Should I have goiter surgery?

Today I went to one ENT surgeon and will go to another on Aug 7th. I am not happy with taking out my thyroid because it is functional but it has been enlarged with one bug nodule on my left lobe for a few years now and is feeling like its compressing. All my levels of hormones have been normal all along but now because of its size is competing for space in my throat. I was just told I have a small nodule on my vocal cord making my voice raspy and the ENT doesn’t think my goiter is contributing to my voice change. They all have been saying for years to remove the goiter because of the size even though there isn’t any cancer present (did all the tests) but I have chosen to monitor it with sonograms and leave it until now. I have some symptoms recently complicating my breathing and swallowing. I am at a crossroad and can't ignore this because I feel it in my throat now but because my TSH, T3 and T4 levels are normal I don't want to remove it. Not sure if I should remove the entire thyroid or half of it if I decide to have the surgery because there is no way of telling what will happen in the future. I am scared to change up my hormone levels with meds because I am also in Menopause. I am not on any meds for anything and feel great but my throat is tight now with the goiter being over 4 cm. I have another surgeon appt. and will have to make a decision within a few weeks. Anyone care to share their surgery story of partial or total removal of their thyroid with me? Anyone successful in shrinking a large goiter? Please feel free to advise. I really feel like I am dammed if I do and dammed if I don’t. Thanks.

[898_1]

Colloid filled nodules are treated with PEI, however if nodule is calcified PEI will not help.

[ddisthe1]

Thank you for your response. My reports says it is a large complex nodule involving most of the left lobe measuring 4.2 x 1.9 x 2.9 and has not changed since prior studies done each year dating back from 2009. No other discrete thyroid nodules or intrathyroidal calcifications. Should I ask the ENT about PEI treatment? I need to look it up before I go to get a better understanding of what it is. Do you think based on that explaination it should be removed?

[Brucergoldberg]

In my opinion - if you have hashimotos - have the whole thing taken out.   You will probably need to have the rest of it removed at some point.   I debated about having mine half taken out or whole.  I had a sonogram done that showed the destruction and what was causing all my pain.   Then i debated half or whole over and over......

then i went back to the dr. 3 months later my original debate started and she did another sonogram that showed more destruction on the "good side"  so just in the 3 months it showed that there was even more destruction.

The surgery is painless for the most part, quick recovery.  You might be able to balance easier with hormones with the whole thing gone as well instead of having the partially diseased thyroid battling with the hormone replacement.   Good vs evil LOL

also fyi - there is another board that is specific to thyroid surgery if you have interest in interacting with others who went through what you (and i ) went through specific to your debate, shoot me a PM and ill send you over there to pick some brains.

[RachealMarie23]

If you do decide to have the left side removed, there is a good chance another goiter will form on the right side. It is a risk you take. In 2005 I had a very large goiter on the left side of my thyroid and had it removed. The surgeon decided to leave the healthy tissue on the right side since I was only 25 at the time. In 2009 nodules started forming on the right side. During the 4 years with only half of my thyroid, my TSH, T3 & T4 levels were fine. Up until this year we monitored the growth until it was too large and bothersome. It gave me discomfort and I waited as long as I could.
I am now 5 weeks 4 days in recovery from total thyroidectomy.
I have to say the first 3 weeks were rough as hell but I am feeling pretty normal now. I am on 100 mcg of Levothyroxine "Synthroid". I take it like clockwork every morning at 7am.
I have noticed some weight gain and dryer skin, but other than that I feel ok. Oh, on top of the surgery June 13, I had my right ovary removed due to a very large dermoid cyst - exactly 3 months before the thyroid surgery. My hormones were so out of whack!
Most of the life stories I have read on living without a thyroid have all been so negative. I was terrified. But I want you to know that it is not like that for everyone! There is hope of living a normal and happy life! It's all in your attitude & how well you take care of yourself! =)
God bless & I hope all goes well!

[ddisthe1]

Thanks for sharing your story. I do not have hashimotos or anything else other than a gioter with my TSH, T3 and T4  levels being normal. I now have a very small nodule on my right vocal cord which is the real reason my voice is changing as per the ENT. Will see another doctor next week to discuss everything.

[ddisthe1]

I appreciate your feedback and suggestions.

[goitreinfo]

I have a similar situation as yourself.  I found a lump 19 years ago and the specialist told me I should have it taken out.  When I found out that I would be on medication for the rest of my life, I was more that hesitant.  Every couple of years I have had it checked and all is normal but over the years, the Multinodular Goitre has grown and is now a similar size to yours.  I also have normal Thyroid functions.  I am interested to know what you decided at your appointment on the 7th August.  I have had almost 20 good years since first being told to have it taken out (I have been told by numberours surgeons over the years the same thing) without medication but feeling that my time is coming closer.  Good luck...

