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Posted 10/16/2015 3:52 PM (GMT 0)
Have had thyroid nodules since 1999. New one is growing fast and is 6 cm. In the last couple of weeks I have begun having some very minor hoarseness, coughing, and minor pain if I take a deep breath after I've been coughing. Am 66 and in good health. Doctor and I have an upcoming appointment to discuss possibilities of treatment. We don't want to do the surgery too soon, and we don't want to wait too long as my health could become worse as I age and then if problems moved from very minor to critical there could always the possibility that I wouldn't be in good enough health to do well with surgery.

Wondering if anyone else is in this stage or recently made a decision about surgery? Just wondering what factors other people take into account when making the 'when' decision.
Posted 10/17/2015 7:36 AM (GMT 0)
Hi and welcome to the forum ,
A nodule of 6 cm is very suspicious , and if your US confirm that it is growing and that you take levo which did not cause it to shrink, then there is no option but to do the surgery ,if you are on levo then 1/3 of the cases of nodules will shrink , third will remain the same size and third will grow , this is the statistic .

Best wishes ,
Posted 10/17/2015 2:46 PM (GMT 0)
Thanks for your reply.

I’m not on meds now. That is the discussion the Dr. and I need to have after the aspiration comes back. Neither one of us thinks it’s cancer. Not usually as hard to get cells when it is cancer since they multiply so fast. He had to make many tries before he could get enough thyroid cells. He has the cytologist in the room with her microscope when he’s doing the aspirations so he can be sure he has enough cells for a good analysis. We need to decide whether to try the meds route first or to go directly for the surgery.

One concern is if the meds only temporarily stop the growth, there is the possibility that if it starts growing again later down the road I’ll be too old to be a good candidate for surgery.

Also, as I understand it, to go the meds route, he has to first turn off the thyroid from creating the hormone itself so they can get a good, reliable level when they start the meds. I have depression and some cognitive problems from a past brain injury, and I also have a concern about how I’ll react during the “turning off” phase.

I just wonder if there any other things I should be considering before we discuss it together next week.
Posted 10/17/2015 4:41 PM (GMT 0)
Hi ,
Do you have a thyroid panel blood tests results ? those should include TSH ,ft3 and ft4 , if your tsh shows that you are hypothyroid (high tsh) then you need to be put on Levothyroxine even if your free t3 and free t4 are normal , since a high tsh causes your gland to work over time and to have hypo symptoms.

With nodules I would expect that you have Hashimoto's disease which is the cause for you being hypo, to confirm you need to test for antiTPOab and TGab , if either is positive then you have it, with hashi it is likely to have nodules , most of them are benign , but as I said , 6 cm is very large nodule , I assume it causes you swallowing difficulty .

We are not doctors at this forum , only fellow patients who try to help others through our own personal experience , so you should always follow what your doctor instruct you, however , with a nodule of 6 cm that grows , the option of waiting for the levo to shrink it might be a little late , so your doctor might decide for a total or partial thyrodectomy .

If you are on a Levo brand name that works for you , then there is the possibility that it shrinks the nodule, this is the case in the third of the cases, if it does , then it will does as long you take it , according to one bad endo whom I saw once , there is no connection between the dose of the levo and whether nodules shrink or not , I am not sure regarding that so you need to ask your doctor .

Not every Levo product works for every one, you might need to try many before you find the brand that works for you , in the US there are several brand names , they include Synthroid ,the most prescribed drug in the US until the middle of 2014 , there is also Levoxyl and Tirosint , insist on being on brand name and not the generic form , also with hashi it might take a while before you reach the proper dose for you , you will be put on a small initial dose depending on your tsh , and the dose will be increased every six to twelve weeks , this is because with hashi , your tsh will rise again six to 12 weeks after each increase in the dose indicating the need to increase again until you reach the proper dose for you .

Hope this helps, take care and best wishes ,
Posted 10/17/2015 5:16 PM (GMT 0)
Actually I'm not hypothyroid or hyperthyroid. Blood work is normal. I just have nodules.
Posted 10/18/2015 4:45 AM (GMT 0)
What is your actual TSH levels ?
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