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What now? for enlarged thyroid with cysts
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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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What now? for enlarged thyroid with cysts

I found out a month ago that I have an enlarged thyroid with multiple cysts that measure 5 mm.  
All of my bloodwork (Free Thyroxin, Sensitive TSH, Anti-thyroid Microsomal,
Thyroglobulin, TSI) has come back within normal ranges.  I had a thyroid scan and uptake done and there appeared no hot or cold spots.  Although the uptake did reveal high numbers and they asked me to come back in 24 hours to repeat that and it was still high.  I am not on any medications because my Endo says that I don't need any.  I have had trouble swallowing and had felt like someone was choking me with their thumb stuck in the open part of my neck on occasion, but it comes and goes.  My neck hurts every now and then too, but it also comes and goes.  When I have neck pain, there is a gland under my chin that is swollen.
My questions are this:
   1.  Should anything be done about my enlarged thyroid because it has cysts on it?

    2.  Is it normal to have the choking/difficulty swallowing and neck pain that comes and goes?

  Any info on this would be greatly appreciated.
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The cysts are fairly common and based on the description (up to 5mm) - do not need FNA biopsy.  

The labs are normal.  The scan did not add anything to the evaluation.

At this point, the question is whether or not the thyroid overall is enlarged to the point it is causing symptoms.  The other question would be the unlikely chance of iodine deficiency - can test urine iodine to determine this.  If deficient, iodine supplementation (150mcg  / day for example) may be helpful.
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Because I have choking episodes and a catch in my throat at times, my Endo is sending me to have an esophageal done.  He is also sending me to an ENT Dr too for some reason.  I relayed to the Endo that I have also had a stomach ache every time I eat and am losing weight because I am not eating well.  I also have shorness of breath over doing the smallest task.  I have to sit and rest frequently if I am going to pick up toys or things like that.  So, he also wants to send me to have an upper endoscopy done after I see the ENT.  Is this all really necessary?  Will the esophageal really show up a problem if I am not having one of my choking episodes?  I am so afraid that everyone is going to look at me like I'm an idiot if they don't find anything wrong with me.  
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WOW, I thought I was beginning to lose my mind but have many of the same symptoms.  I'm a 50 yr old female also dx'd with fibromyalgia but the feeling a having a too tight neckline on and swollen painful thyroid had me at my internist who did bloodwork and sent me to ENT.  Now the symptoms come and go but supposedly all my results are normal:  US results say right lobe is larger than left right-5.3 X1.3 X 2.2cm left-3.4 X0.8 X 1.9cm.  Two nodules are seen in each lobe of the thyroid, the largest is seen on the right measuring 1cm in greatest diameter.  The isthmus is not thickened, measuring 1.6 mm in thickness.  Opinion: right lobe of thyroid larger than left, 2 nodules noted in each lobe of the thyroid, possibly representing multinodular goiter.  Blood results show T4, free - 1.5.  Thyroglobulin antibodies <20 and TSH, 3rd generation - reference range.  ENT says follow up US in 4 months but this is not causing my current symptoms.  I haven't a clue as to what should follow now, Can anybody help???  Thanks bunches
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Thyroid & Endocrine Center of Florida
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