[Barb135]

A goiter is a swollen, inflamed thyroid.  A nodule is a growth on the thyroid.

While you will hear horror stories about thyroid removal, rest assured that having your thyroid removed is not really a whole lot different from those us, whose thyroids were destroyed by autoimmune disease.  

Once the surgery is done, the most important thing is to find a doctor who will test and treat the resulting hypothyroidism, adequately, according to symptoms, not just labs.

[898_1]

Most nodules treated by PEI (ethanol injection therapy) are smaller than yours 2...2.5cm in diameter, but you still need to explore this option with the specialist who is familiar with procedure. Benign follicular nodules tend to grow in other side of thyroid, but most colloid nodules are removed only due to  cosmetic reason or mechanical obstruction.
Best!

[ettevyva]

There are natural and safer ways to shrink goiters and nodules.   Low Dose Naltrexone shrunk my nodules.  The only time someone should have their thyroid removed is if it is cancerous, and then save as much as you can.  Once you have it removed, there is no healing it, and you will be permanently hypothyroid with medication the rest of your life.  I healed mine with help from the book "Hope For Hashimoto".  Never make such an important decision without research and finding a doctor that can save it.

[tammy88ptl]

you sound very experienced in all this thyroid stuff., I have hashimottos/ hasitoxicosis., took me three opinions to get that plus me being my own investigatorin all this! I had a thyroid uptake scan , diagnosed with multi toxic hotspot nodule/goiters GRAVES.., I didn't agree at all went 100 miles to get another opinion just to go back to same ENDO office I began in but with the MD and not the PA who then agrees yes I have hashimottos thyroiditis he ended up just giving me the same treatment RAI December 17th but never tested my levels again b4 the the treatment to see where I was over a month after the wrong diagnosis of graves... ugh.., I kept telling these drs that I have and had symptoms of both for a very long time.., so confusing. I am only 30 but felt like I walked out of a prison cell sick irritable insomnia hot cold on and on and on...... should I just have them kill the rest of my thyroid like I wanted from the beginning???? DR swears I will eventually be normal thyroid but then ultimately go hypo so watch for signs... the radiologist swears what he gave me in those two capsules (RAI) will destroy whole thyroid gland and if not which is rare 6 months later another dose is appropriate to destroy it all..?? so one dr/PA has one set of percentages., another ENDO., MD  has another set of percentages compared to the RADIOLIGISTS percentage rates of the RAI that I received WOW this is awfull but atleast I know im not mentally ill like I was misdiagnosed and wrongly medicated for over half my  life so I am in a better place now than b4 but still way confused on how im going to feel one moment,hour day to the next...???  

[tammy88ptl]

wow you seem very optimistic about all this thyroid stuff? I am still really confused I am 30 with a diagnosis of hashimottos thyroiditis / hashitoxicosis! I cant stand it never knowing how I am going to feel one moment or hour or day or month or year to the next now that ive had a thyroid uptake scan then RAI December 17th 2012 and looking over my whole life and not even knowing who I am, I was unfortunately misdiagnosed as mentally ill for over half my life to the point I will say I am allergic to all antidepressents antiphyscotics and mood stablizers except benzos., they all did nothing or made me worse!!! I guess it upsets me mostly cuz of my children they have had to suffer through all of this and still are they don't know me and the older ones just think drs don't know what they are doing and mommy will always be sick in some way or another.. =( I always tell them it will get better there has to be a reason I was lucky to catch it at age 30 still young lol.. most likely will have a hysterectomy within the next few months also so the hormone thing I get maybe or someday I will have a lot of experience with all this and can help others. its nice to see some optimistic=)

[georgiasue552]

I have a similar thyroid problem to yours.  My thyroid levels were normal
so I ignored the large glands.  However last year I had a thryoid test and
the goiter was 3.3 and last month in the test is was 4.3 so it is getting larger and doctor thinks I should have it removed.  I have trouble breathing at night sometimes and a choking sensation too.  The surgeon wants to
remove the whole thyroid and then I would be on thyroid medicine for life which upsets me too.  I am going to talk to my surgeon in a couple of weeks with lot sof questions.  Mainly the necessity of removing the whole
thyoid - I believe it is because if you don't more goiters will grow on what
is left of thyroid.

I am going to ask also about weight gain and other problems.  I am 64 now
and very healthy but I dont think i should wait ten more years when I might not be.  I mainly don't want to have trouble breathing.  the GOOD news is that this surgery is one of the less risky - only 2 % of people having this surgery have complications.  

Let me know if you have any questions you might want me to ask and will let you know how my surgery goes.  It takes 3 hours I am told and one night in the hospital.  I am scared of having surgery AT ALL but i am also
sure that the growth will only get bigger and constrict my airway.more.