Thyroid nodules - terrified, PLEASE read

[pulisa]

Get a referral to a decent endocrinologist who will easily be able to make an assessment of your ultrasound. He/she may also order more specific thyroid-related blood tests as the standard one just measures TSH. I have symptoms of hyperthyroidism but my bloods don't show this. Nodules can cause hyperthyroidism and I think the free T3 blood test is the one for this.
I have to say that my endocrinologist did say that TC was a cancer which had a very high survival rate so if I did have it,it was one of the "better" ones to have. So I was prepared to get bad news..but I didn't despite the urgency of my referral. I was referred for ultrasound on the afternoon my nodules were discovered and saw the consultant on the following Monday as advised by the sonographer.

[Cptdebbie]

Hi Steph,
I am not supposed to seek reassurance either, but sometimes I just have to. I think of it like a diet. If I don't cheat every once in a while, I'm not going to be able to stay on the diet.

My husband has Stage 4 Lung Cancer. A 1.1 cm thyroid nodule showed up on one of his regular CT exams. His oncologist completely dismissed it, saying it was irrelevant and nothing to worry about. It may be that the CT scan showed details about this nodule that enabled a quick diagnosis. I am not sure. Nevertheless, that is a pretty big nodule and it is benign.

You are going to be just fine. I'm amazed at how differently I react to things when my health anxiety is under control. You doing excellent things to take care of both your mental and physical health. You've got this

[Andrash]

[QUOTE=Serotoninsteph;1801819]

I read your previous post, but it is easier to quote this one as it is shorter.

Hi Andrash,

Thanks so much for your reply. It made me feel better. The thing is that I know that just because it says they don't appear suspicious doesn't mean they're not, and my understanding is that ultrasounds aren't the most reliable. It's scary because I have the other symptoms - long standing cough and sore throat, pain up the sides of throat, throat clearing, that are all TC symptoms so when combined with all these nodules it is frightening. I don't understand why the radiologist didn't offer more information. Seems lazy to just say multiple nodules without describing them more and not giving a number- like this could be five, ten, twenty for all I know! I wish they would explain what about them isn't suspicious. I've read that hypoechoic solid nodules are pretty indicative of cancer. I know I need to stop doing this. As for sources, actually these days Google can lead to reliable sources indeed, but there are lots of unreliable ones as well. I use official cancer sites and nhis which I think are a little more on the reliable side, but regardless, I need to somehow train myself to get off Google. Thank you very much for your insight and support. I really appreciate it.[COLOR="blue"]

I put (what I think are) important stuff in bold and I will respond, by order of appearance.

1. I apologize in advance if I will insult you, but I have to be blunt here - this is typical health anxiety thinking. If you go to your office and see a briefcase in the hallway, what would your first thought be? Would it be "Oh, someone forgot a briefcase" or "Hmmm, just because this looks like an ordinary briefcase doesn't mean it is not a time - bomb planted by ISIS"? Your GP thinks it is not cancerous, ultrasound says the nodules are not suspicious, you'll also go to the specialist for the final diagnosis - and I am honestly willing to bet my house these will be confirmed benign. However, you have to stop concentrating on the worst and break the anxiety cycle - it is not just mental anguish anxiety is causing, it can also break your immune system and mimic symptoms of the disease you fear. I am not saying that is going on here (your doctor will diagnose you, not us here), but it is definitely a possibility.

2. They might be TC symptoms, but they might also be symptoms of hundred other not at all scary things. Benign things are common, cancers are rare. If cancer was as common as HA sufferers (including me) thought it was, entire human population would have been wiped out long ago. Moreover, you said yourself - in the past three months, apart from severe anxiety, you also had a viral bronchitis twice - that may well be the reason for your sore throat/coughing episodes (especially coughing - after I had had pneumonia I had sporadic coughing fits for almost 6 months, for example).

3. This is where Dr Google leads you up the garden path and fuels your anxiety. To their trained eyes (and it takes 10 years of training to become medical professional) they are not suspicious. They do not have an appearance that cancer has - that is why they are not suspicious. The Google says "they are indicative of cancer". OK, they might be, but that doesn't mean they ARE cancer. The briefcase thing again - a lonely briefcase left in the train compartment is indicative of a terrorist attack because terrorists obviously have to put the bomb somewhere and briefcase fits their purpose. However, in 999 cases out of 1000, it is just a briefcase that someone forgot.

