u/lostandwanderin

To preface, I’m located in the U.S. and currently don’t have health insurance. I found a website that allowed me to order my own lab work so I could bring updated results to my appointment. I ordered my usual labs, along with thyroid labs that I’ve been monitoring over the years.

I’ve been on this thyroid journey for quite a while, but more recently I’ve developed some new symptoms, including:
• My goiter seems to be increasing in size.
• More frequently have the sensation that something is “stuck” in my throat.
• I’ve started having intermittent difficulty swallowing.
• Ongoing, significant fatigue.
• Joint aches and pains.
• Random outbreaks of hives.

Below is a timeline of my thyroid labs and ultrasounds. I haven’t had a repeat ultrasound since March 2025 because the plan was to monitor yearly. At that time, one of my nodules was only 0.1 cm away from meeting biopsy criteria.

With all of this in mind, are there any specific questions I should ask my PCP? Is there anything else that could be done to help identify what’s going on or provide some symptom relief?

Thyroglobulin Antibodies (TgAb)
Reference range: ≤1–2
January 2019: 3
June 2023: 22
June 2026: 148

Thyroid Peroxidase Antibodies (TPO)
Reference range: <9
January 2019: 1
June 2026: 82

Current Thyroid Labs:
TSH: 2.76 mIU/L
Free T4: 1.2 ng/dL
Free T3: 3.6 pg/mL

Thyroid Ultrasounds:
March 2018
A few small nodules measuring less than 5 mm bilaterally.
I was advised to follow up yearly.

March 2025
8 mm hypoechoic nodule in the right middle pole (TI-RADS 4); no further follow-up was recommended for this nodule.
Multiple scattered benign-appearing, anechoic, well-circumscribed cysts throughout both thyroid lobes (TI-RADS 1).
Nodule 1 (Isthmus)
Size: 1.4 × 0.4 × 1.2 cm
Location: Isthmus
Composition: Solid or almost completely solid (2 points)
Echogenicity: Hypoechoic (2 points)
Shape: Wider than tall (0 points)
Margins: Smooth (0 points)

I know no one here can diagnose me, but I’d really appreciate any suggestions on what additional testing, referrals, or questions might be reasonable to bring up at my appointment.