Swallowing problem not from thyroid?

[TiredOfDoctors]

Hi...I've had Hashimoto's for approx 6 yrs. Taking Synthroid, last TSH was within normal range (I think .9). About 6 months ago I started to have problems swallowing...felt like food was getting "stuck". Went to family doc, he said my thyroid was enlarged, sent me for an ultrasound. Found one nodule on my left side, and a few very small ones on the right. Family doc then sent me to ENT doc who ordered a CT scan of the neck, showing same results as ultrasound. Since I was still "choking" all the time, was then sent to endo doc...he recommended to have the thyroid removed because it was compressing on my esophagus causing the choking. He sent me to the surgeon who was to remove it...surgeon wanted me to get FNA of the nodule first and see a gastro doc just to rule out any additional problems. FNA was unable to be done due to 2 veins wrapped around nodule. The gastro doc feels that the swallowing problems are due to scar tissue in the esophagus from acid reflux and the thyroid has nothing to do with my complaints. He says my thyroid isn't large enough to cause the compression. He has ordered an EGD (putting a camera down my throat to look around). My concern is that I very rarely get indegestion, so I find it hard to believe that acid reflux could be the cause of my problem. Does anyone know if having the EGD test is a regular test that is performed when a thyroid patient has swallowing problems? My other thyroid related symptoms include fatigue, hair loss, and being cold all the time...I doubt that any of that has anything to do with the swallowing issue though. Thank You!

[gassy]

Yes, I can relate to your swallowing problem as I have had this lump in my throat since June 30/05 and it's still here today Jan.2/06!!
The only thing I have been told that it has nothing to do with my thyroid (I'm Hypo) and that's about it.  I've had ultrasound, neck x-rays, barium swallow and nothing to be found. If you ever get a diagnosis please keep in touch I'm tired of pursuring this as the Dr's think I'm nuts! Good Luck

[mshypo]

I was reading something the other night about suppressive therapy in Hashimoto's...for goiters.  I do know that Armour has worked very well for many of my thyroid forum members to shrink both goiters and nodules.  And it sure sounds like you're still hypo...so I'm wondering if suppressive therapy with Armour Thyroid might help your situation.  Seems like I remember reading that doctors use to use this strategy (shrinking nodules with armour) rather frequently...now it seems they like to take out the thyroid.

[Mark Lupo, M.D.]

There can be silent reflux so the EGD makes sense -- but not from a thyroid standpoint -- if the thyroid is pushing on the esophagus significantly the CT would usually demonstrate that -- if there is still question a barium swallow would show an extrinsic compression and narrowing of the esophagus at the level of the thyroid.  I tend to think the thyroid is not likely cause of the choking.

I don't understand why an FNA cannot be done under ultrasound guidance - usually we can get around any blood vessel.  Check out thyroidologists.com to find an endo specializing in thyroid - most of us do US guided FNA in the office and rarely have i seen a situation where a vessel is in the way.