Age: 68 years old woman Wt. 57 kg Ht. 5 feet 2 inches Medication: BP: Telmikind AM 40/5 0-0- ½ Diabetes: Glycomet 500mg 1-0-1 Cholesterol: Zyrova 5 mg 0-0-1 Symptoms: No pain, no swelling, no weight loss , only feels body becoming hot more in lying down position, tired feeling, but works throughout the day. Lab report: TSH 0.06 mcIU/ml Total T3 109 ng/dl Total T4 7.7 mcg/dl USG thyroid report: Both lobes of thyroid and isthmus diffusely enlarged, shows multiple hypoechoic nodules, honey combing, cystic change and peripheral vascularity and rim calcification . One nodule measuring 1.4 x 0.4 cms in left lobe shows both central and peripheral vascularity. Rt lobe:1.8x2.0x3.8 cms Lt lobe:2.0x1.8x3.6 Isthmus:0.8 Bilateral parotid and submandibular glands normal No focal lesion/ calcification Few bilateral level IB lymph nodes with maintained fatty hilum largest 13x 6 mm on right Carotid and jugular vessels normal Impression: Enlarged thyroid with colloid nodules Hypoechoic nodule in left lobe showing central and peripheral vascularity. Thyroid scan Tec-99 pertechnetate 5 mCi Rt lobe normal in size patchy radiotracer concentration Lt lobe and isthmus enlarged show patchy radiotracer concentration with areas of decreased uptake B/L salivary glands well visualized Impression: Multinodular goiter with multiple cold nodules in left lobe Please tell if FNAC is required, Tablet Methimez 5 mg 0-0-1 is advisable. Please guide and help. I do not have credit card how do i pay your fees?