# Enlarged thyroid with nodules, multiple symptoms and possible referral



## Armywife4 (Dec 13, 2016)

Hello there, so I went an had an U/S done of my thyroid and the person who performed it was a Dr. He told me that my thyroid itself was enlarged, I had 2, 1cm nodules on the left and one 2cm nodule on the right. He also said that I had a lymph node on the left as well. Long story short, I am stationed with my spouse in Germany, and the test was done at an office in the German economy. So, the report was in German, and a little in English. I am being told I will need to wait 2 weeks for the report to be translated. In the meantime my TSH is 2.94 and my Free T-4 was 7.1. I had told my Dr. that I am having a hard time swallowing, choking in the night and am losing my voice throughout the day. He now wants to refer me to an otolaryngologist. I already have a referral for the rheumatologist (I had a positive ANA), an MRI of the brain, and a cardiologist. I was thinking all of this difficulty with swallowing and what not was more than likely a result of the enlarged thyroid and nodules. I really don't want another referral if I can help it. My Dr. who is wanting to send me to the otolaryngologist hasn't seen my report yet, though I did tell him of the findings that the other Dr. spoke of. I know he needs to see if for himself, I was just wondering if I should sit and wait around for the report before making any other appointments. I have lots of other problems, or symptoms I suppose. Hot flashes, muscles spasms in my feet and hands, fatigue, weight fluctuation, hair thinning, skin irritation (especially after the shower),heart palpitations,severe brain fog/trouble concentrating (writing letters backwards, hence the MRI of the brain),fingernail trouble/deformities,swollen lymph nodes in clavicle,neck, jawline. etc. I just want to feel better, but I have a job and it's so hard to get to all these different appointments. Thanks everyone!


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## my3gr8girls (Mar 18, 2016)

Many, though not all, of your symptoms certainly could be attributable to hypothyroidism. It doesn't appear that you are terribly hypothyroid though. I certainly wouldn't want to advise you to cancel any appointments, but I do think a thorough evaluation of your thyroid is warranted. You should probably have a fine-needle aspiration biopsy of your nodules.


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## jenny v (May 6, 2012)

Do you have ranges for each of the lab results you mentioned? I'm betting the ranges in Germany are different, so that FT4 test might not be as crazy high as I'm thinking.


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## Armywife4 (Dec 13, 2016)

Sorry about that! I should have included those. My blood was actually ran and tested at an Army treatment facility, so I am not sure if they use the ranges that Germany does.

Here are my labs and ranges:

*TEST Result Units Reference Range*

Thyroxine 7.1 mcg/dL 4.5-12.0

Thyroptin 2.94 mcIU/mL (0.36-3.72)

Not sure why the reference range for the Thyroptin is in parentheses. My last Thyroptin test was 2.68 and before that it was 1.87. I have years of lab results for thyroid tests, and the results are all over the place. Thank you for your assistance.


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## Lovlkn (Dec 20, 2009)

The visit with the otolaryngologist will likely give you the answers you are looking for. Prepare yourself for the option of them surgically removing your thyroid as they are trained to do such.

Enlarged thyroid with choking is not a good thing.


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## joplin1975 (Jul 21, 2011)

That's a pretty standard referral for your issues. It's likely they will recommend surgical removal, as Lovlkn mentions.


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## Armywife4 (Dec 13, 2016)

Lovlkn said:


> The visit with the otolaryngologist will likely give you the answers you are looking for. Prepare yourself for the option of them surgically removing your thyroid as they are trained to do such.
> 
> Enlarged thyroid with choking is not a good thing.


