I recently had a FNA results T3, this was performed for a 'lump' right-side of neck. This has been on going for 4+ years (leftside thyroidectomy 24 years ago).
It was repeated 2 weeks later and resulted T2 and the size is 4cm, my symptoms are and have been for many years, difficulty in swallowing, feeling of something stuck in my throat, weight gain & tiredness although my bloods are in target....
My surgeon is willing to remove but I feel he thinks it's for cosmetic reasons? If the removal will not improve any of my symptoms which he does not think it will is there any point in having it removed?
Any advice would be welcomed.... Thankyou
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FiftyClub
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No surgeon would be completely willing to do this if he felt it really were cosmetic. Surgery on the thyroid is dangerous due to its position in the neck. From what you describe, you have a mild form of those symptoms where the surgeon would not hesitate to take action.
The surgery would improve some things, BUT it would introduce other things. Swallowing and things stuck in your throat would likely disappear, but weight gain and tiredness would likely remain, mainly die to the fact you would then be dependent upon Levothyroxine which does NOT usually relieve all symptoms for athyreosis.
I would suggest you do nothing unless or until your symptoms become a lot worse, but you need to bear in mind that the longer you leave it, the more dangerous becomes the surgery, so it's your choice.
The 2 most important things to remember are:
(1)Levothyroxine will be the only medication offered but NDT is far better for you. I refer to the instruction in the GMC's booklet
, advise you download and read entire document for yourself from GMC web site. Query your GP/Endo/Surgeon about this as they will be unlikely to tell you or even profess to be unaware of it.
"Consent - patients and doctors making decisions together";
part 2 "making decisions about investigations and treatment, Sharing information and discussing treatment options" states:
"(9) You must give patients the information they want or need about:
(l) any treatments that you believe have greater potential benefit for the patient than those you or your organisation can offer."
(2) It is HIGHLY recommended that you avoid having Radioactive Iodine treatment for a number of reasons. I believe the strongest reason is that you are more likely to succumb to cancer, your immunity being compromised by the inadequacies of Levothyroxine. Disbelieve what I say if you like, but I got Kidney cancer after my TT whilst on levothyroxine monotherapy. I survived with one kidney but with other forms of cancer, I would now be dead!
Feeling of lump in throat can be due to being hypothyroid
What were your most recent thyroid results
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
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 half or third 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?
Private tests are available as NHS currently rarely tests Ft3 or thyroid antibodies or all relevant vitamins
I've had all bloods done, I'm in BUPA so I'm confident all bloods are correct?
The FNA came back T3 and 2 weeks later T2. I have never been on medication, I had left side thyroidectomy in 1996.
If having thyroidectomy will not improve the lump feeling, weight gain, tirdness and irritable cough of trying to remove something that isnt there, I really don't want to go ahead with such invasive surgery..... I can live with the sight of it, its cosmetic, which surgery is defo out of the question for
I have multinodular goiter and last night I kept waking up coughing. This can sometimes happen but not all the time. Are you sure you don't need some kind of thyroid hormone replacement? I know mine becomes more swollen when my levels are off.
If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before any blood tests, as biotin can falsely affect ALL BLOOD test results
What exactly do you mean " FNA came back T3 and 2 weeks later T2"? T3 and T2 are thyroid hormones. Did you have 2 FNAs? That would be very unusual especially just 2 weeks apart. Let me know, I'm fascinated.
Hi, I don't know what T2 and T3 mean, but presumably not cancerous. You don't say if you are on medication or totally reliant on your remaining thyroid gland. If you are not on medication then starting some may help symptoms. Obviously, if you have the remaining gland removed you will be dependent on levothyroxine or other hormone sources. You need to consider that the gland may continue to swell. This may cause breathing difficulties in addition to swallowing.
I had a goitre with an apparently normal functioning thyroid gland, but swallowing was difficult and breathing while sleeping and as a result had a total thyroidectomy nearly 20 years ago. I have been on levothyroxine since and have been well. While I appreciate many people do not thrive on levo, many others, like me, do.
I agree such intervention is not worth taking if for purely cosmetic reasons. I lived with a large goitre for a number of years, but when it interfered with eating and sleeping action was necessary. I wish you well and hope you make the decision that is right for you.
This is from Dr. Clayman (was head of MD Anderson’s thyroid cancer section and now has his own thyroid cancer clinic in Florida and considered one of the best)
Thank you. That puts a whole new light on this post. Briefly I thought the world had moved on and suddenly I had forgotten everything I ever knew about the thyroid.lol
So if FiftyClub's tumour went from T3 to T2 in two weeks this means it has shrunk? If it is indeed cancerous is it not better to have it removed when it is small?
This could be because of someone different interpreting the ultrasound results or the ultrasound looking at a different area. “In office” ultrasounds can be imprecise vs radiology department or specialist high resolution machines with an experienced tech doing a complete mapping of the thyroid and cervical lymph nodes which are then measured with computerized aids. The actual morphology of cells and nodes is still fairly subjective and based on the experience/skill of the person reading the US pictures or FNA slides.
Agree - it is best to remove cancer while still small and not yet spread.
As to FiftyClub’s surgeon saying this would be “cosmetic” - when a tumor or swollen thyroid is causing swallowing or breathing problems that is certainly not “cosmetic”. Also if FNA results are “inderminate” and the thyroid removed, the pathology often shows a cancerous node on the backside which a) wasn’t visible on ultrasound so b) was not accessible for a FNA.
my symptoms are and have been for many years, difficulty in swallowing, feeling of something stuck in my throat, weight gain & tiredness although my bloods are in target....
Please add actual results and ranges
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
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)
Private tests are available as NHS currently rarely tests Ft3 or thyroid antibodies or all relevant vitamins
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