HomeAnswersEndocrinologythyroid function testHow does a thyroid profile show thyroglobulin antibody?

What do the thyroid profile parameters suggest concerning the thyroglobulin antibody and management of the nodule?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

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Published At May 26, 2023
Reviewed AtOctober 9, 2023

Patient's Query

Hi doctor,

I have a question about thyroid function tests. I had a test this morning, and the results are as follows:

  1. T4 3.4 mcg/dL (5 to 12)
  2. TSH 1.37 mIU/mL (0.27 to 4.2)
  3. Free thyroxine 1.28 ng/dL (0.8 to 1.8)
  4. Free T3 357 pg/dL (260 - 480)
  5. Thyroglobulin antibody 15.1 IU/mL (0 to 115)
  6. Thyroid peroxidase antibodies

I attached the detailed file and the details of the ultrasound. Please help me understand the value of thyroglobulin antibodies and also how I should manage the nodule.

Kindly help.

Hi,

Welcome to icliniq.com.

Your thyroid function and antibody levels are in the normal range. The dominant thyroid nodule on the right side by the report is a cyst and is usually benign. The other nodule is also of low risk according to the report and smaller, so repeating the ultrasound in 6 to 12 months is all that is needed for now. I would prefer to see the images of the nodules if available.

Patient's Query

Hi doctor,

I do not have the images of the nodules. I am a bit confused because, for BTA U2 (benign) nodules, the British Thyroid Association does not recommend further testing. How often should I have repeat ultrasounds? Also could you please explain what is the cause of nodules? The final question I have is about thyroglobulin antibodies. I am reading that it should be zero. I see that it is within the normal range but worried that it is positive.

Hi,

Welcome back to icliniq.com.

I follow ATA (American Thyroid Association) or the TIRADS (Thyroid Imaging Reporting and Data System) risk scoring and usually the ATA guidelines. The smaller nodule is BTA U2, and ATA is low risk, so I recommend repeat ultrasound in 6 to 12 months for a couple of times and if there is no increase in size then every three to five years. For the cyst, if there is an increase in size with the symptom, then aspiration or ablation can be considered. The above schedule is for the smaller nodule and will be more than enough for the cyst. The nodules may be caused by a single cell line or a few cell lines of thyroid cells that grew autonomously and degenerated to become a cyst. Why? We cannot be sure, it could be due to iodine deficiency, smoking, being overweight, or genetics. The thyroglobulin antibody can be measured in the general population also. During the nodule formation or degeneration or an episode of inflammation of the thyroid or randomly some thyroglobulin may have been exposed to the general circulation or immune system and antibodies may have formed. So I will not be worried unless the ultrasound characteristics change.

Patient's Query

Hi doctor,

The nodule and the cyst were incidental findings in the ultrasound done for muscular pain. Could the nodules be there for years or do they form suddenly? Are they really that common? They caused me significant anxiety. I was under the impression that nodules form in women only.

Hello,

Welcome back to icliniq.com.

Yes, most nodules are found incidentally nowadays. They are quite common. At your age, it may be less common but not unusual. At older ages, one in two may have a thyroid nodule. They must have been there for months or years. The nodules can form in men also, as you must have guessed by now.

Patient's Query

Hi doctor,

Can I please confirm something about the size of the nodule? The nodule is up to 1.2 inches big. Shall I be worried about the size because it is quite big? Does this mean that it is more likely to become malignant? I assume that since it is a cyst and not a solid cyst it does not carry the same risk for cancer.

Hi,

Welcome back to icliniq.com

The report says it is a cyst with a tiny solid peripheral component - so it is benign and the chance of becoming malignant is too small. The size itself does not carry a higher risk. If the peripheral solid component changes during follow up then can consider fine needle aspiration cytology (FNAC), but again the chance of that is low.

I hope this helps.

Patient's Query

Hi doctor,

What does it mean that the cyst is markedly hypoechoic?

Hi,

Welcome back to icliniq.com.

It is redundant cyst means fluid. So will be markedly hypoechoic or anechoic. Only a solid lesion should be characterized by the degree of echogenicity compared to surrounding normal thyroid tissue. Rarely a solid lesion may be markedly hypoechoic to the point of being confused as a cyst - or a cyst is mistaken as a markedly hypoechoic solid lesion - a trained radiologist should not have difficulty in making this distinction.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Thiyagarajan. T
Dr. Thiyagarajan. T

Diabetology

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