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Dr. Andrew Rynne

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Nodule developed in the right middle lobe and have high TSH value. Safe to take synthroid?

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Dr. Sudhir Kumar

Neurologist

Practicing since :1994

Answered : 5687 Questions

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Posted on Tue, 11 Dec 2012 in Thyroid Problem and Hormonal Problems
Question: I thought I had already submitted my question. Recently had a physical and a follow up ultrasound of my thyroid the radiologist recommends a Fnb and my Dr says let's do a wait and see and wants to put me on synthroid. tSH level is 10.8. Radiologist report:
Mid portion of right lobe relatively hyperechoic nodule w/heterogenicity has developed micro calcification and ill defined margin etc. conclusion reads thyroid within normal size has become more hyperechoic w/ vascularity. Nodule has increased in size and is associated with micro calcification. "This is considered sufficiently suspicious for neoplasm". Equivocal modular areas in both upper poles. Should Ingo with the Dr wait and see or the radiologist
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Answered by Dr. Sudhir Kumar 2 hours later
Hi,

Thank you for posting your query.

I would agree with your Radiologist. As the size of lesion has grown, and the margins are irregular, with calcification, one needs to exclude a neoplasm. I feel, even if it is a neoplasm, most likely it would be a benign one.

In addition, since your TSH is high (suggestive of hypothyroidism), I would agree with your doctor's decision to start Synthyroid.

I hope it helps. Please get back if you have any further queries.

Wishing you good health,
Dr Sudhir Kumar MD DM
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Sudhir Kumar 7 hours later
Thanks for getting back to me. Does the synthroid shrink nodule. Should I take that for a couple months before having biopsy? I had put on some weight and was going to start with a couple supplements from dr XXXXXXX Is there anything Supplements or homeopathic remedies I should avoid while on synthroid
See you are a neurologist. Could this thyroid issue cause the headache on right side of head and some facial twitching on same side mostly near mouth and the eye on that side is getting more blurry. Left side
doctor
Answered by Dr. Sudhir Kumar 5 hours later
Hi,

Thank you for getting back with more details.

Synthyroid replacement therapy in hypothyroidism may reduce the size, if the increased size is due to a goitre. This condition is common in Sub-Himalayan region, as they have iodine deficiency causing goitre. So, it is a common sight to see people there with large swellings in the neck region. So, it may be appropriate for you to wait for a couple of months prior to biopsy. However, if you feel that the size in increasing at a faster rate, you can go for an early biopsy.

There is nothing specific to avoid while on thyroid supplements.

Headache, facial twitchings and blurring of vision are not related to the thyroid problem. They could occur due to strain, excessive computer use, lack of sleep, etc.

I hope it helps. Please get back if you have any more queries.

Best wishes,
Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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