Suggest Treatment For Elevated TSH Levels

Brief Answer:
Thyroid

Detailed Answer:
I have noted your thyroid nodules and lab results.

The elevated TSH requires further assessment in the form of thyroid auto-antibody testing to see if you have a permanently underactive thyroid condition called hypothyroidism ,necessitating treatment with thyroid medication.

Next you need to be examined comprehensively regarding the thyroid nodules. A fine needle aspiration biopsy can be considered.

You need a thorough in-person consultation with a qualified endocrinologist. When I see someone like you in my practice, I typically order the following blood tests in addition to a detailed physical examination:

CBC (Complete Blood Count, also known as Hemogram; includes Hemoglobin, WBC and Platelet counts)
Electrolytes (Sodium and Potassium in particular)
HbA1c (Glycosylated Hemoglobin = your last 3 months' glucose average). Also known by other names such as GlycoHemoglobin or Glycated Hemoglobin or A1c
Liver function tests (SGOT , SGPT, Albumin, Bilirubin, Alkaline Phosphatase)
Kidney function tests (BUN, Creatinine)
Thyroid autoantibodies : Anti Thyroid Peroxidase (TPO) antibodies and Anti Thyroglobulin antibodies
25 hydroxy Vitamin D levels (ideal range 40 to 60 ng/ml = 100 to 150 nmol/liter)

None of these tests require any fasting and can be done at any time of the day

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Brief Answer:
Follow up

Detailed Answer:
Based on the information you have provided , it is not possible to tell if it is cancerous. That is why I recommended further testing

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Brief Answer:
Second follow up

Detailed Answer:
In this case it is quite likely you have a permanently underactive thyroid condition and that you will likely benefit from a medication called levo thyroxine.
However the final decision will be made by the endocrinologist you see in-person. Sometimes 'pseudo-nodules' are seen in this condition on ultrasound. This determination is also possible by following up regularly with an endocrinologist

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