Advice please

Hi. I'm new to the group and looking for some advice please. I've had various hypo symptoms for a very long time but have put most of them down to stresses of everyday life. I started having problems with swallowing and was eventually referred to ENT. Had an ultrasound which revealed a 5cm nodule on my thyroid. Blood tests were apparently normal. Results as follows:

Serum Free T4 Level 16 pmol/L 10-22

Serum TSH Level 0.72. My/L. 0.30-5.50

Consultant also said I have reflux despite not experiencing any symptoms. Prescribed gaviscon and antacids which have made no difference to swallowing. In fact, as time has gone on sensation of my throat being squeezed has gotten worse.

I've now had a barium meal swallow and CT scan of my neck and chest and await the results. I've been referred to a thyroid surgeon. Im confused that my bloods are supposedly normal despite the large nodule. What do my results mean? Should I ask to see an endocrine specialist? Why have I just been referred to a surgeon? I spoke to my GP who seemed offended by my questions and basically implied I should just wait to see thyroid surgeon. Any thought gratefully received.

2 Replies

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  • Welcome to the forum, Betty41.

    Thyroid levels are euthyroid (normal) so you don't need referral to endocrinology right now.

    5cm is a very large nodule, and is probably compressing your trachea. I'm not surprised you are experiencing difficulty swallowing. I had difficulty swallowing and breathing with a nodule 2.8cm and had a hemilobectomy to remove the thyroid lobe which the nodule was on.

    You've been referred to a thyroid surgeon as it's protocol to do fine needle aspiration biopsies on nodules >2cm to rule out malignancy. 95% of nodules are benign. If the nodule is benign it is likely the surgeon will want to do a hemilobectomy to ease your swallowing. Your remaining thyroid lobe will be expected to produce the thyroid hormone you require. If the nodule is malignant it is likely a complete thyroidectomy will be done and you will require daily thyroid replacement for life.

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    I am not a medical professional and this information is not intended to be a substitute for medical guidance from your own doctor. Please check with your personal physician before applying any of these suggestions.

  • Before you have any form of surgery it would be a good idea to get a complete list of thyroid test results and also levels of minerals and vitamins which are essential for thyroid function.

    If you end up having surgery to remove some or all of your thyroid, you will reap the benefit of having those test results in the future because they will give you some idea of what levels you had when you feel the way you do now and before anything gets removed. They might not be ideal results (you say you've had hypo symptoms for a very long time), but they might end up being better than the results you have after surgery if you are inadequately treated.

    I don't know how much you know about the thyroid. T4 is a prohormone - it mostly acts as the raw material that the body needs for creating T3. The thing that makes most of us feel dreadful is too low a level of Free T3 (which is responsible for making people hypothyroid) or too high a level of Free T3 (which is responsible for making people hyperthyroid).

    So it is very, very useful to know what your level of Free T3 is before anyone attacks your thyroid with a scalpel or anything else. Antibody testing is worth having too.

    Unfortunately you are unlikely to get all the results you need from the NHS. But you can get them done privately with a finger prick test. The one many people use is this one :

    homebloodtests.co.uk/

    Go to the above link and look down the left hand side of the page. Click on the blue badge with "Thyroid Check Plus Ten" on it.

    You get sent a kit through the post, you prick your fingers with the lancets provided, then send it back through the post using guaranteed next day delivery.

    You also need a vitamin D level. Again, doctors don't agree to this test very often, but you can get it done with a finger prick test too :

    vitamindtest.org.uk/

    betteryou.com/vitamin-d-tes...

    You can get discounts off some private testing. See the following link and follow the links within it :

    thyroiduk.org.uk/tuk/testin...

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