What size goiter needs to be removed

[natinalsfan]

I have had an ultrasound the past three years of my thyroid. I have one small nodule and a diffuse goitre. What is considered large?

I have problems swallowing larger pills and sometimes choke with food but nothing more water doesn’t help to push it down. My results below. They have stayed pretty stable the past three scans. I am currently on 65mg of nature throid. Low ferritin and vitamin d. High TG antibodies.

6.1 x 1.7 x 1.3 cm right lobe

5.1 x 1.5 x 1.2 cm Left lobe

Diffuse thyromegaly.

[Blockchain]

If you’re symptomatic with large goiter that should be enough to have it removed. Especially if your chocking.

I had mine removed about a year ago due to those same problems, I had three nodules though all solid and difficulty regulating my tsh. I have Hashimoto’s and have had hypothyroidism since I was 12 years old. Never had my antibodies tested till I was 34! I was told it wouldn’t matter because it doesn’t change the course of treatment.

[Lora7again in reply to Blockchain]

I have a multinodular goitre and sometimes choke but I have no intention of having it removed because I am now on my second remission. A lot of people have struggled with getting adequate treatment after they have had their thyroid removed and have struggled with their health. It is a personal choice and you need to read up on what can go wrong because your vocal chords can be damaged and there are other risks as well. You can read my story on my profile page. That should have been to OP btw I am on my iPhone and pressed the wrong button

[Blockchain in reply to Lora7again]

It is definitely a personal choice. I had biopsies performed prior to the removal which were negative for cancer. After the thyroidectomy cancer was found .

You definitely want to do your research related to surgeons if you do choose to have it removed. I read somewhere you should go to a surgeon that performs at least 150-300 thyroidectomy per year.

Some HEENT docs will perform it but don’t have a lot of experience.

The surgeon that did mine does 30 per week.

[greygoose]

65 mg Nature Throid is a very small dose. Are you sure you're adequately medicated? Have you tried a higher dose? What are your blood test results: TSH, FT4, FT3?

[SlowDragon Administrator]

Recommend you get FULL thyroid and vitamin testing

Your symptoms suggest under medicated

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

Do you have Hashimoto’s?

Ask GP to test vitamin levels

You may need to get full Thyroid testing privately if in UK 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)

If/when also on T3, or NDT make sure to take last 1/2 or 1/3rd of daily dose 8-12 hours prior to test, even if this means adjusting time or splitting of dose day before test

Is this how you do your tests?

[natinalsfan in reply to SlowDragon]

Thanks everyone. I do have Hashimotos. Only have elevated Tgab.I have been on meds for 3 years. The dr. Put me on nature throid to begin then switched me last year to a slow release compounded and I started having a lot of symptoms return. I have been back on nature throid and symptoms are relieving. The tightness in my throat has always been constant on both meds. My mom had hers removed in her sixties due to large nodules and my brother had half removed but he was hyper. I am 48.

Latest results below. This was fasting and 7am before taking meds.

Vitamin B: 692 (232-1245 pg/ml)

Folate: >20 (>3.00)

Tsh: 1.59 (.45-4.5 usu/ml)

Rev T3: 16.1 (9.2-241 ng/dL)

Vit D: 31.2 (30-100 ng/ml)

T4: 5.5 (4.5-12 ug/dL)

T3: 113 (71-180 ng/dL)

Zinc: 81 (56-134 ug/dL)

Ferritin: 22 (15-150 ng/ml)

Free T3: 2.8 (2-4.4 pg/ml)

Free T4: .92 (.82-1.77 ng/dL)

TGAB: 4.8 (0-0.9 ui/ml)

TPO: 21 (0-34 up/ml)

I take blood builder for the ferritin. I take vitamin d supplement of 4000 per day. My cholesterol and triglycerides are high too. The dr put me on three month keto and my numbers for cholesterol and triglycerides didn’t lower.