Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Am 59 And Have IGA Nephropathy For The Past 9
Question: am 59 and have IGA nephropathy for the past 9 years which is being treated with Cardace 10 mg, Minipress XL 2.5+ 5 mg, Lipitor 10 mg, and fish oil capsules. In addition I have benign prostratomegaly (Grade 3) since XXXXXXX 2016 without any symptoms and no medication.
In XXXXXXX 2017 my thyroid ultrasound showed a solitary small nodule in my right lobe of the thyroid at 9 x 6 mm. Left lobe was normal. All else i.e parotid gland, lymph nodes, ishtmus, were normal. The XXXXXXX 2018 ultrasound showed the same right lobe nodule 9 x 5.7 mm, all else normal.
My thyroid ultrasound in July 2019 showed multiple nodules with the biggest in the right lobe at 8.8 x 6.3 mm. The comment was that both lobes appear mildly enlarged with coarse echotexture and increased vascularity. Isthmus, parotid and sub mandibular glands appear normal, and there were no enlarged lymph nodes. The diagnosis was Multi Nodular Goitre.
I have attached the ultrasound for July 2019 for your review.
My thyroid test result in October 2018 was : TSH (ultrasensitive) 1.34 uIU/ml (Ref 0.54- 5.3) , Free T3 - 3.19 pg/ml (Ref 1.4-4.4), Free T4 - 1.40 ng/dl (Ref 0.8-1.8).
My recent TSH (ultrasensitive) in April 2019 was 1.45 uIU/ml (Ref 0.54- 5.3). I do not display any thyroid symptoms and do not take any thyroid medication.
My queries are as under:
1. Please review my July 2019 ultrasound result and give me an opinion as to whether any medication / further testing is required given the above history. My GP is of the view that a 'wait and watch' option is the best as my TSH is normal and I display no symptoms.
2. The nodule in the right lobe has not changed much in the past 3 years - does an ultrasound also indicate if a nodule is fluid filled or not ? I am concerned about the possibility of cancer of the thyroid.
3. If no medication is required at present, what should I be looking out for in future which would require further testing and possible medication?
Thanks
In XXXXXXX 2017 my thyroid ultrasound showed a solitary small nodule in my right lobe of the thyroid at 9 x 6 mm. Left lobe was normal. All else i.e parotid gland, lymph nodes, ishtmus, were normal. The XXXXXXX 2018 ultrasound showed the same right lobe nodule 9 x 5.7 mm, all else normal.
My thyroid ultrasound in July 2019 showed multiple nodules with the biggest in the right lobe at 8.8 x 6.3 mm. The comment was that both lobes appear mildly enlarged with coarse echotexture and increased vascularity. Isthmus, parotid and sub mandibular glands appear normal, and there were no enlarged lymph nodes. The diagnosis was Multi Nodular Goitre.
I have attached the ultrasound for July 2019 for your review.
My thyroid test result in October 2018 was : TSH (ultrasensitive) 1.34 uIU/ml (Ref 0.54- 5.3) , Free T3 - 3.19 pg/ml (Ref 1.4-4.4), Free T4 - 1.40 ng/dl (Ref 0.8-1.8).
My recent TSH (ultrasensitive) in April 2019 was 1.45 uIU/ml (Ref 0.54- 5.3). I do not display any thyroid symptoms and do not take any thyroid medication.
My queries are as under:
1. Please review my July 2019 ultrasound result and give me an opinion as to whether any medication / further testing is required given the above history. My GP is of the view that a 'wait and watch' option is the best as my TSH is normal and I display no symptoms.
2. The nodule in the right lobe has not changed much in the past 3 years - does an ultrasound also indicate if a nodule is fluid filled or not ? I am concerned about the possibility of cancer of the thyroid.
3. If no medication is required at present, what should I be looking out for in future which would require further testing and possible medication?
Thanks
Brief Answer:
you may undergo a 99 Tc uptake scan
Detailed Answer:
Dear sir, thyroid gland has a lobular structure. in this , at times some nodules become large and so are detected on USG, if still larger might be visible clinically as well.
your reports show the same thing over the past 2 years. the initial nodule has not grown in size, there is no pain, and the consistency is soft and XXXXXXX these things rule out cancer. over time , single nodule has become multiple, so that again is not a concern, because all nodules are <1 cm.
your thyroid report functionally is also normal , so no symptoms you are facing.
you may not do anything as of now. but if you insist, 99 TC uptake scan for thyroid can be done and if any cold nodule is detected, fnac is suggested from that nodule. then cancer is ruled out.
regards!
you may undergo a 99 Tc uptake scan
Detailed Answer:
Dear sir, thyroid gland has a lobular structure. in this , at times some nodules become large and so are detected on USG, if still larger might be visible clinically as well.
your reports show the same thing over the past 2 years. the initial nodule has not grown in size, there is no pain, and the consistency is soft and XXXXXXX these things rule out cancer. over time , single nodule has become multiple, so that again is not a concern, because all nodules are <1 cm.
your thyroid report functionally is also normal , so no symptoms you are facing.
you may not do anything as of now. but if you insist, 99 TC uptake scan for thyroid can be done and if any cold nodule is detected, fnac is suggested from that nodule. then cancer is ruled out.
regards!
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you for your comprehensive response. My follow up queries are as follows:
1. My preference is to do nothing at present as there are no symptoms, thyroid test is normal, etc. Is the 99 TC uptake scan for thyroid absolutely necessary to do, or is it an option which you are suggesting?
2. Suppose the nodules are > 1 cm in future, it is then necessary to do FNAC?
3. Can I improve the thyroid i.e reduce the nodules, without any medication through diet etc?
Thank you.
1. My preference is to do nothing at present as there are no symptoms, thyroid test is normal, etc. Is the 99 TC uptake scan for thyroid absolutely necessary to do, or is it an option which you are suggesting?
2. Suppose the nodules are > 1 cm in future, it is then necessary to do FNAC?
3. Can I improve the thyroid i.e reduce the nodules, without any medication through diet etc?
Thank you.
Brief Answer:
Cold nodules
Detailed Answer:
dear sir, the 99 tc scan is suggested to pick up cold nodules if any . and they can be then followed.
in case in future the module size > 1 cm, then FNAC would be mandatory.
no exercise , diet or yoga will change the nodules. or their future course, though u will find people claiming to do so.
so, the summary is 99 tc scan and then u may report me back.
regards
Cold nodules
Detailed Answer:
dear sir, the 99 tc scan is suggested to pick up cold nodules if any . and they can be then followed.
in case in future the module size > 1 cm, then FNAC would be mandatory.
no exercise , diet or yoga will change the nodules. or their future course, though u will find people claiming to do so.
so, the summary is 99 tc scan and then u may report me back.
regards
Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
