Multinodular Goitre benign

Hi I believe like many that I've had a thyroid issue for a number of years but I was constantky fobbed off by my GP who blamed my PCOS for weight gain and fatigue. In the last ten months I've cut out sugar and grains and the majority of processed foods and only eat sourdough bread occasionally. This was done to also deal with mild HS which I have managed to control flare ups with these diet changes especially by eliminating certain nightshades. But despite these changes my weight has remained the same, overweight BMIA and I'm still really tired. I know I need to exercise more but it's hard to start when you're tired and you feel you look hideous! For the past year I've had a choking sensation when eating and a fullness in my neck but again this was ignored by my old GP. I finally switched GPs last week and she immediately felt my neck and booked me in for an ultrasound scan. I had the scan on friday at St Barts and she diagnosed benign multinodular goitre and has advised me to see an endocrinologist before I see a surgeon as he will just want to remove it as one of the lumps is 4cm! Which explains the choking! I would love to improve my energy levels and lose weight and I'm open to using a naturopath as well as working with my new GP. My blood tests hve always come back 'normal' even though I have all the hypo symptoms. Here's results from May 2013 HbATc 32 // Free T4 15.7 // TSH 2.25 apparently I'm not pre diabetic which is good. I'm now looking for advice on how to deal with my new GP and get the right treatment. Also because the lump is causing an obstruction is surgery likely and should I push to have it all removed or is it better to keep some of your thyroid. My mother had her thyroid removed when I was a month old an her sister had thyroid cancer. Many thanks in advance for your advice and help.

5 Replies

  • Welcome to the forum, Kateeliza.

    If the 4cm lump is only on one of the thyroid lobes you will be able to have a hemilobectomy and retain the other thyroid lobe which, in theory, will produce the hormone your entire thyroid gland produced. In practice it may underperform and you may need some thyroid hormone replacement. It is probably better to retain some of your own thyroid gland where possible.

    You can ask your GP to test ferriin (stored iron), vitamin D, B12 and folate as low levels/deficiencies can cause fatigue, low mood etc. similar to some hypothyroid symptoms. Thyroid peroxidase and thyroglobulin antibody blood tests determine whether you have autoimmune thyroid disease (Hashimoto's) which destroys the thyroid gland eventually although progression is delayed with thyroid hormone replacement.

    My hemilobectomy was done to remove a tumour which was compressing my windpipe making breathing and swallowing difficult. Post surgery histology showed cancer so I had a follow up completion thyroidectomy 3 months later. I recently had my first dental work since my thyroid was removed. It's so much easier when you can breathe :-D

  • Thanks so much for your reply and advice. I will try and push to get a complete blood work analysis completed. I'm glad you can breathe easier! I'm looking forward to that too! :D

  • Its more likely the PCOS was caused by under active thyroid!!

  • I had a doctors appointment this evening and he went through the ultrasound results.

    Clinical Details: Diffuse anterior and left neck swelling, slow progression. TFTs normal. ? Goitre, or subcut fat.

    Findings: The left lobe of the thyroid gland is moderately enlarged as a result of several non suspicious hyperplastic looking thyroid nodules, the largest of which lies in the lower pole and has a maximum diameter of 4cm. There is tracheal deviation to the right by approximately 1cm. No retrosternal extension. Within the right lobe of the thyroid, which is of normal volume, there are further small non suspicious nodules in keeping with background micronodular hyperplasia. It would be sensible to correlate with thyroid function tests and referral to endocrinology. for discussion of treatment options if appropriate. The salivary glands and cervical lymph nodes are unremarkable.

  • He was adamant it had nothing to do with my thyroid as my TSH is functioning fine. He even said it wasn't a goitre even though the thyroid is enlarged! He contradicted himself in one sentence! He recommended I see an ENT doctor because my thyroid levels are fine and I insisted on an endocrinologist. I mean this is what the radiologist recommended also. Madness! He gave me a copy of my blood tests and he said my Ferritin is low 36 (10-160) so I will now start taking Iron and my Vit D which I already supplement. I can see that this may be another predictably arduous journey but hopefully the endocrinologist won't be a sadist!

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