4. I didn't mean Google is unreliable for everything, just for medical purposes and especially for self - diagnosing. Self diagnosing is always unreliable and self diagnosing with google leads to health anxiety. Why? Because all that Google provides is the list of possible diseases based on your symptoms. So, if your throat is sore for a month, you will naturally concentrate on cancer (as it is life threatening) and not on, I don't know, strep infection (as it is benign). However, medical professionals do not base their diagnosis just by symptoms - they look at your medical history, overall health and they also do tests (bloods, scans, mris, ultrasounds whatever). I mean, that is why they are professionals and that is why we pay them. Only with all these tools at their disposal can the diagnosis be correct - certainly not just by matching symptoms with possible diseases because when we do that, we all think we have cancer or worse.

5. Again I have to be blunt - typical HA thinking. You use "official cancer sites". For God sake why? You are neither a cancer patient nor a survivor nor diagnosed with cancer. However, I sadly know the answer (as I went through the same cycle - you can look at my first thread if you want. Actually please do, since our stories have some similarities.) - your anxiety and Internet "sources" have convinced you that it is cancer and you are operating from that assumption instead of doing what anxiety-free people do when confronted with symptoms: trust medical professionals, RULE OUT scary things and concentrate on treating (in 99.9% of cases) mild/benign conditions they have.

And of course, you are very welcome - next time it will be you helping me And please accept my apologies if there was rudeness - I just wanted to make sure that the message had got across.

[pulisa]

A lot of people with HA do a lot of "reading" on the internet when they really should be listening to their OWN doctor/consultant who is dealing with their OWN medical issue. Waiting for test results is nerve racking but so is googling symptoms and reading stuff which has nothing to do with their OWN body but everything to do with feeding their HA and creating intense fear when a condition has yet to be diagnosed.

[Dani84]

I also have thyroid nodules. Dr says they're nothing to worry about.

[Serotoninsteph]

Hi all. Thank you so much for your support in this, I feel so comforted knowing I have a place to turn to. Just got my blood test results, and my TSH levels are normal. The doctor said I now need a neck CT, and has marked it as urgent on the requisition. When asked, he said it is because I'm worried but I don't think a doctor would request an urgent CT based on patient worry. I can't help but feel he is concerned and doesn't want to say so. So now I wait for a CT appointment, and next week I will see my ent (I've been seeing her since the throat issues and have had two normal scopes) to have her review the US results. Doc also put in a referral to an endocrinologist. All of this is very overwhelming and I can't shake the fear based on everything I foolishly read about hypoechoic, solid nodules. Combined with my symptoms, and the fact that they are solid and hypoechoic I can't help but think, what else could they be other than the big C. I'm trying my best to hold on to the fact that the US report said "not sonographically suspicious" but the fact that I need an urgent CT scan sort of says to me that the US report holds little weight. If they are so small and don't look suspicious why do I need all that radiation on my neck? I just don't understand why I would need that if there wasn't major concern. I'm really scared. I'm not googling any more, but I just feel so overwhelmed. My husband is sick of me, and I don't feel like I have much support right now. So I wanted to post this. I know I am a broken record. Thank you for giving me a safe space to vent.

---------- Post added at 14:50 ---------- Previous post was at 14:47 ----------

I also have thyroid nodules. Dr says they're nothing to worry about.

Hi, thank you for your reply. Do you know the size of yours and if they are solid/hypoechoic? What details were you given about yours? I have other symptoms as well, I don't know if you managed to get all the way through my first post but they're all listed. My doc says I now need a CT scan and I'm pretty terrified.

---------- Post added at 14:52 ---------- Previous post was at 14:50 ----------

[QUOTE=Andrash;1802026]

I didn't take any of your post as rude or insulting - it was educational and to the point, and you are right about everything. Thank you. I got my blood test results and saw my doctor today. I posted a new reply on the thread with the details. Will continue to update! Thank you for your support.

I put (what I think are) important stuff in bold and I will respond, by order of appearance.

1. I apologize in advance if I will insult you, but I have to be blunt here - this is typical health anxiety thinking. If you go to your office and see a briefcase in the hallway, what would your first thought be? Would it be "Oh, someone forgot a briefcase" or "Hmmm, just because this looks like an ordinary briefcase doesn't mean it is not a time - bomb planted by ISIS"? Your GP thinks it is not cancerous, ultrasound says the nodules are not suspicious, you'll also go to the specialist for the final diagnosis - and I am honestly willing to bet my house these will be confirmed benign. However, you have to stop concentrating on the worst and break the anxiety cycle - it is not just mental anguish anxiety is causing, it can also break your immune system and mimic symptoms of the disease you fear. I am not saying that is going on here (your doctor will diagnose you, not us here), but it is definitely a possibility.

