Hoarse voice and single thyroid nodule increasing in size

[kluesy]

I have been getting hoarse for several months.  I have a single hypoechoic 1cm nodule with vascularity that has increased in length from .5cm to 1cm in four months.  Should I get a biopsy?  My TSH is 0.01 with normal free t-3 and t-4.  I take Nature-throid for thyroid.  Any help would be appreaciated.  One dr told me I am fine.  I have a bad feeling about this,esp since my voice is so rough.

[MANmom]

There is a nerve that runs through your thyroid, the recurrant laryngeal nerve.  It controls vocal function and breathing.  If the nodule is pressing on that nerve, that could be the cause of the hoarseness.  When the doctor removes the thyroid, they have to "peel" the thyroid tissue away from that nerve.  If they damage that nerve during surgery you could have permanent hoarseness or need a tracheostomy the rest of your life.  That is why if you are going to need surgery, you want an experienced surgeon.  If the nodule is pressing on that nerve, that could be the reason you are hoarse.  In regard to a lot of growth, that is considered somewhat fast, they get concerned with fast growth, the type of cancer called anaplastic or metastatic thyroid cancers both grow rapidly. A friend's mom's metastatic thyroid cancer grew big within a couple of days.  Sometimes it depends on who is doing the measurements, some techs and/or doctors measure them differently.  For instance, after my lobectomy where they did find microtumors of cancer, my Endo measured the other nodule and thought it had shrunk...took it out and it was actually the biggest foci of cancer, 1.5 cm.  They just don't know and can't really tell without a good biopsy of removal of the nodule.

[kluesy]

Thanks for your replies.  I did make an appointment in mid May with an endo, so hopefully he will do more testing for me.  The voice continues to be hoarse, with no cold or any reason for it happening.

Is 1/2 cm growth in four months a lot?

Thanks again!

[katbid]

You really should get that nodule checked out.  At least do the biopsy.  Biopsies are not always reliable.  Did you have the uptake scan done?  You probably should get that done so you can see how your thyroid and your nodule is acting.  I can tell you that hypoechoic has a better chance of being cancer.  Also if you get an uptake scan done, you will know if the nodule is cold or hot.  A cold nodule (photopenia) has more chance of being cancer.  I had a 2cm solid hypoechoic nodule that was cold.  I had my thyroid removed and found that I had stage two cancer.  I had papillary in one nodule and follicular varient in the a different nodule.  
I would not just say "your fine" and let it go.  I also had low TSH (just like you).  Are you seeing a GP or an Endo?  I would recommend an Endo that specializes in thyroid.  
To elaborate on the biopsy,  I did not have one done.  My Dr. said that the FNA can be unrealiable because: they would do several sticks into the nodule, but it could totally miss a spot where you may have cancer cells.  I have heard a lot of people having FNA's that say "no cancer" , and then find out later that they did have cancer.  The thyroid is pretty tricky.  
Good luck

[MANmom]

I would see an ENT, it could be thyroid and it could be GERD.  I had hoarseness and nodules, I did have cancer. GERD can cause irritation to your vocal chords, but you need to see an ENT and have him scope your chords.  When he scoped my chords they were fine, even though I did have GERD.  I had a biopsy, they still could not tell if it was cancer.  I am a singer, so hoarseness was not good, so I had 1/2 removed.  Turned out I did have cancer, so I had a TT, then RAI.  Don't ignore it, see an ENT.