no symptoms, doubting need for surgery

Hi all, newbie here. Looking for some advice about surgery.

I've had a pretty big thyroid nodule for over ten years, several FNAs and ultrasounds all came back benign. It's about 5cm but has stopped growing. Until last year all my blood tests came back normal but during my recent second pregnancy routine tests showed my T3, T4 and TSH were all high. I am extremely lucky in that I have not experienced (or at least not noticed) any symptoms of my hyperthyroidism at all - no sleeplessness, shakiness or weigh-loss - in fact I'm so dog-tired from having two little kids I could fall asleep standing, and I'm still yet to shift the baby-weight….. A small dose of carbimazole (5mg a day) has brought the T3 and T4 within range but the TSH still stubbornly high after 9 months on the meds.

My consultant has put me on the list for a partial thyroidectomy to remove just the side with the large nodule (after the tracer test showed that the single nodule was the cause of all the probs). I've met my surgeon and he seems 'a safe pair of hands' (!) but I'm having doubts about whether I should even have the surgery and all the risk this entails. I genuinely feel well and the lump in my neck is not really noticeable yet. The most symptoms I've had is a twitchy eye and having to clear my throat a lot!

My question is, has anyone out there been in a similar situation? can symptoms suddenly come on severely with no warning? Has anyone decided to live with a toxic nodule and suffered no symptoms? Has anyone ever had a nodule shrink on its own? And for all those who've had surgery, would you have done it if you had no symptoms?

I appreciate how lucky I am to be symptom-less when many people on here must be really suffering but i would be very grateful to hear from anyone out there has been in the same situation. I have two very little kids and beginning to think I must be crazy for opting to go through major surgery when not feeling ill.

Thanks in advance

3 Replies

  • Welcome to the forum, Rubymurray.

    Extreme fatigue is very definitely a hyperthyroid symptom. Not all hyperthyroid patients lose weight, many gain weight and not just because the Carbimazole is slowing their metabolism.

    5cm is a large nodule and is probably pressing on your windpipe if you need to clear your throat frequently and on a nerve making your eye twitch. Large nodules are usually removed to relieve compression on nearby organs or stop them growing into them.

    Once the hemilobectomy is done you should be able to come off Carbimazole once your thyroid levels have stabilised which may take several weeks and in most cases the remaining half thyroid picks up the slack and produces the hormone required. If not, you will need some Levothyroxine. As your FNAs have been clear you have time to mull it over so don't be rushed into making a decision.

    I had a 2.8cm cold nodule compressing my windpipe which made breathing and swallowing difficult. By the time it was removed 5 months later it was >4cm. I was very symptomatic with Hashimoto's but categorically told that symptoms couldn't be due to thyroid because bloods were 'normal'. The surgery was straightforward and the wound healed quickly and well and I have a fine white line in the hollow of my throat which is barely noticeable.

  • thank you. nobody has ever told me that you can be hyper and fatigued! Thats all great information, thanks for your response

  • Rubymurray, Here are a couple of links about hyperthyroidism and symptoms. You don't have to have all the symptoms and as I said a significant minority of hyper patients gain weight rather than lose it.

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