2. They might be TC symptoms, but they might also be symptoms of hundred other not at all scary things. Benign things are common, cancers are rare. If cancer was as common as HA sufferers (including me) thought it was, entire human population would have been wiped out long ago. Moreover, you said yourself - in the past three months, apart from severe anxiety, you also had a viral bronchitis twice - that may well be the reason for your sore throat/coughing episodes (especially coughing - after I had had pneumonia I had sporadic coughing fits for almost 6 months, for example).

3. This is where Dr Google leads you up the garden path and fuels your anxiety. To their trained eyes (and it takes 10 years of training to become medical professional) they are not suspicious. They do not have an appearance that cancer has - that is why they are not suspicious. The Google says "they are indicative of cancer". OK, they might be, but that doesn't mean they ARE cancer. The briefcase thing again - a lonely briefcase left in the train compartment is indicative of a terrorist attack because terrorists obviously have to put the bomb somewhere and briefcase fits their purpose. However, in 999 cases out of 1000, it is just a briefcase that someone forgot.

4. I didn't mean Google is unreliable for everything, just for medical purposes and especially for self - diagnosing. Self diagnosing is always unreliable and self diagnosing with google leads to health anxiety. Why? Because all that Google provides is the list of possible diseases based on your symptoms. So, if your throat is sore for a month, you will naturally concentrate on cancer (as it is life threatening) and not on, I don't know, strep infection (as it is benign). However, medical professionals do not base their diagnosis just by symptoms - they look at your medical history, overall health and they also do tests (bloods, scans, mris, ultrasounds whatever). I mean, that is why they are professionals and that is why we pay them. Only with all these tools at their disposal can the diagnosis be correct - certainly not just by matching symptoms with possible diseases because when we do that, we all think we have cancer or worse.

5. Again I have to be blunt - typical HA thinking. You use "official cancer sites". For God sake why? You are neither a cancer patient nor a survivor nor diagnosed with cancer. However, I sadly know the answer (as I went through the same cycle - you can look at my first thread if you want. Actually please do, since our stories have some similarities.) - your anxiety and Internet "sources" have convinced you that it is cancer and you are operating from that assumption instead of doing what anxiety-free people do when confronted with symptoms: trust medical professionals, RULE OUT scary things and concentrate on treating (in 99.9% of cases) mild/benign conditions they have.

And of course, you are very welcome - next time it will be you helping me And please accept my apologies if there was rudeness - I just wanted to make sure that the message had got across.

---------- Post added at 15:11 ---------- Previous post was at 14:52 ----------

I have nodules, just discovered back in January on ultrasound. My ENT isn't concerned at all. I had a follow up ultrasound Monday and one shrunk and the other is exactly the same. Mine are also 7 mm

That's great news! For me it's the nodules in combination with my other symptoms (cough, hoarseness, sore throat) that are concerning. Did you have any other symptoms? My US report said none of the nodules have a sonographically suspicious appearance, and my blood test for tsh levels was normal but my doc wants me to have a neck ct so I'm really frightened! Are your nodules solid? Mine were hypoechoic on the US and my doc says that means they are solid and not cysts.

---------- Post added at 15:18 ---------- Previous post was at 15:11 ----------

Hi Steph,
I am not supposed to seek reassurance either, but sometimes I just have to. I think of it like a diet. If I don't cheat every once in a while, I'm not going to be able to stay on the diet.

My husband has Stage 4 Lung Cancer. A 1.1 cm thyroid nodule showed up on one of his regular CT exams. His oncologist completely dismissed it, saying it was irrelevant and nothing to worry about. It may be that the CT scan showed details about this nodule that enabled a quick diagnosis. I am not sure. Nevertheless, that is a pretty big nodule and it is benign.

You are going to be just fine. I'm amazed at how differently I react to things when my health anxiety is under control. You doing excellent things to take care of both your mental and physical health. You've got this

I love how you said if you don't cheat once in a while, you're not going to be able to stay on the diet. That is a brilliant analogy! Thank you for your support.

