Could this be a thyroid nodule?: I have had a... - Thyroid UK

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Could this be a thyroid nodule?

Caroline369 profile image
15 Replies

I have had a sensation of a lump at the base of my neck for about 6 weeks now when I swallow or drink, I cannot feel anything with my fingers though as the throat is lumpy so hard to know what is normal. It is at the base of my neck on the outside of my windpipe near the collar bone. Sometimes it can be a tiny bit sore to swallow, other times just annoying. Could this be a thyroid nodule ? Think an ultrasound might be required.

I have had many thyroid bloods done in the past which show thyroid OK but maybe low ish T4.

My last bloods were

Tsh 2.25 (0.27-4.2)

Ft4 14.6 (12-22) (that's the highest its ever been)

Ft3 5 (3.1-6.8)

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Caroline369 profile image
Caroline369
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SlowDragon profile image
SlowDragonAdministrator

Looking at previous posts…..loads of symptoms suggesting autoimmune thyroid disease also called Hashimoto’s

Last Medichecks test…..both thyroid antibodies negative

Request ultrasound scan of thyroid

Or get one privately £150

20% of Hashimoto's patients never have raised antibodies

healthunlocked.com/thyroidu...

Paul Robson on atrophied thyroid - especially if no TPO antibodies

paulrobinsonthyroid.com/cou...

When were vitamin D, folate, ferritin and B12 last tested

Looking at previous posts

You are taking 4000iu vitamin D

Need to test vitamin D twice year when supplementing

Ferritin very low in previous posts

Didn’t see folate or B12

IBS - have you had coeliac blood test done

Are you now on strictly gluten free diet

Endometriosis?

Possible Lyme….bite?

Caroline369 profile image
Caroline369 in reply to SlowDragon

Hi SlowDragon

Thank you for your very quick and detailed reply it is very much appreciated. And how kind of you to look back at my past posts too.

These last results were from 23rd August 2021

Ferritin was good 93 (13-150)

B12 was 153 (25.1 - 165)

Folate was 17.2 (>4)

Vit D 141 (50-200)

Had endoscopy few years ago and samples taken plus bloods - negative for celiac so I didn't bother going gluten free after that.

Lymme, hmm, well I kinda was tired anyway before I had a bite from what I presume was false widow spider bite as I never saw what bit me. Left me with a black necrotic wound that took months to heal and about 6cm diameter. Don't know if that would have anything to do with things??

I have been on Low Dose Naltrexone for aboutc4 months now and that has helped say 20%. Is LDN ever used for thyroid issues do you know ??

After you replied I emailed my GP to ask for a referral letter to an Endo.

I think you previously mentioned the ultrasound before and I think it's a good idea even before seeing an endo. Do you have to take radio active iodine for the ultrasound?

Thanks again.

SlowDragon profile image
SlowDragonAdministrator in reply to Caroline369

No you just get scanned…very easy

Many, many thyroid patients are gluten intolerant but not coeliac

Always worth trying strictly gluten free diet…..3-6 months

But get ultrasound test as first step

Many thyroid patients do try LDN, often with good results

thyroidpharmacist.com/artic...

Caroline369 profile image
Caroline369 in reply to SlowDragon

I rang one place today about ultrasound, they said need GP referral, will try a few other places just in case . If I get a private ultrasound does it need to be an endo who does it? Who reads it? Can anyone do the ultrasound??

That was very very interesting about the Low Dose Naltrexone how it can be used for thyroid too. Thank you for the link . That is maybe why I feel a bit better on the LDN. J am gonna try the drops next time though.

Do u think LDN can be used alone for hypothyroidism/ hashimoto's?

Going gluten free, aww it could be difficult, I am nearly vegan, apart from chocolate!! Wish I could stop eating it !!

A quick question, I am 44 but about 10 years ago I used to be able to focus on trying different ways of eating like ntermittent fasting , veggie keto, carb cycling high protein etc and stuck to it rigidly and had great focus on this type of thing as I found it interesting.

Now I don't have the same interest, focus or drive to try any diet method ( I am nearly vegan ethically so I don't have to try at all here) is the lack of focus a motivation for things thyroid related, does medication improve this, I find my lack of focus and drive very frustrating. Or is it just age !!

SlowDragon profile image
SlowDragonAdministrator in reply to Caroline369

What vitamin supplements are you currently taking

As a vegan (or vegetarian) essential to regularly retest B12 and ferritin

Very Difficult to maintain iron/ferritin on vegan diet

B12 you highly likely need to supplement daily….test before starting

academic.oup.com/nutritionr...

