Thyroid test normal,but why?

[rockerwoman]

I had a subtotal thyroidectomy back in 96,due to a large goiter,cutting off my airway.It came back negitive for cancer.

Now my right side is doing the same thing,and it's loaded with many nodules.Though my Biopsy came back normal as  my thyroid test did too.

Then if my lac work is normal *WHY THE NODULES" I dont want surgery again,as it's growing larger and larger.

Thyroid test normal,but why?

[GravesLady]

If your nodules grow too large there can be complications, one being: Some nodules will grow own into the chest area and surgery by that time will be complicated.  They'd have to break through the ribs to get to it. Sub-sternal thyroid glands, a thyroid will grow downward rather than up and out within the neck. When this happens, the thyroid will grow down the trachea into the chest. This can become an even bigger problem since the chest is surrounded by a very rigid bone structure (the chest cavity). The top of the chest cavity is made up of the spinal column in the back, the first and second ribs on the sides, and the collar bones (clavicles) and breast bone (sternum) in the front. When a thyroid gets enlarged within this rigid bony structure, it will compress those structures which are soft such as the trachea, lungs, and blood vessels (the bones will not give way).
So your nodules need treatment by one means or another as follows.

Compression-related symptoms may be indications for surgery. When surgery is contraindicated or refused, several nonsurgical approaches are available. Radioiodine treatment, percutaneous ethanol injections, and the new technique of laser photocoagulation.

Radioiodine treatment doses commonly used (5–30 mCi, 185–1,110 MBq) and 7–10 mCi, 259–370 MBq) have been tested, RAI seems to be devoid of major side effects. Significant shrinkage (ranging from 31% to 60%) can be also achieved in patients with nontoxic multinodular goiter.

Percutaneous ethanol injection (PEI) for the treatment of solitary, autonomous thyroid nodules. Since then, PEI has also been used to treat nonfunctioning solid and cystic nodules. An experienced operator must perform PEI; multiple injections are often necessary to achieve complete ablation, and adverse effects are not uncommon (pain, ethanol seepage outside the nodule, and rarer events, such as transient thyrotoxicosis and recurrent laryngeal nerve damage). The best results have been obtained in the treatment of large or symptomatic cystic nodules. with a shrinkage of >50% in 88%

Ultrasound-guided percutaneous laser ablation (PLA) minimally invasive alternative to surgery for the ablation of nonfunctioning and autonomous thyroid nodules that cause pressure symptoms
procedure is performed under ultrasonography guidance. The major drawback of PLA is that it is currently impossible to identify the true boundaries of the laser-induced tissue damage.
PLA is a rapid (duration around 30 min) and inexpensive procedure that can be performed on an outpatient basis. Postablation neck pain can be controlled with 1–2 days of oral analgesics or corticosteroids. Given the risk of damaging vital structures and the absence of data from large prospective trials, PLA should be performed only in specialized centers.
A 50–70% decrease in nodule volume and amelioration of local symptoms can reportedly be achieved with 1–3 sessions of PLA, or a single treatment performed with multiple optical fibers.

Nodules that are exerting pressure on surrounding structures, surgery should seriously be considered.

Discuss the options with your doctor to see if any of the above are applicable to or for your nodules.

Good Luck!

[ifupleze]

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