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Bilateral Multinodular Goiter/Hyperthyroidism
So, I'll be as specific as I can be.
30 y/o. Male.
About a year ago, while going through a tremendously stressful personal situation, I developed a rubbery feeling around my throat which felt as if I was wearing a collar of sorts. I found it hard to breath, though there wasnt any real trouble with lung capacity or the like. It felt as if someone was sitting on my upper chest at times. There was also a feeling of intense brain fog that arose concurrently, as well as a constant need to clear my throat as if there was something (a lump) in it. I had also lost between 5 and 10% of my body weight. My muscles in my upper body and gluts seemed to be disappearing, particularly my deltoids and shoulders. My usually low bp and pulse would skyrocket (resting 95-105 bpm, 145/85) and quickly decrease. After about a month the rubbery collar feeling began to disappear. About that same time, I noticed a easily visible peas-sized hard lump fixed to the midline of my trachea just above my collarbone. This is when I decided to go to my PCP.
My PCP basically told me that the lump was not large enough to be of concern. He suggested that I have a Serotonin Imbalance and strongly suggested I pursue that. He ordered bloodwork including CBC w/diff, hepatic function, Basic Metabolic Panel, and a one-time TSH and Thyroxine reading. He said that there was nothing of concern in any of the results and that I was fine. However, when I looked at the report, my glucose was 103. Just for reference, my TSH was 1.63 and my throxine was 8.9. (cont)
30 y/o. Male.
About a year ago, while going through a tremendously stressful personal situation, I developed a rubbery feeling around my throat which felt as if I was wearing a collar of sorts. I found it hard to breath, though there wasnt any real trouble with lung capacity or the like. It felt as if someone was sitting on my upper chest at times. There was also a feeling of intense brain fog that arose concurrently, as well as a constant need to clear my throat as if there was something (a lump) in it. I had also lost between 5 and 10% of my body weight. My muscles in my upper body and gluts seemed to be disappearing, particularly my deltoids and shoulders. My usually low bp and pulse would skyrocket (resting 95-105 bpm, 145/85) and quickly decrease. After about a month the rubbery collar feeling began to disappear. About that same time, I noticed a easily visible peas-sized hard lump fixed to the midline of my trachea just above my collarbone. This is when I decided to go to my PCP.
My PCP basically told me that the lump was not large enough to be of concern. He suggested that I have a Serotonin Imbalance and strongly suggested I pursue that. He ordered bloodwork including CBC w/diff, hepatic function, Basic Metabolic Panel, and a one-time TSH and Thyroxine reading. He said that there was nothing of concern in any of the results and that I was fine. However, when I looked at the report, my glucose was 103. Just for reference, my TSH was 1.63 and my throxine was 8.9. (cont)
Ok. One last follow up. How could i forget the hair loss/dry texture? As well as a feeling of exhaustion, simultaneoulsy combined with endless energy? I can wake up after sleeping 10 hours, and feel like I barely slept. I also up until a few months ago, had pain when swallowing or yawning on the side of my throat which corresponds witht he larger half of my thyroid. ENT found no inflammation in the throat itself.
Really finished now, and I'll await your response. Apologies for the length, but this is the picture you cant paint for the doctor in the 5 mins you have with them.
Really finished now, and I'll await your response. Apologies for the length, but this is the picture you cant paint for the doctor in the 5 mins you have with them.
I am not currently in the position to afford psychiatrist visits or the meds ( been down that road of escalating costs before). However, the twitching has become almost unbearable, accompanied by axillary, pectoral, shoulder pain and feelings of swelling (though there is no swelling) that comes and goes sometimes almost instantaneously. I For a month or so I had terrible stiffness in the tarsal region of one foot. I have also developed hot skin w/o fever (can come and go almost instantaneously), sweaty/rubbery palms and feet, and feelings of adrenaline rushes that can be triggered by the most miniscule stimulus. Recently stopped taking aciphex and fasciculations decreased greatly (id say 90%) though theyre ramping back up again.
I really dont think I'm crazy. Ive lived with depression and anxiety my whole life, and never had any such problems. While I fully accept the ability of the mind to do incredible things to the body, is it possible that all of this is solely due to? After being diagnosed with bilateral multinodular goiter, should more function tests have been ordered? Is it possible that my thyroid hormone levels can fluctuate and were taken at a time (a year ago) when they were closer to normal? I hear that multinodular thyroid can function normally, but am I out of line for thinking that too many nodules to count will have no effect on my thyroid? Hyperthyroidism a possibility? Can the thyroid affect other glands like adrenal glands?
