solitary nodule

[kcr01]

My mother, father and sister all have/had thyroid disorders. (Father and sister severe hypo, mother had thyrotoxicosis in her late 20s).  I have symptoms of a thyroid disorder but labs have been normal (last TSH was 1.17 in October 2008).  For over a year I have had a feeling of fullness in my throat and my voice gets hoarse now nearly every night.  It doesn't hurt, but it does feel "strained," and I think I'm speaking loudly but the volume of my voice does not get up that high and people have trouble hearing me.  I don't have allergies, and I get acid reflux infrequently, though I am going to look into that as a cause.

My primary sent me for an ultrasound in January - she felt thyroid felt enlarged on physical exam.  She sent me a letter a week later: Ultrasound results showed no enlargement but a small nodule in the lower right pole that shows no characteristics of malignancy.  

She didn't run any new labs and suggested no follow up at all, and I don't know the size of the small nodule, etc.  I'm not concerned that it's cancer or anything because it seems as though she felt it was very small, but could this nodule be causing my worsening voice problems?  Should I at least keep track of it?

[Mark Lupo, M.D.]

Yes, you need to keep track of this.  we usually repeat ultrasound in 6 months to ensure it is stable then every 12-18 months thereafter.  There is no additional blood test that is needed and thyroid medications are not indicated.

If the nodule is >1cm then it needs to be evaluated for possible FNA biopsy.  

[cajuns]

Hi, please dont feel like you are alone in this. I have been for a long time and just found this forum myself.

I just had a ultrasound about a week ago, and other tests results showed that I am hypo. NO one has ever felt my throat at all, and the tech would not give me any answers to the results. It has to be read, then sent to your doctor.  The ultrasound showed that I have two nodules and the dr has ordered a biopsy on mine.(I don NOT trying to scare you) As far as I can understand, and please, I am new at these results, an ultrasound only shows something that is enlarged or is not. I too, have had tests running out of my ears for years now. I have lost my voice several times over the years for no reason. I am NOT saying that the nodule you have is cancer, most are not, but ithe nodule that is there could very well have something to do with you being hoarse. If something is attached to your thyroid, it could very well be the reason you are hoarse. I have been told that, most nodules are non cancerous.
I don't know what your other symptoms are, but mine is like, when I first put something in my mouth to try and eat, the first bite makes my throat hurt a little bit, and have a little trouble swallowing, and have a lot of saliva.  After the first bite, I'm okay. Have you had your antibodies checked on your thyroid? Tsh levels are not enough if you suspect it is your thyroid that is causing your problems.

Even if you have no malignancy, but you have a nodule, that could very well be the root of why your throat is bothering you. Are you on any meds at all? If you are, what kind, and why?

Understand, I am NOT a DR, and I am NOT giving medical advice. I am just giving you my opinion on what MAY be going on, based on what has been going on with me over the years. But again, it may not be.  I know how frustrating this can be. I have, am, going through the same thing. Sad to say, it seems to take a very long time to try and find out what is going on, and if it is thyroid related.