Thyroid Isthmus Nodule: Morning, lovely people! I... - Thyroid UK

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Thyroid Isthmus Nodule

Unconventionalbutter profile image

Morning, lovely people! I’m a 22 year old female with an upcoming ultrasound as my dr suspects nodules on my thyroid and so i’m on the hunt for some advice/info! :)

Has anyone had any similar experience with nodules in the middle of the thyroid (isthmus)?

I have some questions about nodules:

1. Could it be felt by hand?

2. How big was it? Did it take up the whole middle section?

3. Could you see it when swallowing?

4. Was your nodule benign or malignant?

5. Did it feel hard or soft?

6. Is it common to have nodules on both lobes as well as the isthmus?

What were your other symptoms? I also have 2 kidney bean sized lymph nodes behind the strap muscle on the right side & a lump ON my adams apple (which dr said could be unrelated) All of those lumps are painless. I get a tightness feeling around that area, and seem to always collect saliva back there too. Also get a dry cough followed by gagging as it takes hardly anything to set my reflex off nowadays.

Context: Have been checked previously for different types of infections like sinus, flu covid… all of the above and nothing had come of any of it.

Thanks in advance and good luck on your thyroid journeys 👍🤍

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Unconventionalbutter
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2 Replies
SlowDragon profile image
SlowDragonAdministrator

Welcome to the forum

Sometimes goitre or nodules can be seen, felt. Often the patient says they can feel thyroid is swollen or tight yet medics can’t feel anything

Good that GP has organised an ultrasound scan

You also need FULL thyroid and vitamin testing

NHS often only tests TSH

Have you had any blood tests?

For full Thyroid evaluation you need TSH, FT4 and FT3 tested

Also both TPO and TG thyroid antibodies tested at least once

Very important to test vitamin D, folate, ferritin and B12 too

About 90% of primary hypothyroidism is autoimmune thyroid disease, usually diagnosed by high thyroid antibodies

Autoimmune thyroid disease with goitre is Hashimoto’s

Autoimmune thyroid disease without goitre is Ord’s thyroiditis.

Both are autoimmune and generally called Hashimoto’s.

Low vitamin levels are extremely common when hypothyroid, especially with autoimmune thyroid disease

20% of autoimmune thyroid patients never have high thyroid antibodies and ultrasound scan of thyroid can get diagnosis

In U.K. medics hardly ever refer to autoimmune thyroid disease as Hashimoto’s (or Ord’s thyroiditis)

Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test

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 all relevant vitamins

List of private testing options and money off codes

thyroiduk.org/getting-a-dia...

Medichecks Thyroid plus antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins

bluehorizonbloodtests.co.uk...

Only do private testing early Monday or Tuesday morning.

Link about thyroid blood tests

thyroiduk.org/getting-a-dia...

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

Symptoms of hypothyroidism

thyroiduk.org/wp-content/up...

Tips on how to do DIY finger prick test

healthunlocked.com/thyroidu...

Medichecks and BH also offer private blood draw at clinic near you, or private nurse to your own home…..for an extra fee

Common with possible thyroid issues to develop dairy intolerance

Symptoms include cough, sinus, post nasal drip, excess saliva etc

PurpleNails profile image
PurpleNailsAdministrator

Thyroid nodules are are very common, half of older people will have them.

Some nodules can be felt externally, but small ones or ones located deep or behind the front area of thyroid can go hidden.

Most nodules are under 1 cm & do not concern doctors. Over 1cm are often given a fine needle aspiration.

The thyroid moves up & down with swallowing but should not be visible. If thyroid is swollen or a nodule is attached to thyroid, the action of swallowing can make it obvious.

Years ago after 2 doctors sent me away saying my neck look fine. I was at an appointment with nurse & I asked her to look at my neck when I drink water, I had taken a bottle with me.

When you tip you head back & gulp any swelling can sometimes become more evident. I was immediately sent for bloods and referred for an ultrasound scan.

The scan revealed a benign but large 5cm colloid nodule which was noted covered the isthmus - the entire middle of my neck is swollen, but it’s off centre as is from the left lobe.

The FNA showed it is a benign nodule and nothing else was done. I returned about 9 months later as my swallowing was feeling affected & the doctor said your function results have not been done. Other blood test had come back but not thyroid function.

After further investigation it turned out the nodule was hyper functioning and I had high thyroid levels. When I later went back through old medical records I had increasing level for over 4 years & it had been missed.

The nodule is harder that rest of neck but has a slight squish to it & has a definite edge.

I have a solitary nodule but multiple nodules across entire thyroid is common too.

I can have a tightness feeling & the description of saliva collecting - that too.

I’ve also had salivary gland inflammation, Submandibular gland under jaw became swollen like a wobbly bouncy ball. Doctors seemed unaware but it was likely caused by the thyroid lowering medication. It was scanned 2x but it resolved.

I had other symptoms related to high thyroid levels but they developed very gradually. I had an insane appetite, low energy. Which cased weight gain, the majority lose weight. I have an increase in migraines when levels are high & at one stage my finger nail began lifting off the nail bed.

ENT will be looking at thyroid from surgical viewpoint, is this nodule malignant or causing a physical issues. You must also ensure that the function has been checked. ENT will assume GP or Endocrinologist will be dealing with hormone levels.

TSH, FT4, FT3. TPO & TG antibodies. TSI & TRab if TSH low or FT4 / FT3 high.

Also important to check folate, ferritin, B12 & Vitamin D.

Add any results you have with lab range. Ranges vary between labs.

Summary

1. Could it be felt by hand? A) Yes

2. How big was it? Did it take up the whole middle section? A) 5cm centre left

3. Could you see it when swallowing? A) Yes

4. Was your nodule benign or malignant? A) Benign but hyper functioning.

5. Did it feel hard or soft? A) Hard

6. Is it common to have nodules on both lobes as well as the isthmus? A)Multiple nodules is more common that solitary nodules.

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