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Even though it sounds drastic to have your thyroid removed I would take that over cancer. Have the aspiration and go from there.
That would be a reasonable person's method, I suppose. I am so afraid of having my thyroid removed, I will examine various avenues before that if that is the ultimate suggested course.
If your TSH was "way off," then you either have over- or under- active thyroid function. (Way off hi or lo?) Those kinds of thyroid problems are really common, so it wouldn't be rare to have Grave's or Hashimoto's thyroid problem plus a mass or cyst. [Let's forget about a pituitary problem for the sake of this discussion.]
If the doc called it a cold nodule, we presume it is a solid nodule and not a cyst-- ultrasound is good at telling the difference. "Cold" means it's not functioning thyroid tissue, so it shouldn't affect the TSH one way or the other.
Thyroid ca can present as a cold nodule ("hot" ones are rarely ca.) Therefore, waiting to aspirate it for diagnosis purposes is unwise. The longer you wait if it is ca, then the more time for it to metastasize and become a worse problem. Thyroid ca is very treatable when caught early....The aspiration procedure isn't as bad as having a tooth pulled.
I'm guessing your TSH was high, suggesting under-active thyroid, but not so far off that the doc felt treatment was absolutely required just yet. Taking thyroid replacement at this point would suppress your own thyroid function and screw up the value of a thyroid scan, should they feel another one is important in the near future.
As far as living without a thyroid, I've been doing it for 21 yrs now- one cheap pill every AM. I played amateur hardball until age 60 (my eyes went before my legs) and did most of the work building my own house last year at age 68. --Ah looks bad, but Ah feels fahn!
OK, listen -- thanks for your reply. The TSH was 0.19. The portal for the test results is down, so I'll get more info tomorow. I'm glad to hear you've been feeling fahn for so many years taking the thyroid meds. That is encouraging.
I had a huge nodule on my thyroid, and having the aspiration was really not bad. Due to the size of the nodule, although the aspiration was inconclusive, when they went in to remove it, cancer was found behind it so they took the whole thyroid gland. The unpleasant part was afterwards when I had to do the radio-iodine treatments, including an ablation and a full body scan. Preparation for the ablation meant going totally hypothyroid, and that was unpleasant. The ablation was a large dose of radio-iodine followed by 3 days of isolation due to being radioactive.
As long as you take your thyroid replacement meds if your thyroid is removed, you shouldn't have any problems. My daughter went through the same thing a few years later. We are both just fine.
A funny anecdote-- it was halloween a few days after my surgery. I still had steri-strips all around my neck, and it scared a few little children when I went out in public.
Thanks again. You all are giving me courage to go through with the aspiration.
I had been hypothyroid for years but no other problems. I had an ultrasound done for something else on my neck and they found a nodule. did a needle biopsy which was inconclusive. So I had the entire thyroid removed and it was Papillary cancer. I was suppose to have the follow up radioactive iodine but for certain reasons I did not have it. this was three years ago and I have been on Levothyroxine since then, no real problems to speak of, though now I am concerned as I have some lymph node pain in my neck and have a hard time getting doctor to do anything about it or check it out.
I think I did the right thing going for the full thyroid removal though.
It's hard to understand why the doctor isn't moving to diagnose this problem you are having better. I am glad I went to a very kind doctor who is an assistant professor of endocrinology at a university. She listened to me and is working with me, holding my hand throughout this. I explained how reluctant I am, she did not pressure me, but is still my "friend," meaning she is sympathetically doing what she can, given my limited desire to have my thyroid removed. I thank you all for your answers. It helps. Most likely I'll have the aspiration done soon, and pray for wisdom. I hope you feel better.
So I had an overactive gland, and they gave me 3 options for treatment: surgery, trying to kill off just the right amount of thyroid to make me 'normal,' or trying to stabilize me with meds. Surgery was my last resort, so I went a few years of being stabilized on meds before they found cancer after a biopsy. Had the surgery + radioactive iodine treatment. Been living without my gland for well over a decade and feel fine. I request name brand meds though because they tend to be more consistent dosage-wise. No other complications but recovery kind of sucked. Definitely have a biopsy before resorting to surgery imho. No need to remove your gland if it's otherwise functioning properly. My mother has a nodule but it's been checked out multiple times and she's fine, she doesn't have any other thyroid issues.
OK, listen -- thanks for your reply. The TSH was 0.19. The portal for the test results is down, so I'll get more info tomorow. I'm glad to hear you've been feeling fahn for so many years taking the thyroid meds. That is encouraging.
Curiouser and curiouser.
Your doc sounds like she's compassionate & knows her stuff.
You have a low TSH, suggesting either over-active thyroid or under-active pituitary (not likely, but not impossible). Her reluctance to treat just yet suggests it's not so over-active that there's symptoms.
Your nodules are cold, ie- not producing significant amounts of T4, so we can't blame them for the low TSH. Only ~10% of cold nodules turn out to be cancer, and the fact that you have more than one also makes ca even a little less likely. The colder areas might just be normal thyroid tissue suppressed by the hotter surrounding functioning thyroid cells.
