what causes a thyroid gland to diminish in size?

My Thyroid Ultrasound shows diminished size of the thyroid gland, left thyroid lobe being smaller than the right which is heterogeneous in its echotexture without definite evidence of focal masses. If indicated nuclear medicine thyroid scan and uptake may be of help for further characterization given the history of hypothyroidism.
So is this something to be concerned about? My Doctor wants me to have the scan done but is it really necessary since the cost is alot and my insurance only covers so much.
Yes thyroid problems do run in my family about 34 total have a problem with theirs.

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