Thank you for your response! This is all so new to me. I read several things that said the next step could be an FNA, and some that said I would need to see an endocrinologist. How does one tell if they have an autoimmune disease that is affecting their thyroid? I had a postive ANA test, so my doctor has referred me to the rheumatologist. When I asked if my ANA results could be the result of this thyroid business and he said no. I finally got a call today from a nurse at the clinic and she said she had to call over to get the report, so I am looking at another 2 weeks (after already waiting 2 as of this coming monday) to get the transcribed report. She did however say that at the bottom of the report there was a little bit of english with enough findings to "move forward". She told me my dr. would be calling me in the morning. Sometimes I feel like it is worse than others...especially at the end of the day. It feels like I have a wad of tissue stuck in my throat and it takes a conscious effort to swallow. I wake up drenched all throughout the night and my vision has significantly declined. I had to see an optomotrist who put me on steroid eye drops, an ointment, lubricating drops and fish oil (they think this is from my autoimmune, possibly sjogren's syndrome.) Is it customary for the otolaryngologist to opt for surgery almost always? Thank you for all of your patience and guidance. I appreciate it very much, my husband is deployed, and with work and my two kids, I stayed exhausted. I haven't talked to anyone, including my husband, about this. I feel feel like all of this is going to end up being nothing. I haven't felt good for years and the dr.s would always pass me along since my labs were "normal". It wasn't until I got a good doctor who saw me for my nails and pain in the neck that decided to actually try to help me. Thank you again everyone.


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## Armywife4 (Dec 13, 2016)

joplin1975 said:


> That's a pretty standard referral for your issues. It's likely they will recommend surgical removal, as Lovlkn mentions.


Thank you for your response..is that due to having the goiter and the nodules? I have been doing some research, but it is nice to talk with someone who has actually been through it. My mom had a nodule and the FNA determined she had follicular cells and hurthle cells, but she can't remember anything much about who she saw, etc. So thank you for taking the time to talk to me. I am very overwhelmed with all of this. I am 33, an athlete and I eat very nutrious foods....poultry, vegetables, fruits, grains, etc. I am a personal trainer and certified in nutrition and this makes the 3rd day I am skipping the gym. No energy, and too down. I have a coordinator at the hospital trying to make all these appointments for me because the staff keeps hanging up on me due to a language barrier. She is also trying to get all my appointments on the same day or two. I feel like one day I woke up,someone flipped a switch and it all fell apart.


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## joplin1975 (Jul 21, 2011)

You'll probably get an FNA next, yes. But you might not. If you are choking and/or having trouble swallowing, there's not really too many other options than to have all or part of the thyroid removed.

The FNA is considered the gold standard for determining if you have autoimmune issues (they look at the cells for evidence of autoimmune disease) BUT a very common way to more or less land on autoimmune is to test thyroid antibodies, including TPO, TSI and Tg/TgAB.

Where to go next on your thyroid journey really depends. A lot of people see ENTs for thyroid disorders. Some see endos. Others get treated by general or integrative physicians. The type of doctor matters less than how well versed they are in thyroid conditions. A lot of endos strictly focus on diabetes and that's why many see out the help of ENTs or other specialists.

I don't know the answer to your question re: ANA.


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## Armywife4 (Dec 13, 2016)

joplin1975 said:


> You'll probably get an FNA next, yes. But you might not. If you are choking and/or having trouble swallowing, there's not really too many other options than to have all or part of the thyroid removed.
> 
> The FNA is considered the gold standard for determining if you have autoimmune issues (they look at the cells for evidence of autoimmune disease) BUT a very common way to more or less land on autoimmune is to test thyroid antibodies, including TPO, TSI and Tg/TgAB.
> 
> ...


You are so knowledgable! Thank you very much. Ok, I think I need to just sit back and wait for them to call the shots. My boss made me feel better today when he heard me on a break talking to the nurse about getting my appointments on the same day. He told me to take as many days as I needed because my health is what's important. So I am just going to listen to the docs and know it will all work out. I keep worryign about having it removed, and being on meds and not being able to figure out the dosage etc.


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## joplin1975 (Jul 21, 2011)

Full disclosure: I was not well-medicated after surgery and had a crummy, oh, 18 months. There were lots of appointments and blood tests and I was kinda certain I would never, ever have a normal life again. Fast forward to now and I can tell you categorically that I feel fantastic and having my thyroid removed -- even with all the bumps in the road -- was the best decision ever.

The nice thing about these boards is we can help you advocate for yourself. I think people who gather up information and advocate on behalf of themselves really have the best outcome.

It's going to be ok.


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