[hope_girl]

I have had thyroid nodules. Man I wish they had never been found! They were found by accident! But doctors will test and test once something is found! In the end it all turned out to be ABSOLUTELY NOTHING and I spent YEARS going for check ups, biopsies, etc. and LOADS of money and time. some of mine are larger than yours and they actually were suspicious. I was told mine were “complex nodules” and that I needed a fine needle biopsy. The results? Inconclusive! Because an ENT did it and didn’t have ultrasound guidance. They repeated the biopsy. Again inconclusive. (And it is not fun) They wanted to REMOVE half of my thyroid bc they couldn’t say If it was cancer or not. I said no and saw and Endo. She said it would have been completely unnecessary to have any part of my thyroid removed. So please, only consult an Endo for this! Loads of people go under the knife when nothing at all is wrong with them! She advised that even though they were suspicious it would be better to watch them over time bc thyroid cancer is SO slow growing. Years of slow growth even. So, every six months I went to have an ultrasound. Each visit was “is this cancer looking?” Finally I moved towns and had to change Endo Dr. well, the newest US was done on a different machine causing the nodules to appear bigger so ANOTHER biopsy was ordered. FINALLY I got a definitive answer: no this is not cancer. Still they wanted me to come in every six months till I finally switched to another Endo who told me after several visits that I no longer need to monitor it. Oh, just 12 years later. I was also told previously that it was a multinodular goiter. My final
Endo disagreed. Never had one off blood test. The stupid nodules were just an incidental find and I wasted so much time and energy and worry. If it makes you feel better I know someone my age (41) who actually had the slow growing thyroid cancer. She had it removed, took a radioactive pill and that was it. And that was like 10 yrs ago. Easy peasy.

You getting sick is not caused by the thyroid nodules. They don’t make you sick. That’s your health anxiety trying to connect the dots bc that’s what we do. We do catch colds though. And sinus infections. And sometimes you catch things back to back. It’s just part of being human!

Try not to worry. This sounds like nothing. You were told they aren’t suspicious. Please take it from someone who had suspicious ones - and it all turned out to be NOTHING - you will be okay!!!

---------- Post added at 04:09 ---------- Previous post was at 03:59 ----------

Forgot to mention the very first thing I had was a neck CT scan. If I could do it all over again I would Bypass the ENT totally. Go straight to the Endo. I don’t even think they looked at my CT scan. But who knows. The Endo is MORE SPECIALIZED than the ENT. so what if it takes 3 months to get an appointment. You can skip the BS. These thyroid nodules are so nothing ESPECIALLY if you were told they aren’t suspicious. You don’t need to know why they aren’t suspicious. But you do need to know it’s okay to let the doctors do their job and you just show up. Don’t google. You will only read the worst one weirdo story that will freak you out. Hope this helps.

[Serotoninsteph]

hope_girl,

You can't imagine how much you have helped me tonight! I can't thank you enough for this valuable insight and support, you really have made me feel so much better!! Thank you, thank you, thank you!!!

[pulisa]

I've just read through my ultrasound report and my nodules were classed as solid hypoechoic ovoids (the largest was 3cm and the others were 2cm and 1cm). I didn't google these definitions before getting my biopsy results because I knew I would be terrified by what I read.
They were all benign.
If you do need to have your nodules biopsied (and they may not be big enough) you need to have an ultrasound-guided fine needle aspiration of them. You do not want an inconclusive result. You need a decent sample taken by a consultant radiologist.

I'm not sure why your doctor has ordered a CT scan of your neck. I hope it's not for "reassurance". An endocrinologist would be the best person to consult for analysing thyroid nodules.

[hope_girl]

Pulisa is right. An ultra sound guided fine needle biopsy is the only way to go. That’s what my final biopsy was. The first two were not. I sat there thinking WTH was that ENT thinking not doing this. I can’t stress how important it is to skip the ENT and go right to the Endo. It’s really a shame ENT’s don’t just send people on. I’ve met several people with scars on their necks who told me they had nodules that were inconclusive for cancer so they had either the whole thyroid out or part of it. When I ask what kind of Dr did the surgery - ENT!

---------- Post added at 13:48 ---------- Previous post was at 13:40 ----------

And when those people got the results back after surgery - not cancer. Boom. Unnecessary surgery.

Glad I could help you feel better. However. You reassurance only lasts a little while and has the reverse affect eventually bc it feeds the cycle of HA. Yes, this is a medical thing that requires some appointments and some procedures. But it’s truly very minor. However you are likely going to freak yourself out all over again. Do you have a therapist? CBT is the best form of therapy IMO for HA. You need strategies for coping with this. Posting on forums might give you some immediate relief but I would suggest you tackle it with a therapist. It is the only thing that has helped me for real. Make friends with the nodules. See this as a time to really focus on your health anxiety while you do have a real medical issue going on that’s not major but has enough “scare” to set the stage for health anxiety to spiral. This is time to practice what you have already learned and/or gain new skills for coping. Does that make sense?