# throat, thyroid????



## oceanmist (Apr 30, 2007)

I went to the ENT for the second time this week. My throat is so sore! Its pinching and throbbing and hurts when I swallow, its been going of for a while. This Dr.! Today says he must be missing something...seriously? He was mocking me! Like I can image this pain is he out of his mind! I had a tumor in my throat 25 years ago. It feels exactly the same as it did then....apparently he sees nothing. My question is does my blood work for my thyroid have to be out of range to have problems like thyroid cancer, thyroiditis. My family doctor has not sent me to a END because my blood work is in normal range.
:sad0049:

Ocean


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## Christinals (Sep 9, 2010)

I am very sorry you are so sick. It is very frusterating to get Dr.'s to listen. If you have spent any time on these boards searching, you will find that you are *NOT* alone! Sounds like you need to find another Dr. I know it's difficult to switch, and sometimes very difficult to find a Dr. accepting new patients. Try to get on a cancellation list for the earlies apptment possible, and let them know what's going on.

From my understanding. Your bloodwork can be completely normal and you can still have thyroid cancer, and other thyroid issues (someone correct me if I am mistaken). It really depends on what blood tests you have had done. Do you have copies of your blood work? If you don't, be sure to get them. If you have them, post them and be sure to show the ranges as well.

Have you had an ultrasound to see if you have a nodule? I would think that would be one of the first things they would do for you.

Best of luck and let us know what you decide to do.
:hugs:
-Christina


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## GD Women (Mar 5, 2007)

"My question is does my blood work for my thyroid have to be out of range to have problems like thyroid cancer, thyroiditis. My family doctor has not sent me to a END because my blood work is in normal range."

Cancer - No. Normal thyroid levels appear in some thyroid canacers.
Most patients with thyroid cancer do not have either hypo- or hyperthyroidism; rather they have normal thyroid function despite their cancer.

Occasionally, symptoms such as hoarseness, neck pain, and enlarged lymph nodes do occur in people with thyroid cancer.

Thyroiditis - Yes. Thyroiditis is an inflammation (not an infection) of the thyroid gland. Several types of thyroiditis exist and the treatment is different for each. Antibodies that attack the thyroid cause most types of thyroiditis.


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## oceanmist (Apr 30, 2007)

I have two nodules and I go in every 6 months or so. I remember it first started at 1mm and now one of them is 1 cm. They say it nothing. God help me!!!! I have such a sore throat.
I have to go in for another thyroid altrasound in a couple of weeks but there just going to say it looks FINE!!!!!
I'm searching the net trying to think of a way to get into see a ENDO in my location....call each and everyone of them begging????? I know the drill (you have to get your family doctor to refer you) it could take months. Its hurts to talk. You would think this NEMROD!!! would send me to a Endo. I don't think I spelt that right...oh well you know what I mean.
Thank you Christina I was kind of worried that might be the answer....I have to get in to see someone ....soon
Thanks


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## Christinals (Sep 9, 2010)

I just found a new Dr. myself. Started from scratch again, but it was worth it had my biopsy today!!

I can't believe they wouldn't want to do a FNA on the nodules..especially if they have grown. You need to have them checked. You must find a DR to do that for you. This is not good. *Not to mention you feel awful!*

Best of luck! Keep pushing forward.


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## GD Women (Mar 5, 2007)

Ultrasound tells if a nodule is "solid" or a fluid-filled cyst, but it will not tell if a nodule is benign or malignant. Ultrasound allows accurate measurement of a nodule's size and can determine if a nodule is getting smaller or is growing larger during treatment.

Needle Biopsy or Fine Needle Aspiration is somewhat controversial. Some physicians are fond of it, and others feel its usefulness is actually very limited. The accuracy rate of this test in the evaluation of follicular cancer is quite poor. For papillary cancer it is much higher, perhaps 90% to even 95%. A lot depends upon the pathologist who is looking at the cells removed by the needle. Unfortunately, the biopsy report will often say such things as "inadequate specimen" or "thyroid cells present", or "compatible with..." or "suggestive of ...". None of these "impressions" are helpful since they do not give a clear and precise diagnosis. Also, it has been the experience that when a patient comes to the office with a diagnosis of definite thyroid cancer on needle biopsy, the tumor in the gland felt suspicious on physical exam alone, such that thyroid surgery should be recommended regardless of what the needle biopsy indicates. Therefore, doing the needle biopsy can be unnecessary. Also, while rare, there is the possibility of cancer cells being spread by the needle biopsy. There has been only one case of this. Finally, needle biopsy is sometimes a somewhat painful procedure.

As a general rule, most endocrinologists recommend a FNA (Fine Needle Aspiration Biopsy) for palpable nodules larger than 1 to 1.5 cm. There is currently intense debate about whether all identified nodules over 1 (or 1.5 cm) require FNA. Some feel that only the smaller non-palpable nodules (1.5 cm) with suspicious characteristics need to be biopsied. A thyroid nodule which is larger than 3 cm, cystic/solid or large and cystic/solid may have a higher probability of malignancy (grade C). In glands with multiple nodules, the recommendation of the American Thyroid Association (ATA) is to biopsy nodules that are 10 mm and those that have suspicious features.

