Thyroid lump 20 years after partial thyroidectomy

[pinkpixie]

Hi

I had a partial thyroidectomy 22 years ago when I was 19 as I had a large cyst wrapped around my thyroid which needed to be drained by syringe every 6 months. As far as I'm aware, this hasn't caused subsequent problems until now.

A few months ago, I noticed a lump in my neck on the opposite side to where it was removed. Noone else could see it, so I thought I was imagining it but eventually went to the GP where he said it looked like a goiter.

He referred me for an ultrasound which is now a week tomorrow, a 4.5 week agonizing wait. I already had blood test results from 6 months ago from feeling tired where an iron deficiency was found, but my thyroid levels were apparently 'normal' (I didn't ask for them, just took 'normal' at face value).

I'm really worried about the ultrasound next week, just incase it's something nasty as I have two young children. The GP said it felt hard, and not like a cyst as I had before. He also said possibly, my remaining thyroid is working very hard to produce the right hormone levels and so it has enlarged, has anyone heard of this happening?

I do have some symptoms that might be linked to a thyroid problem, including pins and needles in my fingers sometimes, feeling a bit light headed sometimes, and my fringe is very very dry and snaps off easily (which is relatively new). I also feel tired a lot, I felt a bit better when I took iron supplements but now my iron levels are normal.

Any advice would be gratefully received.

[Clutter]

Pinkpixie,

An ultrasound scan is not painful or invasive. Wear somthing which allows access to your throat, neck and upper chest. The radiologist will smear gel on your skin and glide a hand held imager over your throat and neck to image the thyroid gland and surrounding organs. Probably won't take more than 20 minutes. A report will be sent to your GP around 10 days later outlining the size of your thyroid gland, noting the texture of the gland and the size and location of any nodules and cysts and whether they have any calcification or blood flow to them.

A hard lump is usually a goitre or thyroid nodule. A goitre can form to enlarge the thyroid in an attempt to produce more hormone or because of autoimmune thyroiditis (Hashimoto's) causing inflammation. It is rare for adults to die without having one or two thyroid nodules and 95% of thyroid nodules are benign. Nodules <1cm are rarely malignant. If the nodule is >2cm you will probably be referred for a fine needle aspiration biopsy. Nodules rarely affect thyroid levels with the exception of 'hot' nodules which cause hyperthyroidism.

Ask your GP receptions for a printout of your recent thyroid results and ranges and write them into a new post for advice. Your GP said "your thyroid is enlarged because it is working hard to produce hormone". This does happen but autoimmune thyroiditis (Hashimoto's) also causes inflammation. It suggests to me that your FT4 hormone must be low-normal and TSH must be high-normal. NHS won't usually diagnose hypothyroidism and prescribe Levothyroxine until TSH is over range or FT4 below range.

[Clutter]

Pinkpixie,

Btw, 'normal' in relation to blood test results simply means results are within range. Some ranges are very broad so simply being in range or normal isn't the same as 'optimal'. Get into the habit of asking for your actual result and range.

Pins and needles in hands or feet is often due to low/deficient B12 and folate. Fatigue can be due to low ferritin/iron. Thinning hair and lack of regrowth can be due to low ferritin/iron or low thyroid hormone.

Ask your GP to test ferritin, vitamin d, B12 and folate to see whether low vit/minerals are causing your symptoms if thyroid results are 'normal'.

[pinkpixie in reply to Clutter]

Thank you Clutter for your replies, that's very informative and helpful. It's also useful to know roughly how long the ultrasound may take as I'm not sure what to expect, which is probably adding to my anxiety levels about it all!

Also thanks for the info on low levels of other things . My ferritin levels have been restored following six months of ferrous sulphate, but I haven't had the other things tested. Are these deficiencies linked to thyroid problems or are they standalone issues?

[Clutter in reply to pinkpixie]

Pinkpixie,

They can be standalone issues but they are also common in thyroid patients.