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Toxic Nodule

Is there ever a good reason to not treat (medication, RAI, or surgery) a toxic/hot nodule?  Is it a good idea just leave it there until it gets worse?  

Thank you!

4 Responses
649848 tn?1534633700
You leave us with a lot questions... Can you give us more information, please?  

What symptoms do you have?  What blood work has been done and what are your test results, with reference ranges?  

Did the doctor give a reason for not treating the nodule at this time?

Any other information you care to provide would probably be helpful, as well.
Avatar universal
Hi Barb135,

Due to symptoms and doing the water & mirror test I asked my old gp to check my thyroid.  It was enlarged and my numbers were on the hyper end, but within range so sent me to an Endo.  

I've seen her once so far. She diagnosed me with a toxic multi nodular goiter.  She then sent me to have an uptake done which confirmed the toxic nodule.  I then had an ultra sound where they measured and assessed all the nodules.  I don't know how many she didn't tell me she just said "a lot" when I asked.  The two largest are 4.1 and 4.9cm.  And I'm uncertain of the size of the hot nodule as she said she can't tell.  Though I would think if one was to compare the uptake and the ultrasound you could get a good idea of which one was hot.  Right?  

I was then sent to have a biopsy done on both of the largest nodules which came back benign.  

I told her all the symptoms I was having, and what the Cardiologist told me (that he believes they hypertension and tachycardia is being caused by my thyroid), and that the goiter had gotten bigger since I last saw her.  She told me I didn't need to see her again for another 6 months.

The worst (daily) of my symptoms are tachycardia (I'm now on a beta blocker), hypertension (better since I'm on blood pressure meds), lack of concentration, thick brain fog, weakness, muscle pain (especially in my upper arms and thighs...the muscles "harden"), joint pain....especially in my hips, sore throat, cold hands and feet, chest discomfort, shortness of breath, air feels heavy and thick, muscle spasms, my feet hurt so bad I have to wear slippers all the time to reduce the pain I feel from walking on them, constant dry mouth....always thirsty, my eyes constantly bother me (feel dry and uncomfortable but are perpetually teary), blurry vision, hair loss, headaches, I can't walk up the stairs without it feeling like a mountain...out of breath, legs hurt terribly, fatigue, emotionally a mess, depression, irritability,my anxiety was through the roof but is much better with the beta blocker, the shaking isn't as bad either.  I think that's all.

I asked my previous gp to check my iron because I had clear symptoms (including chewing ice) for over a year and a half ago.  He only checked one test and said it was fine.  I asked my new gp to check it for me (this was just over a week ago) and I'm now on 324mg of ferrous gluc.  My ferritin is down to 9.  So, some of my symptoms may be due to that or at the very least exacerbated them (as most of these symptoms.

Besides the iron results this is what he sent me:

Free T4 3.0 (Range 1.4-3.8)
T4, total 10.5 (Range 4.5 -12.0)
T3 uptake 29 (range 22-35) *from what I understand this was unhelpful and doesn't give me enough info on t3
TSH .27 (range .40 - 4.50)

I have a hot nodule.

Thyroglobulin antibodes <1 (range < or =1)
Thyroid Peroxidase antibodies 4 (range <9)
ANA - Negative 
TBII (Thyrotropin Binding Inhibit Immunoglobulin) <1 (range < OR = 16)

Many with the same problem (hot nodule with symptoms) have encouraged me to see an ENT to have it removed.  I do not think my Endo is doing enough nor listening to me.

Sorry so long!
Avatar universal
I just found this:  https://www.youtube.com/watch?v=kRW98LpfKic

Starting around 4:15  

This what I thought.  It doesn't get better.  So, why wait?
Avatar universal
Any advice would be welcomed.  
How old are you? if you are over 60 surgery is NOT a best option for long-standing goiter.
You may consider radio-frequency ("microwave") ablation for some of your nodules which is less invasive than surgery.
What kind of uptake test has been done (with radioactive iodine or Technetium)?
Did you grew up in iodine deficient area?
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