These are a bit off the cuff--I'm packing for a trip.  (Will be no-mail
till thursday, so email privately if you have comments or questions,
please.)

We give people synthroid to suppress growth, and hope to shrink the
nodule.  The normally active thyroid usually shuts down or at least
decreases production in order to keep things in balance, so most people
don't get hyperthyroid.  (BTW, most people feel pretty good with a high
normal or slightly elevated thyroid level.)  Small nodules can usually
just be followed.  I'd wonder if she has had a fine-needle biopsy...if so
and the nodule is benign, it could probably be left alone.  Surgery would
take care of it once and for all if it's large or if there is concern that
it is cancer.  Synthroid should not cause a problem with breastfeeding.
Many women need it for hypothyroidism and can safely breastfeed.


re:  cholesterol.  The placenta needs LDL cholesterol to make the
progesterone needed for pregnancy.  The liver is responding to hormonal
shifts and making more (most of our cholesterol is not from diet but
rather made by the liver).  I think cholesterol levels should return to
normal during lactation.  I don't have a physiology book at home, and
can't remember all of the specifics--if you want to know more, let me know
privately and I'll try to look it up.

--
Anne Montgomery, M.D.
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St.Peter Hospital Family Practice Residency
Olympia, WA