There is something stuck in my throat...

[kittylovesprog]

Let me just start by saying that I am 23 years old and in generally good health despite all of these problems, so age, weight and diabetes are not really factors in what I'm about to share.

So, back in January of 2013 I got a really bad sore throat. I was working a job at a sales company that had me cold calling all day. I took a few days off of work, but not enough to recover, and continued to talk all day anyways. Fast forward to February 14th. My throat still hurts, but it's not as bad as it was. Attempting to boost my immune system I take a B12 vitamin that was tiny, but after swallowing it felt like I was choking on it, like it was stuck in my throat. My mom reluctantly takes me to the ER because I can still breathe and talk, but the panic is overwhelming. They x-Ray it, find nothing, and my mom takes me home before the ER can scope my throat with a camera because it will cost a small fortune despite insurance. I go home and eventually fall asleep.

The next few weeks the feeling doesn't seem to go away, and every time I eat I feel like the food is not going down and I experience more panic attacks. After a month and losing ten lbs from eating nothing but baby food, my mom lets me go to an Ears, Nose, and Throat Specialist. She scopes my throat and sees a white patch of something stuck on the left side of my ventricular folds, but says my vocal cords look okay. Assuming it's a yeast fungus she gives me a steroid and an anti fungal. These relieve the symptoms immensely but the feeling of "something in my throat" never quite goes away. After a few weeks and another scope she says I'm cured and the white patch is gone, but that "stuck" sensation is still there. At least I'm eating again. After another throat scope the doctor says it's just the aftermath of the fungal infection and the feeling should subside after awhile.

Another couple of months go by and I still feel abnormal and some of the irritation is back. The same doctor sends me in for a barium swallow. After the barium swallow she calls me and recommends a voice evaluation. I'm no doctor but I assume that means the barium swallow came up negative. Out of money again I do not go to the voice evaluation.

By now it's July of 2013. I cannot afford the doctor's, and since I can at least eat and talk (despite occasional hoarseness from vocal overuse, the stuck feeling, and pain) I decide to wait it out and see if I can heal on my own.

Fast forward a year or so to October 2014. I still feel the same, but then mysteriously a lot of the mental symptoms start coming back, including panic (nightmares and shakes) and fatigue. I go to an acupuncturist who greatly relieved the mental symptoms and some of the pain, but the "stuck" feeling is still there. She recommended that I also see a traditional MD and request a blood test to look at thyroid function. I follow this advice and the doctor does get results that show that I have some symptoms similar to mild hypothyroidism.

TSH: .84
T4: 1.13
T3: 2.5

He's an integrative health MD, and he determines that I have sub-acute thyroiditis. To boost my thyroid function he puts me on a thyroid support and iodine supplement. After a week of taking the supplements I feel like I am almost cured. Fast forward a few more weeks and while most of the mental symptoms are still gone, I start feeling pain and the "stuck" feeling again. I also still cannot sing or talk too much without going hoarse or making everything worse.

I still don't know what's going on in my throat. I don't know if the fungal  infection just never quite went away and is now affecting my thyroid or what. My aunt whose a nurse also believes that I need to go on oral Nystatin (fungus medicine) and another strong steroid. While my symptoms seem to fit sub-acute thyroiditis, I haven't seen anything that connects sub-acute thyroiditis directly with a fungal infection. Also, for sub-acute thyroiditis this is lasting an incredibly long time. Does anyone know if this is possible, or have any other theories on what could be happening? I want to sing, talk, and feel normal again.

BTW I'm still taking the thyroid supplements and I'm going in for blood work next Monday.

TLDR a year ago I was diagnosed with a fungal infection of the esophagus and a year later symptoms never quite went away and now I am being diagnosed with sub-acute thyroiditis. Are these two illnesses related? Could a return of the fungus be affecting my thyroid function? Are there any other theories of what might be happening to me?

[kittylovesprog]

Thank you, I will

[898_1]

Subacute thyroiditis is often accompanied by normal thyroid levels, unless follicles are damaged and leak hormone into the blood stream.
It is a wild guess, but you should be checked for arthritis of voice box cartilages and /or inflammation of them.this is quite rare condition affecting men in the past, but because many women are now having cartilage to bone transformation in early age (this why many women now having prominent Adam's apples) the inflammation is also possible.
cartilage has no blood supply, so they cannot catch infection; once they are becoming bone (which has blood vessels) infection can develop
A sign of it is increase of calcification build-up in the walls of voice box and thickening of them

[kittylovesprog]

Thanks for a quick response. While becoming anxious tends to make things worse, it doesn't explain the initial pain/hoarseness factor. My cortisole levels are also normal for the most part according to the same labs. Maybe I'm underestimating the role anxiety plays here though....

It's also odd that the onset was something physical... Choking and the white stuff in my throat. No previous problems tho.

Acupuncture does temporarily help.

The first doctor I saw did not specifically test the white patch in my throat. She just assumed a fungal issue. It might have been bacterial.

I have not had an ultrasound or antibody test...

If it's sub acute, it would be strange because I've had it for a year and a half now.

It's possibly I might've gone through a hyper phase back in October but I can't be sure....

TSH : .84
Reference interval: .27-4.2 (normal?)

T4, free (ng/dL): 1.13
Reference interval: .93-1.70 (normal?)

T3, free (pg/mL): 2.5
Reference interval: >19 yrs- 2.0-4.4
The T3 level was circled on my labs by my doc.

I hope this helps :) thanks Barb

[Barb135]

What are the reference ranges for the T3 and T4 and are the Free T3 and Free T4 or are they Total T3 and Total T4?  They aren't the same tests, so it's important to specify.  

Subacute Thyroiditis often follows a viral infection of the upper respiratory system.  I've never heard of it in connection with a fungal infection, though the fungus could actually have been a virus.

"Subacute thyroiditis is a self-limited thyroid condition associated with a triphasic clinical course of hyperthyroidism, hypothyroidism, and return to normal thyroid function."   http://emedicine.medscape.com/article/125648-overview  

I might be tempted to question the diagnosis, since you didn't have a hyper phase.  Additionally, a certain percentage of cases don't return to normal - some become permanently hypo.

Have you had a thyroid ultrasound to determine if you have a goiter or nodules?  You should also have thyroid antibodies tested to determine if you have Hashimoto's Thyroiditis - goiter (swollen, inflamed thyroid) and nodules are very common with Hashimoto's.  The antibody tests you should have are Thyroid Peroxidase Antibodies (TPOab) and Thyroglobulin Antibodies (TgAb).

If your thyroid is swollen and/or inflamed, that can make it feel like there's something stuck in your throat.  Anxiety can also make it feel like there's something stuck in your throat.  Many people think they don't have anxiety, but the simple fact of not knowing what's wrong and fearing that it might be something serious causes anxiety, even if you specifically "feel" it.

I'd recommend an ultrasound and the antibody tests.