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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Taking Synthroid For Hashimoto S Thyroiditis. Have Multiple Nodules On Lobe Of Thyroid Causing Its Recurrence. Is It Common?

I have had hashimoto s thyroiditis for 8 years and have been well controlled on synthroid for 7 years. in the past year i keep having periods of hyperthyroidism requiring my Dr to reduce my dose of synthroid. This has happened 3 times. I have multiple nodules including 2 large ones ( . 2cm) on either lobe of my thyroid. I have had FNA which showed they were noncancerous. my Dr believes the large nodules are producing hormones causing my reoccurring hyperthyroidism. Is this a common occurrence? I can not find any information about this. my dr wants me to have another thyroid US in February along with blood work and if the nodules have grown any larger she wants me to have a thyroidectomy.
Tue, 10 Dec 2013
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Ayurveda Specialist 's  Response
**
1. autoimmune thyroiditis [hashimoto's disease] has a genetic predisposition and though the disease is focal in the beginning yet it extends to involve one or both the lobes and the isthmus [as happened in your case]
2. and since FNAC has shown them to be non cancerous thus probably are non-toxic multinodular goitre.
3. if your area is endemic it is a common occurrence whereas if it is sporadic area then it will occur time and again.
4. make sure there are no pressure symptoms like dyspnea, engorged neck veins, discomfort during swallowing, stridor. [if swelling becomes large you may notice the same and seek immediate medical attention]

PS.
1. In long standing cases, most of the nodules gradually become inactive and myxedema may ensue, so do ask for signs of hypothyroidism from your Doctor.
2. since it is an autoimmune disease, thus there are chances of increased incidence of other autoimmune diseases like rheumatoid arthritis, disseminated lupus, myasthenia gravis, hemolytic anemia so make sure your attending Doctor have rule out the same with necessary investigations.
3. look out for other endocrine organ failure e.g. Addison's disease, diabetes mellitus, and ovarian or testicular insufficiency.
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Taking Synthroid For Hashimoto S Thyroiditis. Have Multiple Nodules On Lobe Of Thyroid Causing Its Recurrence. Is It Common?

** 1. autoimmune thyroiditis [hashimoto s disease] has a genetic predisposition and though the disease is focal in the beginning yet it extends to involve one or both the lobes and the isthmus [as happened in your case] 2. and since FNAC has shown them to be non cancerous thus probably are non-toxic multinodular goitre. 3. if your area is endemic it is a common occurrence whereas if it is sporadic area then it will occur time and again. 4. make sure there are no pressure symptoms like dyspnea, engorged neck veins, discomfort during swallowing, stridor. [if swelling becomes large you may notice the same and seek immediate medical attention] PS. 1. In long standing cases, most of the nodules gradually become inactive and myxedema may ensue, so do ask for signs of hypothyroidism from your Doctor. 2. since it is an autoimmune disease, thus there are chances of increased incidence of other autoimmune diseases like rheumatoid arthritis, disseminated lupus, myasthenia gravis, hemolytic anemia so make sure your attending Doctor have rule out the same with necessary investigations. 3. look out for other endocrine organ failure e.g. Addison s disease, diabetes mellitus, and ovarian or testicular insufficiency.