Hoshimoto's long term

[EHL]

I am a 32 yr. old female diagnosed with Hoshimoto's Disease and Hypothyroid 11 years ago.  My TSH levels are normal.  I do have an elevated sed rate.  Have been on synthroid 150 for a long time.
Ultrasound shows thyroid enlarged and some nodules.  Have a catscan scheduled.  I do feel a lump in my throat when I swallow.  
I have two questions:
1) Coincidentally, I have had pain inthe back of my neck (most likely a pinched nerve) - but wanted to see if any pain in the back of the neck has ever been associated with thyroiditis.
2) Assuming that catscan results indicate that the enlarged thyroid is the cause of the "lump feeling" what is the general next steps and how are they administered abd what is the usual route of treatment in cases like this?

Thanks!

[Mark Lupo, M.D.]

back of the neck symptoms are not likely related to thyroiditis

the ct scan may not confirm exactly why you are feeling a 'lump'  -- but will tell you if there is a non-thyroid mass, etc that needs to be considered

The evaluation is to do a FNA biopsy of dominant nodules (these are most likely areas of increased chronic inflammation from hashi) -- but needs to be done to test for cancer.

Then, if the symptoms persist, would see a surgeon to evaluate if the thyroid nodules are the likely cause -- if so, then thyroid is removed surgically.

The sed rate is not usually elevated in Hashimotos of 11 year duration.  If this is related to thyroid, it may be a superimposed thyroiditis -- which would cause a very tender thyroid which would improve in 1-3 months.

[lin_9]

A related discussion, hoshimoto was started.