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Enlarged Thyroid, Difficulty swallowing, Swollen Lymph Nodes, etc
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Questions in the Thyroid forum are answered by Mark Lupo, MD. Topics covered include Goiter, Graves Disease, Hyperthyroid, Parathyroid/Calcium Problems, Thyroid Cancer, Thyroid Nodules/Cysts, Thyroiditis, Thyroid & Pregnancy, Thyroid Stimulating Hormone (TSH), Thyroid Tests, and Thyroid Surgery.

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Enlarged Thyroid, Difficulty swallowing, Swollen Lymph Nodes, etc

I was diagnosed w/Hypothryroidism apprx 4 yrs ago and have been taking Synthroid since that time.  I had a physical in Jan and the dr told me that my thyroid gland felt enlarged. He sent me for an ultrasound that showed that I had an enlarged thyroid.  I then began having difficulty swallowing.  I was referred to an ENT who scheduled me for more testing.  I have had a CT (which confirmed the enlarged thyroid)& a barium swallow (which showed that I have a sliding hieatal hernia & slight acid reflux-now taking Nexium).  Bloodwork showed my thyroid antibodies were 749 and they are supposed to be <99. Since Jan, I have had numerous sinus throat infections & have been on 4 rounds antibiotics & 2 rounds of steroids. I just came off the last medicine 5 days ago, and my lymph in my neck are swollen and sore and I'm starting to have difficulty swallowing again. There's no intense pain in my thyroid, but I feel like all of these problems have to be linked because I didnt have any of these symtoms (symptoms) until around the time I had the first ultrasound. I saw an Endochronologist this week, though I still feel like I have no answers.  Now, over the past couple of days, I've also developed a very stiff neck. It hurts really bad, I can barely even turn it or try to look down.  I feel like I've been to more doctors than I can name over the past 2 months and I'm hoping for some help through other areas.   Have any of you heard of these symtoms (symptoms)?  Any ideas?
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You have hashimotos with an associated enlarged thyroid -- sometimes this can be painful and cause increased lymph node swelling.  This is difficult to treat.  It is important to make sure there is nothing to biopsy -- ie nodules or suspicous lymph nodes on CT/ultrasound.  The mainstay treatment is keeping the TSH optimal (around 1.0).   Steroids can help a little.  Usually this gets better with time, occassionally patients may need surgery.  Given all these considerations, it sounds like the thyroid itself does not hurt and it appears that the thyroid is not likely causing the swalloing problem (ie, no indentation of espophagus on barium swallow in area of thyroid).  May be best to take a break from doctors for a while and see if things get better.
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Mark Lupo, M.D.Blank
Thyroid & Endocrine Center of Florida
Sarasota, FL
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