Dr. Divakara. P
Internal Medicine
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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Patient's Query
Hello doctor,
I am a 41 year old male. My weight is 196 lbs and height is 6 feet. I have nodules in the thyroid gland since last two years. Initially, it started as a feeling of imbalance in the head about two years back. The initial assumption was vertigo and later it was found to be a small nodule in the left lobe. The blood test performed about one and half years ago revealed T3 104 ng/dL, T4 6.60 ug/dL and TSH 0.04 mU/L. The blood test performed about a year ago revealed a TSH of 68 mU/L. The blood test performed 10 months back showed T3 108.8 ng/dL, T4 7.2 ug/dL, TSH 0.73 mU/L, cholesterol 196 mg/dL and blood pressure 90/130 mmHg. The blood test performed about two weeks ago showed T3 128.5 ng/dL, T4 8.8 ug/dL, TSH 0.73 mU/L, blood pressure 100/140 mmHg, cholesterol 96 mg/dL, cholesterol serum 235 mg/dL, triglycerides 193 mg/dL, LDL 143 mg/dL, HDL 53 mg/dL, VLDL 39 mg/dL and FBS plasma 96 mg/dL. The present signs and symptoms include trembling hands, high tension, anxiety, weight gain, blood pressure, kind of numbness in head and a type of balance missing (not giddiness). Currently, I am not taking any medicines. I wanted to know whether my problem is hyper or hypothyroidism. Should I need to do FNAC again? As the nodules are increasing, should I start taking iodine food supplement? I have read both to avoid iodine supplement and to take it (case to case). Whether the iodine supplements will help to reduce nodules? Is there any natural way to reduce the chance of surgery? Are there any diet control suggestions for the condition? Is there any detailed specialist checkup needed? I am also attaching the previous four USG reports, biopsy report and HRCT of temporal bones. Please help me.
Hi,
Welcome to icliniq.com.
Basically, your scan reports (attachment removed to protect patient identity) are showing that you have thyroiditis (inflammation of the thyroid gland) along with a nodule in the thyroid gland. Because of this problem you are having the symptoms. Initially,you had hyperthyroidism due to thyroiditis as your TSH (thyroid stimulating hormone) was low, but eventually, from hyperthyroid, you became normal thyroid as your TSH has normalized. Instead of going for a FNAC (fine needle aspiration cytology) again, I recommend you to get an iodine scan done for your thyroid. If that shows any problem, then you may have to get FNAC of nodule again. Most of the food contains iodine and so there is no need for a special diet. But, anyhow you will be given an iodine pill before doing the iodine scan.
Patient's Query
Thank you doctor,
Presently, the doctor advised me to avoid tapioca and cabbage. Are there any other food items harmful to me? In your view, is surgery the only option to get rid of this problem? After surgery, what are the chances for new nodules formation?
Hi,
Welcome back to icliniq.com.
Avoid cauliflower and spinach also. At this point, we cannot decide whether you need surgery or not. Only after the scan and if needed after a repeat FNAC it can be said with surety. Radioiodine therapy is an option other than surgery. If surgery is done, then the chance of a repeat nodule is less, but there is a possibility.
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Internal Medicine
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