Possible thyroid issues - Doc has referred me to the ENT dept.

[BrecklandRanger]

Just saw my dr this morning re possible thyroid issues (mild lump feeling in throat/voice becomming more hoarse). She has referred me to the ENT dept. Is this standard procedure? I thought that they would refer me to an endocrinologist?

Gonna pay for a full thyroid profile, and see what's going on there as just had a basic thyroid check from the doc and she mentioned everything seems ok (my last thyroid bloods showed elevated rT3).

Thanks.

+++ Update +++

Attended the ENT at Norwich. They checked the throat with a camera, felt my neck for any issues, and asked a few health/lifestyle questions. Turns out I don't have throat cancer, and told me I'm fine.

[greygoose]

Elevated rT3 is unlikely to be what's causing your symptoms, because rT3 is inert. Not even worth what it costs to test because it doesn't give you any information that can't be got from other tests.

In fact, it doesn't give you much information at all, just that it's elevated. And, there are so many things that can cause that, and only one of them has anything to do with the thyroid. Could be high cortisol, low ferritin, an infection, a low-calorie diet, or many other things.

What you do need tested for starters is:

TSH

FT4

FT3 - most important

TPO antibodies

Tg antibodies

vit D

vit B12

folate

ferritin

and perhaps CRP

Did she say why she'd referred you to an ENT? This does sometimes happen, and I'm never quite sure why. I had the same symptoms you have - plus more throat problems - about 30 years ago, and went to see an ENT because I thought it was a something wrong with my throat. The ENT doctor told me there was nothing wrong with me, and had no explanation for my symptoms. He seemed to be totally unaware that the thyroid is right next to the oesophagus, and that it was swollen. But, I suppose it was better to be safe than sorry.

[BrecklandRanger in reply to greygoose]

Thanks. Will be checking (nearly) all of those markers, so will update this forum once the bloods come in.

After Googling, it seems that ENT do have resources to identify a dodgy thyroid (ie scans). Doc also wants me to have a chest scan, and not really sure how that relates to the slight lump in the throat.

[Linzr in reply to BrecklandRanger]

I was referred to ent after constant feeling of pressure at bottom of my throat or like something was stuck, constantly having to clear my throat etc had my appointment wed passed there and had the camera through my nasal passage and into the back of my throat. Appears everything is normal. Ent said thyroid wouldnt cause this im not convinced. He did suggest that its because of acid reflux which i take regular omeprazole for, ive had to double up since october time, but this aint helping either

[BrecklandRanger in reply to Linzr]

So no scan? I used to suffer from major acid reflux until I went gluten free.

[Linzr in reply to BrecklandRanger]

No scan no as everything appeared as normal. Not quiet sure what is causing it. Its a horrible sensation and its there all the time. They also said stress or anxiety can cause the sensation but i dont think ive been overly stressed.

[BrecklandRanger in reply to Linzr]

One of the first questions the doc asked me did I suffer from acid reflux (so maybe this could be the cause?). They should've checked your vocal cords/throat for any possible damage (from the acid).

[Linzr in reply to BrecklandRanger]

Its either reflux or its the levothyroxine im guessing. I forgot to take my levo yesterday due to being in a rush for a 12hr shift and ive not taken it today yet as im going to try taking it at night. But strangely enough it throat sensation doesnt feel as bad today. The ent said thyroid med wouldnt do this but im not convinced

[greygoose in reply to Linzr]

It's more likely to be the hypo itself than the levo. You probably have low stomach acid, a lot of hypos do. So Omeprazole will be making things worse rather than better. You probably need to raise your stomach acid rather than lowering it. And Omeprazole is a really bad thing to take for more than a few days.

[Linzr in reply to greygoose]

Im on omeprazole as i suffer with bad acid reflux and also a previous ulcer. The omeprazole stops the acid from irritating the ulcer.

[greygoose in reply to Linzr]

Do you still have an ulcer, then? Acid reflux can just as easily be due to low stomach acid as high. The symptoms are the same.

[Linzr in reply to greygoose]

Ive messaged you

[Lesleyg13 in reply to BrecklandRanger]

Similar to you when first visiting my GP with hypo symptoms one of my problems was with swallowing, particularly pills and hard food getting stuck, and had a mildly sore throat a lot of the time. I was also referred to ENT, under the 2 week referral rule, they did an endoscopy. I asked at the appointment would they be looking at my thyroid and was told no they didn't look at thyroids. Hopefully it will be different for you, but best not to get your hopes up.

(My endoscopy only picked up non erosive gastritis, which could well be another hypo symptom. At another ENT appointment I also had the camera up the nose, was told it could be post nasal drip causing problems.)

Like you my TSH was within their"normal" range, so my long list of hypo symptoms was dismissed as irrelevant.

If I could wind back the clock a few years I'd be pestering my GP for a thyroid scan to be done - especially if your ENT appointment doesn't pick anything up. Also would/should have done private blood tests earlier, which you're doing anyway, great move.

Finally self medicating with NDT solved my swallowing and sore throat problems.

[BrecklandRanger in reply to Lesleyg13]

Thanks. No, I won't get my hopes up too high (I had bad experiences with TRT on the NHS), but will see what happens.

So I take it things have improved on NDT?

[Lesleyg13 in reply to BrecklandRanger]

Yes massively improved thanks. Still tweaking dose, I've only been on NDT about 6 months. Couple of minor symptoms returned recently so I may be one of those who needs a slightly higher dose in the winter months. I felt the benefits of NDT on my energy levels within just a few days, felt like a minor miracle! I haven't ever tried levo because NHS GP described me as subclinical and wouldn't prescribe anything. I had a below range FT3 level, so NDT containing T3 seemed a good fit.

Looking forward to seeing your full blood results.

[SlowDragon Administrator]

Previous post says you were stopping T3 due to problems getting more T3

Are you now back on T3?

Bloods should be retested 6-8 weeks after any change in medication

Stopping T3 can cause considerable upset

[BrecklandRanger in reply to SlowDragon]

That's right, but was only on it for a very short time (2 wks), and was a while back. So any t3 should be clear by now.

[SlowDragon Administrator in reply to BrecklandRanger]

Takes minimum of 6-8 weeks for endocrine system to settle after such a jolt

Important to test vitamin D, folate, ferritin and B12. They frequently crash right down when T3 is stopped. Can take months to recover to optimal levels if not supplementing

[BrecklandRanger]

+++ Update +++

Attended the ENT at Norwich. They checked the throat with a camera, felt my neck for any issues, and asked a few health/lifestyle questions. Turns out I don't have throat cancer, and told me I'm fine.