The present review of the literature regarding B12 status among vegetarians shows that the rates of B12 depletion and deficiency are high. It is, therefore, recommended that health professionals alert vegetarians about the risk of developing subnormal B12 status. Vegetarians should also take preventive measures to ensure adequate intake of this vitamin, including the regular intake of B12 supplements to prevent deficiency. Considering the low absorption rate of B12 from supplements, a dose of at least 250 μg should be ingested for the best results.3

Test Folate annually and test vitamin D when supplementing vitamin D

Vegans need to test iodine levels

SeasideSusie has info on best iodine test

medicalnewstoday.com/articl...

SeasideSusie profile image
SeasideSusieRemembering in reply to Caroline369

Urine iodine test by Genova Diagnostics, details here:

thyroiduk.org/help-and-supp...

Click on "list of available tests" and it's on page 3 of the pdf, test code END25.

PurpleNails profile image
PurpleNailsAdministrator

If you incline your chin upwards and swallow (or gulp a little water) your thyroid moves up and down any nodules / swelling of the thyroid moves with it.

It can go unnoticed unless looking for it.

I did this when explaining to nurse I thought there was an issue. 1 side was very visibly different. 2 doctors had said my thyroid looked fine. I was referred for a scan & bloods straight away.

Caroline369 profile image
Caroline369 in reply to PurpleNails

Hi PurpleNails

I have felt around and looked in the mirror and I just can't see anything noticeable even doing the swallowing thing . Perhaps where I am feeling this is lower than my thyroid position?

PurpleNails profile image
PurpleNailsAdministrator in reply to Caroline369

Nodules aren’t always visible from outside especially if they are inward then they are more likely to affecting swallowing, breathing or voice. I can feel my nodule just above my collar bone with 1 finger. It measures 5cm to considered large, the Thyroid can descend down behind collar bone where you describe having a painful point. ultra sound scan is best to look at health & size of thyroid and detect any nodule/s.

Scans with Radioactive iodine are a different type of scan, called a thyroid uptake scan. This type of scan measures the level of function in different areas of thyroid. I had this type of specialist scan after 2 ultra sounds for suspected toxic nodule. Often it’s only done If you are hyper without autoimmune.

Caroline369 profile image
Caroline369 in reply to PurpleNails

Thank you PurpleNails, that is very very useful info, both about the position and ultrasound, good to know. I rang today about ultrasound and need GP referral, hopefully should get that though I have a severe sore throat now so will have to wait until that passes .

Caroline369 profile image
Caroline369

OK just a quick update, very quickly within 2 weeks saw ENT who put camera up nose and down throat. Saw nothing, said muscle strain! ENT never mentioned ultrasound. Thankfully my GP had referred me for ultrasound and got one done a few days ago. GP receptionist said the ultrasound report said thyroid normal. Cyst found. That's all she could tell me and said GP wants me to make an appointment to speak with him. So I so not know if cyst on Thyroid or in another part of neck. Swallowing is mildly sore sometimes but not all times. I have looked up cyst removal surgery, should not have viewed those pics!! So will hopefully get an appointment on Monday and will discover what type and location the cyst is. 😳

PurpleNails profile image
PurpleNailsAdministrator in reply to Caroline369

If it’s a small thyroid cyst they may leave alone. Some cysts can be drained but often refill over time.

If the cyst is concerning, I think surgeons often remove the lobe the cyst is affecting.

Have you had thyroid antibodies tested?

Caroline369 profile image
Caroline369

Thyroid Antibodies were 12.3 (0.00 - 115) in August 2021. In 2018 they were <10.

12.3 is low isn't it.

PurpleNails profile image
PurpleNailsAdministrator in reply to Caroline369

Yes both low. <10 means less than (test not able to detect) so may be 0. As both are below the acceptance & expected limit they are negative and this shows there’s not sign of autoimmune.

You do have low FT4 & a healthy TSH is around 1. Your FT3 is good. A healthy TSH is around 1. The higher it goes the more the thyroid is struggling. If thyroid levels are in range Drs do not get concerned until TSH reaches 10 or FT4 below range. So something to monitor.

Caroline369 profile image
Caroline369

Yeah the low t4 is what I wonder is causing my symptoms so I am trying to get an appointment with a thyroid specialist endo to run his eye over my bloods to see what he thinks. I am waiting on a reply back.

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