won't comment on those results.

Have you ever been tested for thyroid antibodies?

Even if your nodules are innocuous, you could still have a thyroid condition.

[Writermss]

Thank you Gibbon1 - provided great comfort! Goolara, I can't find the labs -- I was tested for thyroid antibodies a few years ago and the test was normal. I definitely do NOT feel well and have hypo symptoms for quite a while. Just found the "Stop the Thyroid Madness" website and have been on that too.

At this point, the primary wants me to have a sleep test. I don't have sleep apnea; that will be a complete waste of time. I am just so tired all the time. I can sleep for 12 hours, get up for an hour, and be tired again. I was never like this before.

Did anyone else experience anything like this with nodules? Btw, I am going to ask for a full thyroid panel again with antibodies test.

[goolarra]

Good idea on the complete panel.

When you get the results, post them, and we'll help you interpret them.  Bear in mind that just being "in range" on FT3 and FT4 is often not good enough to relieve symptoms.  FT4 should be about midrange and FT3 upper half to upper third of range.

Be sure they test both TPOab (thyroid peroxidase antibodies) and TGab (thyroglobulin antibodies).  Some of us with Hashi's are TPOab positive, some TGab positive and some both.

You might also request vitamin D, B-12, iron and ferritin tests.  Deficiencies in any of those can cause crippling fatigue and mimic thyroid symptoms.  

[Gibbon1]

PS: Don't sell your doctor short, if he's giving you a sleep test, it means he's taking you seriously.  I had a friend who how had a sleep disorder, he slept 'fine' but really he wasn't sleeping properly and it caused him a number of health issues.

[Writermss]

Thank you both for the helpful info! I will post labs when I have them done and will do the sleep test. You convinced me!

[Barb135]

Just a quick addition:  if you  have Hashimoto's, it's not unusual for symptoms to show up long before FT3/FT4 indicate a problem.

[Cheryl000]

I have multiple nodules in both lobes and ithemus.  Have suffered for many years with extreme fatigue, muscle aches/weakness, almost daily headaches, brain fog, memory problems, dizziness, ringing in ears, etc. When the nodules were discovered a few months ago, I was sure that it was my thyroid that was cauing my symptoms.  But my endo said my thyroid tests were normal, though TSH was on the low side, but still in normal range. I was sure she was wrong and that I had a thyroid problem because I felt so bad all the time.  So she sent me for a vit d test.  Results were that I have a severe vit d deficiency. She put me on prescription megadoses of vit d.  In just 2 weeks my headaches were infrequent, my energy level was much better, the ringing in the ears was gone.  I am now a month into the 3 month vit d prescription and I feel so much better.  I feel normal again. I haven't had a single headache in about 2 weeks, I have very little muscle aches, no dizziness, no brain fog, no ringing in ears, and only slight memory issues.  It's amazing!  Unfortunately for me, my thyroid nodule FNB results are "indeterminate" and a full thyroidectomy has been recommended by the endo.  I'll be seeing an ENT next week for his opinion.  I finally feel so good again, I don't want to lose my thyroid now, and risk going back to feeling so bad all the time.  But my reason for posting here is to tell you to PLEASE have your vit d checked.  If this is what is causing your symptoms, its just a matter of taking the megadoses to get you back on track.  And you'll be amazed at how quickly and easily you can get your life back if you are found to be vit d deficient.  Good luck to you!