Without complete details & the ability to examine you and the scans, (not to mention what the heck do we all know?) we can't tell you what to do. But in regards your original question, by our collective experiences, we can tell you that needle bx is easy and life without a thyroid, should it come to that, is no problem.
Your doc sounds like she's compassionate & knows her stuff.
You have a low TSH, suggesting either over-active thyroid or under-active pituitary (not likely, but not impossible). Her reluctance to treat just yet suggests it's not so over-active that there's symptoms.
Your nodules are cold, ie- not producing significant amounts of T4, so we can't blame them for the low TSH. Only ~10% of cold nodules turn out to be cancer, and the fact that you have more than one also makes ca even a little less likely. The colder areas might just be normal thyroid tissue suppressed by the hotter surrounding functioning thyroid cells.
Without complete details & the ability to examine you and the scans, (not to mention what the heck do we all know?) we can't tell you what to do. But in regards your original question, by our collective experiences, we can tell you that needle bx is easy and life without a thyroid, should it come to that, is no problem.
Best wishes.
Reviewing your post, I have a few questions. As I remember it, the doctor said my TSH is low, then the ultrasound revealed a mass ? - she called it a nodule. And there were lots of folds or messy situation on the thyroid, I forget the term, all wrinkled up. I haven't been taking meds for the low TSH, she told me the hyperactivity comes from the brain which is making up for the low activity of the thyroid. I may not even be relating her words properly. But I think that's what she told me. My question is: do people who have low TSH4 levels feel fatigued? I think I've been fatigued for decades, but pushed myself to go to work, etc. And, if a person has his thyroid removed and takes medication, does he get more energy???
My mother had a goiter and had her thyroid removed when she is was in her twenties. She is 91 now and has taken thyroid pills for a long time. She has never had a problem.
Reviewing your post, I have a few questions. As I remember it, the doctor said my TSH is low, then the ultrasound revealed a mass ? - she called it a nodule. And there were lots of folds or messy situation on the thyroid, I forget the term, all wrinkled up. I haven't been taking meds for the low TSH, she told me the hyperactivity comes from the brain which is making up for the low activity of the thyroid. I may not even be relating her words properly. But I think that's what she told me. My question is: do people who have low TSH4 levels feel fatigued? I think I've been fatigued for decades, but pushed myself to go to work, etc. And, if a person has his thyroid removed and takes medication, does he get more energy???
Your TSH levels might have nothing to do with the nodules. Normally if you have low TSH levels it indicates your thyroid isn't putting out enough and you feel fatigued. When a person has his thyroid removed or it is indicated that his thyroid isn't doing the job, medication is prescribed that supplies the hormone your thyroid should have been producing. You'll feel tons better when you take it.
I've got the opposite problem - too much thyroid - and I get the jitters if I don't keep it under control with medicine. The bank probably wouldn't recognize my signature. That can drain your energy, too, making you so shaky you feel like your legs won't support you when you try to walk.
So the thyroid is an important organ, and it in turn is controlled by the pituitary gland in your head, which can be a big part of the problem. Endocrinology is an under-appreciated department of medicine.
Reviewing your post, I have a few questions. As I remember it, the doctor said my TSH is low, then the ultrasound revealed a mass ? - she called it a nodule. And there were lots of folds or messy situation on the thyroid, I forget the term, all wrinkled up. I haven't been taking meds for the low TSH, she told me the hyperactivity comes from the brain which is making up for the low activity of the thyroid. I may not even be relating her words properly. But I think that's what she told me. My question is: do people who have low TSH4 levels feel fatigued? I think I've been fatigued for decades, but pushed myself to go to work, etc. And, if a person has his thyroid removed and takes medication, does he get more energy???
A little basic physiology: the pituitary gland (the "Master Gland" located at the base of the brain) is the thermostat telling the furnace (thyroid gland) how hard it should work. The heat, so to speak, is the thyroid hormone level in your blood (thyroid hormone = thyroxine = T4).
If your TSH is low, then either you're making a little more T4 than you need to (house is warm enough; no need for furnace to stay on), or your pituitary isn't functioning properly. (Problems of pituitary limited to TSH are rare-- often another hormone system is also not working right.) If it's the pituitary, then your T4 may be low. Symptoms like fatigue, lethargy, weight gain and hoarse voice don't appear until T4 levels get pretty far below normal, but they go away quickly with thyroid replacement meds.
If your pituitary is ok, then your T4 level may be normal (so you'd feel ok) or your T4 might be high. Symptoms like tremors, hi bp, hi HR, sweating, "nerves" & weight loss develop as T4 levels rise. A slight elevation may not cause noticeable symptoms.
The "usual" causes of over- or under-active thyroid are very, very common-- so it wouldn't be unusual to have a typical thyroid problem PLUS a thyroid nodule. Now the problem becomes one of proving if yours are benign or malignant. ..Skinny-Needle biopsies are much easier to take than pulling a tooth.
Fatigue is a universal complaint -- more often caused by stress &/or poor sleep than by physical illness.
Female monthly cycles are extremely sensitive to thyroid function and changes there are often the first hint of thyroid problems.
Your translation of the doc's description is still a little confusing. What's your TSH level and T4 level?
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