When Should You Request Thyroid Ultrasound?

thyroid ultrasound

Thyroid Ultrasound

While most of us with Hashimoto’s know how important a complete thyroid panel is, there is another assessment just as crucial. Thyroid ultrasound is valuable as a screening tool and yet many physicians do not routinely order them, at least not in the same way breast mammogram, colonoscopy, and other similar preventative tests are recommended.

Since 1990, thyroid cancer has been the fastest growing cancer in the United States particularly among women.  I’ve often heard that people assume thyroid cancer is the “good cancer” assuming it’s not deadly.  I don’t know anyone who has gone through thyroid cancer and thought there was anything “good” about it.  In fact, they were quite afraid and with good reason.

Cancer is cancer

Anyone can get thyroid cancer; however, people who already have thyroid disease are at greater risk.  You may have heard that Hashimoto’s and Graves’ disease are considered to be “precursors” to thyroid cancer, and unfortunately, this is true.

Thyroid ultrasound will help your doctor determine if any nodules are present and their size. If any do exist, an ultrasound will show if there are any suspicious nodules and if they are fluid-filled or solid.  

Symptoms of Thyroid Cancer

The most common symptoms of thyroid cancer include:

  • Nodules or unusual lump in the neck
  • Swelling or sensation of tightness in the neck
  • Breathing problems
  • Coughing
  • Difficulty swallowing
  • Changes in Voice or Hoarseness
  • Neck or pain in the throat area

When to Request Thyroid Ultrasound

You should request a thyroid ultrasound when initially diagnosed with hypothyroidism, Hashimoto’s or Graves’ disease as a baseline.  

If the scan is euthyroid (normal) you should then repeat a thyroid ultrasound every other year.  Without a baseline assessment, it’s difficult to accurately determine what is normal for you and what is not.

Thyroid ultrasound is an excellent assessment screening tool and it’s usually covered by most insurance plans.  If you don’t have insurance coverage or you have a high deductible, I have learned the out of pocket total cost for a thyroid ultrasound ranges from $200 to $300.  

Ultrasound does not use radiation, it’s non-invasive and virtually painless.  However, I remember when I had my first thyroid ultrasound, the pressure against my throat as the “ultrasound wand” (transducer) moved over my neck made me feel anxious.  It was still SO worth it to know my thyroid gland was normal in size and there weren’t any nodules.  

The Bottom Line

We utilize preventive health screenings for breast, colon, heart, kidney, liver, and blood vessel health.  Why should we wait on thyroid ultrasound?   Do we wait until someone “feels” something in their colon before a colonoscopy (age 50+ years or family history)? Absolutely not.  The standard of care for thyroid cancer screening is the thyroid ultrasound. If it is not covered by your insurance or you have a high deductible plan, I recommend you contact the We Care Medical Mall, a national organization who assists people with no insurance or high deductibles to obtain affordable imaging in their local area.  


Given the fact that thyroid cancer is the fastest growing form of cancer, and even more so for people with Hashimoto’s or Graves’ disease, my hope is that the medical community and society-at-large will start to embrace routine thyroid ultrasound screening equally as important as those traditionally utilized.


I would love to know your thoughts on the matter!  




  1. Christianson, A. (n.d.). Diagnostic Methods: Lab Testing. Hashimoto’s Institute Practitioner Training, PowerPoint, 2015.
  2. Farrell, E., Heffron, C., Murphy, M., O’leary, G., & Sheahan, P. (2016, October 28). Impact of lymphocytic thyroiditis on incidence of pathological incidental thyroid carcinoma. Head & Neck. doi:10.1002/hed.24544
  3. Thyroid Cancer Information: What is Thyroid Cancer | CTCA. (n.d.). Retrieved November 28 2016, from http://www.bing.com



  • Kay

    Reply Reply March 2, 2018

    I had an endo order one when I was first diagnosed with Hashi’s. Had to leave her practice because she wouldn’t test my FT3 and only wanted to dose by TSH. Have never been able to get another doc to do a follow-up and it’s been 7 years since the first. you are right, my oncologist would never let me go seven years w/o a mammogram!

  • khali

    Reply Reply June 30, 2018

    Mamograms are not good for you, better is a Tomography that does not use radiation

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