Thyroid Nodule Questions

Hi-
I'm new to the Thyroid board (been posting on Lyme board for some weeks). Was hoping some of the experienced folks here could help give me some perspective.

My thyroid blood tests have all been normal for past 6 months or so that I've not been feeling well (fatigue, anxiety, brain fog, low body temp, swollen lymph nodes in neck). T4 - 1.5, TSH- 1.820, T3 - 98, TPO - 8. Always tested positive for some bands of Lyme (and co-infection Babesia now) so had been treating that with antibiotics and herbs for most of 2012.

Started having some intermittent neck discomfort (dull ache) month ago, and only last week did one of the docs suggest getting ultrasound on thyroid as one side of neck seemed slightly fuller. Well, today I had ultrasound and tech said she saw couple of nodules (one larger one on side giving me the intermittent discomfort). Now I have to wait for radiology to get back to me on what this can mean and I'm freaking out a bit. The questions I have-

- Could a nodule on the thyroid cause my symptoms yet still not impact the blood tests? If thyroid was causing symptoms I would have thought one of the prior tests would have been abnormal range.
- Is a fine needle biopsy most likely now? Or can ultrasound often rule out some things?
- Do nodules that cause some kind of discomfort typically require intervention (surgery etc.)?
- Anyone have similar experience with thyroid and also lyme diagnosis?

Any help is appreciated. Thanks

Thanks for response.  Not sure if they tested for antibodies - is the test called something else?  Is this a test for Graves? 

I finally got used to all the Lyme testing / treatments and now its back to square one. 

Well radiologist report shows 3 nodules on thyroid, the largest is 3cm and the one likely causing some of the neck discomfort.  Dr didn't provide other specifics.  Referred to ENT who will likely want to do biopsy on the bigger one.  Do they typically do the fine needle biopsy right in the office?  I know most are benign but hard not to think of the other scenario. 

Thanks for replies. Surprised your doc won't touch nodule until 10 cm - that's nearly 4 inches. Here is the reading from my ultrasound:

"within the right lobe, there is a well-defined, complex, predominantly cystic mass with a 1.4cm solid nodule within it at the mid pole. The mass measures 3.3 x 2.2 x 2.0cm in length, width, and depth respectively. There is increase vasularity within the solid nodule and within the periphery of the mass.
Within the left lobe, two nodules are identified. These include a well-defined, oval cystic lesion within the central mid pole measuring .4 x .4 x .3 cm in length, width, and depth respectively in which there is peripheral increased vascularity, and well-defined, isoechoic solid nodule within the anterior mid pole measuring .7 x .5 x .5cm in the same dimensions in which there is peripheral increased vascularity.
The thyroid parenchyma is diffusely hetereogenous. The overall vasularity appears normal"

Any comments on what this may indicate - particularly the "increased vasularity" comments?

I am scheduled for ultrasound guided biopsy next week to get sample of the solid core of the larger nodule. The ENT thinks that perhaps this nodule hemorrhaged thus filling the cystic mass quickly and causing some of my pain last week. As I no longer have pain, and the lump seemed to appear very quickly, this would seem to make sense.

Well fortunately results came back from biopsy - benign. Thank God. Have to get ultrasound every year or so to watch if it is growing. Still think something is not totally right with thyroid so will ask to have all the blood tests and antibody tests mentioned. Thanks for the feedback.