Pain in throat/neck with goitre

[cazza321]

I have had a multi-nodular goitre for just over 2 years. I've had ultrasounds and 2 FNA's which indicate it is not cancerous. I have a 3cm nodule on one lobe and lots of other smaller nodules but they have not changed in appearance or size over the 2 years. My blood results have been within range, usually my tsh is around 3.5 (0.5-5) and my T4 is around 10 (9-24). My tsh did creep up to 6.7 in may, my t4 was in range, the test was repeated last week and my t4 had come back down to 3.7. Since then end of feb this year my throat has felt very tight and uncomfortable. I had an ultrasound last week and the lady that did it said although there was no change in appearance she felt I should think about having my thyroid removed due to the pain. I had an appointment with neck-specialist this morning and he felt the pain may not actually be related to my thyroid might be due to a sinus problem ( i am quite "sinussy" and do have problems with a drip down the back of my throat) and he has referred me to an ENT specialist. He did say he would remove my thyroid if I wanted to go down that route but it wasn't his recommendation as he didn't feel it would help. Other than now waiting for my ENT appointment to come through I don't know what to do next. I have lots of symptoms which could be attributed to hypothyroidism and have been feeling rubbish for 4//5 years now but don't feel I am getting any answers from the medical profession. Any advice please?

[Clutter]

Cazza, are you on any thyroid medication?

[cazza321 in reply to Clutter]

Hi Clutter, no I'm not on any medication.

[Clutter in reply to cazza321]

Your fluctuating TSH is suggestive of autoimmune hypothyroid disease (Hashimoto's). Ask for a thyroid peroxidase antibody (TPOab) test. Hashi attacks can inflame your thyroid gland causing paim.

Ask your GP or the ENT to prescribe a trial of replacement level 75mcg/100mcg Levothyroxine to see whether your symptoms improve before you contemplate surgery. Your TSH is high enough for you to experience considerable clinical symptoms and your FT4 is at the bottom of the range making it likely your FT3, the active hormone, is also very low. Thyroid hormone replacement can reduce the intensity and frequency of Hashi attacks thereby delaying eventual atrophy of the thyroid gland and will sometimes reduce the size of the goiter.

[cazza321 in reply to Clutter]

Hi clutter, thanks forbthe advice. I have an appt with gp in a couple of weeks so I will discuss. I did wonder about hashi's but assumed it would have been picked up in the fna?

[Clutter in reply to cazza321]

Cazza, FNA removes cells to test for cancer. TPOab blood test is needed to test for Hashi's.

[Piedo]

Hi crazy my goitre was very similar it took 20 years before

It grew to 4 cms which is the size surgeon recommended to have it removed

No mention of how I felt just my thyroid function test was normal.judging by the problems I have had since I think I would have been better keeping my thyroid for longer. I suppose on of the deciding factors for the surgeon was my father died of cancer the primary of which was in his thyroid .

I hope you get it sorted this site is excellent for giving you help and advice I wish I had found it before I underwent surgery

Piedo

[Clutter in reply to Piedo]

Piedo multinodular goiters are usually benign but surgery may be necessary when they become large enough to compress the windpipe making breathing and swallowing difficult or when they cause pain by pressing on nerves.

[cazza321]

Hi,

I had thyroid antibodies tested by gp and that came back positive so gp has confirmed I have autoimmune thyroid condition but was reluctant to prescribe anything. She has written to endo at the hospital for their advice so am now waiting to see what he suggests. My appt with ent is next week so I'll see what comes of that. I feel like I'm just waiting at the moment until something happens to trigger a response! Very frustrating ....