For FNAB to be regarded as a useful diagnostic tool, it must have a low false-negative rate. The false-negative rate is reported in the literature to be in the range of 1%-11%, with a value 5% being acceptable. Nodule that is shaped more tall than wide (defined as being greater in its anteroposterior dimension than its transverse dimension) has been shown to be suggestive of malignancy

It never hurts to get a second opinion, so keep searching for a good Endo who treats many thyroid patients per year.


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## Andros (Aug 26, 2009)

oceanmist said:


> I went to the ENT for the second time this week. My throat is so sore! Its pinching and throbbing and hurts when I swallow, its been going of for a while. This Dr.! Today says he must be missing something...seriously? He was mocking me! Like I can image this pain is he out of his mind! I had a tumor in my throat 25 years ago. It feels exactly the same as it did then....apparently he sees nothing. My question is does my blood work for my thyroid have to be out of range to have problems like thyroid cancer, thyroiditis. My family doctor has not sent me to a END because my blood work is in normal range.
> :sad0049:
> 
> Ocean


I am so discouraged w/ the medical establishment; I truly am. You poor dear. I hope you can find a doctor that cares about you.

Sometimes cancer does not reflect in labs. While not definitive, high titers of Thyroglobulin Ab are "suggestive" and warrant further testing such as a sonogram, RAIU (which is best, I think) and/or FNA of any nodules if found to be suspicious.

Also, swollen lymph nodes in the cervical area are suggestive of papillary cancer. That would be in the neck, under the jawline and the cervical bone.

I hate to suggest this but you might have to tell somebody if they don't give you the necessary tests as suggested above and it turns out you have cancer that there is going to be a huge "problem" if you get my drift here.

You are in my prayers and thoughts for this.

Why a doctor would mock somebody that is pain is just totally beyond my scope of understanding.


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## lavender (Jul 13, 2010)

I think you know your body best. your last post says you feel bad from .68 to .98. I think you need a doc who is going to help you feel well, not fit in a therapeutic window. Hoping you can find someone who will take your needs seriously!

I totally feel your pain with the punishing nurse. Just went in to get blood drawn, and the lab worker was so grumpy! I swear she took my blood without even looking at me (if that's possible)! I forced myself to smile at her as much as possible and wish her a good day on the way out! At least she got my vein on the first stick and didn't butcher me!

I really wish there was a "comment box" at doctor's offices!


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## Andros (Aug 26, 2009)

oceanmist said:


> I have two nodules and I go in every 6 months or so. I remember it first started at 1mm and now one of them is 1 cm. They say it nothing. God help me!!!! I have such a sore throat.
> I have to go in for another thyroid altrasound in a couple of weeks but there just going to say it looks FINE!!!!!
> I'm searching the net trying to think of a way to get into see a ENDO in my location....call each and everyone of them begging????? I know the drill (you have to get your family doctor to refer you) it could take months. Its hurts to talk. You would think this NEMROD!!! would send me to a Endo. I don't think I spelt that right...oh well you know what I mean.
> Thank you Christina I was kind of worried that might be the answer....I have to get in to see someone ....soon
> Thanks


Oceanmist; I am so worried about you, Honey Bunny! Please consider a GP, a DO, an ENT. You do not have to see an endo to get help.

You are in my thoughts and prayers and I do mean seriously.

Here is the biggest bear hug I could find for you!


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## oceanmist (Apr 30, 2007)

You are all so kind all of you...I deleted my posts this morning because I thought no one cared. After the treatment I'm getting lately and how sick I feel, I'm just not myself. 
Your right I did post that I don't feel well at .68 or .98 my tsh right now is .70 is the range always right? Does it mean I'm not sick? Last year it was 1.45. I'm all over the map. My question is can meds alter the blood work? Like adavan or rivotril for an example. 
My worse fear and symptom right now is I just got off work and my job is I have to talk. It hurts to talk and this has been going on for a few weeks really bad. I notice that I try to limit my talking to give my throat a rest! 
Hugs to you all
Oceanmist


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## lavender (Jul 13, 2010)

You poor thing! I can totally relate to thinking no one cares! I will sit around all day feeling miserable before I call a friend and reach out, and as soon as I do, I usually feel a whole lot better, even if they can't fix anything. It just helps to know someone cares.

First, Is anyone monitoring your Free T3 and Free T4? They might be more telling than your TSH alone. And if your tsh levels are bouncing all over the place, you could feel miserable just from the constant yo-yo-ing.

Next, I am wondering if anyone has checked your antibody levels to see if there is an auto-immune explanation for your changing levels? If the family doc will not refer you to an endo, you can at least ask him/her to run some labs. Here are my suggestions:
TSH, Free T3, Free T3, TSI, TPO, Thyroglobulin Antibodies, ANA.

Make sure you ask for a copy of the results, and if something comes up, the family doc would have a hard time denying you a referral to an endo without risk of malpractice.


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