Any insight would be GREATLY appreciated!
I really dont think I'm crazy. Ive lived with depression and anxiety my whole life, and never had any such problems. While I fully accept the ability of the mind to do incredible things to the body, is it possible that all of this is solely due to? After being diagnosed with bilateral multinodular goiter, should more function tests have been ordered? Is it possible that my thyroid hormone levels can fluctuate and were taken at a time (a year ago) when they were closer to normal? I hear that multinodular thyroid can function normally, but am I out of line for thinking that too many nodules to count will have no effect on my thyroid? Hyperthyroidism a possibility? Can the thyroid affect other glands like adrenal glands?
Any insight would be GREATLY appreciated!
MEDICAL PROFESSIONAL
If the TSH is normal, then the generalized symptoms are not likely thyroid.
The nodularity should be followed with ultrasound, but sounds like you have a node/nodule adjacent to the thyroid -- may be best to find an endocrinologist or ENT who does his/her own ultrasound. Thyroid does not usually directly influence adrenal gland.
You may want to see a general endocrinologist for complete thyroid/adrenal/hormone evaluation.
The nodularity should be followed with ultrasound, but sounds like you have a node/nodule adjacent to the thyroid -- may be best to find an endocrinologist or ENT who does his/her own ultrasound. Thyroid does not usually directly influence adrenal gland.
You may want to see a general endocrinologist for complete thyroid/adrenal/hormone evaluation.
Six months passed and I still had a feeling of constriction in my throat. I went back to my PCP and the nurse practitioner found no signs of infection, gave me 2 weeks worth of Aciphex and sent me to an ENT.
The ENT scoped my throat and found swelling below the vocal cords. He also suggested reflux and gave me a six month prescription of Aciphex (twice a day). At that point I showed him the lump on my trachea. He said it was a thyroid nodule and sent me for an ultrasound.
The radio tech was unable to locate the node in question. The radiologist report noted that the node in question was inferior to the thyroid. The report did indicate however that I have a globally enlarged, Bilateral multinodular goiter. Too many nodes to count. A few were approx 1cm in size, and the rest smaller. All complex in nature. Suggested throid function and radioactive iodine tests.
The ENT did not intend on even notifying me of this until my 3 month follow-up. I was beginning to develop significant twitching and odd sensations all over my body. So, I took the report and my labs from my PCP to a new ENT. He ordered a FNA and lymes disease test. The lymes test only came back abnormal for one of the proteins. During the FNA, the radiologist found the original nodule, and suggested that that is what we should be looking at because he couldnt tell if it was on the isthmus or the thyroglossal duct, but it was hypoechoic. He did not aspirate it and instead sampled the largest of the thyroid nodules, which came back negative for cancer. My ENT did not seem to think that the radiologist suggestion held any merit or that having antibodies for a portion of Borrelia cell membrane was indicative of lyme. Nor did he order and more more thyroid fuction tests or iodine uptake tests. He suggested Anxiety and Serotonin imbalance. (cont)
The ENT scoped my throat and found swelling below the vocal cords. He also suggested reflux and gave me a six month prescription of Aciphex (twice a day). At that point I showed him the lump on my trachea. He said it was a thyroid nodule and sent me for an ultrasound.
The radio tech was unable to locate the node in question. The radiologist report noted that the node in question was inferior to the thyroid. The report did indicate however that I have a globally enlarged, Bilateral multinodular goiter. Too many nodes to count. A few were approx 1cm in size, and the rest smaller. All complex in nature. Suggested throid function and radioactive iodine tests.
The ENT did not intend on even notifying me of this until my 3 month follow-up. I was beginning to develop significant twitching and odd sensations all over my body. So, I took the report and my labs from my PCP to a new ENT. He ordered a FNA and lymes disease test. The lymes test only came back abnormal for one of the proteins. During the FNA, the radiologist found the original nodule, and suggested that that is what we should be looking at because he couldnt tell if it was on the isthmus or the thyroglossal duct, but it was hypoechoic. He did not aspirate it and instead sampled the largest of the thyroid nodules, which came back negative for cancer. My ENT did not seem to think that the radiologist suggestion held any merit or that having antibodies for a portion of Borrelia cell membrane was indicative of lyme. Nor did he order and more more thyroid fuction tests or iodine uptake tests. He suggested Anxiety and Serotonin imbalance. (cont)
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