Another lump after hemithyroidectomy

[Tjl90]

Hi all again..... so 3 weeks almost after my hemithyroidectomy I have another lump in my throat not a sensation of a lump an actual lump..... it's a little higher then my scar it started as a little pea a few days ago now it feels like someone pressing on my windpipe.... I did see my gp this morning and she doesn't think it is an infection.... im having bloods done next week and she's going to ring the my consultant for advice ....... just wondering if anyone else has had this?

[SlowDragon Administrator]

Are you on levothyroxine after having half thyroid removed?

If not then remaining half is likely struggling ....this can cause pain, swelling etc

Bloods should be retested 6-8 weeks after each dose change in levothyroxine

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also EXTREMELY important to test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common, especially if you have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies

Ask GP to test vitamin levels and thyroid antibodies if not been tested yet

You may need to get full Thyroid testing privately as NHS refuses to test TG antibodies if TPO antibodies are negative

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water .

Last dose of Levothyroxine 24 hours prior to blood test. (taking delayed dose immediately after blood draw).

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies

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

For thyroid including antibodies and vitamins

Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have special offers, Medichecks usually have offers on Thursdays, Blue Horizon its more random

If you can get GP to test vitamins and antibodies then cheapest option for just TSH, FT4 and FT3 £29 (via NHS private service )

monitormyhealth.org.uk/thyr...

If antibodies are high this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).

About 90% of all primary hypothyroidism in Uk is due to Hashimoto's.

Low vitamins are especially common with Hashimoto's. Food intolerances are very common too, especially gluten.

So it's important to get TPO and TG thyroid antibodies tested at least once .

Link about thyroid blood tests

thyroiduk.org/tuk/testing/t...

Link about antibodies and Hashimoto's

thyroiduk.org.uk/tuk/about_...

thyroiduk.org.uk/tuk/about_...

List of hypothyroid symptoms

thyroiduk.org.uk/tuk/about_...

The aim of Levothyroxine is to increase the dose slowly in 25mcg steps upwards until TSH is under 2 (many need TSH significantly under one) and most important is that FT4 is in top third of range and FT3 at least half way through range

NHS guidelines on Levothyroxine including that most patients eventually need somewhere between 100mcg and 200mcg Levothyroxine.

nhs.uk/medicines/levothyrox...

Also what foods to avoid (eg recommended to avoid calcium rich foods at least four hours from taking Levo)

All four vitamins need to be regularly tested and frequently need supplementing to maintain optimal levels

[Tjl90 in reply to SlowDragon]

Hi thank you for replying I'm not on Levothyroxine as my thyroid blood tests were due to be done at my 6 week check which isn't u til 30th march but as this lump has appeared my gp has booked my blood tests for Tuesday at 7am and is seeking advice from consultant I'm just a really anxious person my mind starts to over think xx

[SlowDragon Administrator in reply to Tjl90]

Make sure to get blood test as early as possible in morning before eating or drinking anything other than water

Request that vitamin D, folate, ferritin and B12 are included too

[Tjl90 in reply to SlowDragon]

My gp said she would test all of these although my b12 folate and vit d were all low before my op I had b12 injections, iron tablets and told to get my own vit d supplements which if I'm honest I havnt done as I'm just rubbish at remembering I need to go buy some 😀.......... it's the lump that's really bothering me as it feels like it pressing on my windpipe and my throat just feels full...... I felt fine until 3 days ago it started like little pea and just got bigger xxxx

[Tjl90 in reply to Tjl90]

It's also tender to touch and higher up then my original thyroid nodule it feels like it's over one the bones i will try and take a photo

[SlowDragon Administrator]

Sounds like you have Hashimoto’s then

Autoimmune thyroid disease diagnosed by high thyroid antibodies

Very important to keep vitamins at good levels

How low was vitamin D?

GP should prescribe to bring levels to 50nmol.

ouh.nhs.uk/osteoporosis/use...

But improving to around 80nmol or 100nmol may be better

ncbi.nlm.nih.gov/pubmed/218...

vitamindsociety.org/pdf/Vit...

Once you Improve level, you may need on going maintenance dose to keep it there.

Test twice yearly via vitamindtest.org.uk

Vitamin D mouth spray by Better You is very effective as it avoids poor gut function. There’s a version made that also contains vitamin K2 Mk7

betteryou.com/vitamin-d-k2

It’s trial and error what dose we need, with hashimoto’s we frequently need higher dose than average

Government recommends everyone supplement October to April

gov.uk/government/news/phe-...

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also EXTREMELY important to test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common, especially if you have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies

You may need to get full Thyroid testing privately as NHS refuses to test TG antibodies if TPO antibodies are negative

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water .

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies

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

For thyroid including antibodies and vitamins

Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have special offers, Medichecks usually have offers on Thursdays, Blue Horizon its more random

If you can get GP to test vitamins and antibodies then cheapest option for just TSH, FT4 and FT3 £29 (via NHS private service )

monitormyhealth.org.uk/thyr...

If antibodies are high this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).

About 90% of all primary hypothyroidism in Uk is due to Hashimoto's.

Low vitamins are especially common with Hashimoto's. Food intolerances are very common too, especially gluten. So it's important to get TPO and TG thyroid antibodies tested at least once .

Standard starter dose of levothyroxine is 50mcg.

Bloods should be retested 6-8 weeks after each dose increase

The aim of Levothyroxine is to increase the dose slowly in 25mcg steps upwards until TSH is under 2 (many need TSH significantly under one) and most important is that FT4 is in top third of range and FT3 at least half way through range

NHS guidelines on Levothyroxine including that most patients eventually need somewhere between 100mcg and 200mcg Levothyroxine.

nhs.uk/medicines/levothyrox...

Also what foods to avoid (eg recommended to avoid calcium rich foods at least four hours from taking Levo)

All four vitamins need to be regularly tested and frequently need supplementing to maintain optimal levels

[Tjl90 in reply to SlowDragon]

Thank u so much for all the info I will see what the consultant says and blood results hopefully they get to the bottom of it soon xxxx

[Tjl90 in reply to SlowDragon]

I seen my consultant today he said it could be 1 of 2 things causing the lump... anxiety or a small bleed but either way he's not worried and said if it doesn't settle in a week to call him back.... it's really quiet uncomfortable now and I did tell him it feels like it's really pressing on my windpipe hopefully he's right and it passes..... I'm confused as to why he'd think an actual lump is caused by anxiety can that happen? Xxxxx

[Tjl90 in reply to Tjl90]

Also my lab results came back for the nodule they removed and there was nothing suspicious found 🤗 thankfully xxxxx

[SlowDragon Administrator in reply to Tjl90]

Yes...they love to say thyroid patients are anxious

calmclinic.com/anxiety/symp...

[Tjl90 in reply to SlowDragon]

I agree 100%.... 😔 xxx