Expert: Neha Dahiya MD - 11/5/2009

Question
QUESTION: my ultrasound shows features s/o multinodular goitre involving rt lobe of thyroid and parts of rt isthmus.FNAC test shows 'possibility of adenomatous goitre,and thyroid test by srl lab shows T3'-132.6 T;-4 9.1 & TSH;-1.76. DOCTOR ADVISES WAIT & WATCH WITH THYROXINE 25 MCG FOR 3 MONTHS. MY HUMBLE REQUEST IS;- WILL IT BE IN ORDER TO HAVE THYROXIN WHEN ALL T3 T4 & TSH ARE NORMAL/.CAN THIS SMALL GOITRE[VISIBLE ONLY WHILE SWALLOWING]BE DISSOLVED BY MEDICIANS?cant its further growth be arrested? please give your valuable guidence i am 23y/f.

ANSWER: Hello Vijay:

I am not an expert on treatment.
A goiter is an enlargement of thyroid gland and may or may not lead to hypothyroidism. your Thyroid hormone levels are within normal range indicating you are euthyroid (that is producing adequate thyroid hormones)

Please ask your doctor the rationale for starting you on Thyroxine. It is not necessary that medication will reduce the size of goiter. It depends on what is the cause...Most common cause is iodine deficiency and replacement iodine does help.

---------- FOLLOW-UP ----------

QUESTION: Thanks DOCTOR  for your valuable responce.i would further like to know that if my thyroid test is normal then why FNAC test shows possibility of adenomatous goitre %26 ultrasound, features of multinodular goitre.what can be the other cause of goiter in my case? as apparently i am not suffering from hypothyroidism as per findings in my thyroid test.IS THERE ANY OTHER TEST WHICH CAN BE SUGGESTED IN MY CASE?     I SALUTE YOUR GESTURE OF GOODWILL

Answer
Hello:

You can have goiter without associated hypothyroidism.
Goiter is basically enlargement of gland and can be due to a number of reasons.
The most common is iodine deficiency. Others are Graves disease (too much hormone secretion), Hashimoto's thyroiditis these two are auto immune.
Multi nodular goiter - where multiple fluid filled cysts develop
certain medicines, radiation exposure, family history of auto immune disorder.
In pregnancy as well as women develop goiter more then men.

You would need follow up thyroid hormones tests maybe 4-6 months later to see if there is any evolution of the condition and you may have hyper or hypothyroidism.

As long as everything else is normal and the size of nodules does not bother you nothing further should be required