Enlarged thyroid, trouble swallowing, weird labs and lots of symptoms. HELP.

[demi1314]

So about 2 week ago I started to randomly aspirate on my own saliva or liquids when I would swallow.  I went to the Dr. and she said it felt that my thyroid was enlarged and that was a nodule or something on the right lobe.  Well, I had my ultrasound today and the lady wouldn't tell me much until it was interpreted... she said my right thyroid measured 18 x 22 x 5 -- I swear she said mm (millimeters) but form my research they mainly measure in cm (centimeters) on ultrasound, so maybe I misheard.  Some of my labs are back and they are as follows:

TSH 0.58 (very low end of normal)
FT4  1.29 (mid-range)
Total T4  5.9 (low)
Free T3 - pending

In addition, I have a ton of weird symptoms like night sweats, fatigue, increased appetite leading to weight gain, difficulty concentrating, etc.  

Can anyone offer their opinion on what they think could be going on?  All I can say is my right lobe looked much different than the left lobe and she seemed to indicate it was much larger than the left (she only gave me measurements of the right).  My mind is scaring me that I have thyroid cancer because my doctor says all my labs are "fine" but I don't feel fine and I can't swallow 1/2 the time without inhaling my drinks or saliva into the "wrong pipe" and then choking and coughing like a crazy person....

Thanks in advance for any help.

[Barb135]

What's reference range for the Free T4?  Reference ranges vary from lab to lab, so it's necessary to post the range with results.  

We can't really offer much in the line of an opinion until we see the FT3 result, along with the ultrasound results, but I can tell you that thyroid cancer is quite rare and wouldn't produce the symptoms you're having. It's not unusual for doctors to say one is "fine", just because labs are within the reference ranges, when they don't feel fine and they really aren't fine.  Doctors have this way of looking at labs and thinking that anything "in range" is good...

It's possible that there's a nodule that's pressing on your throat causing swallowing issues.

I know it seems easy for me to say, but do try not to worry; we'll help you figure it out, as soon as you post the rest of your results with reference ranges.

[demi1314]

Hi Barb,

So sorry for not posting the range.  I will post those now along with my ultrasound results.

TSH 0.58  (0.30 - 4.20)
FT4  1.29  (0.58 - 1.64)
TT4  5.9  L  (6.1 - 12.2)
FT3  3.2  (2.5 - 3.9)

Ultrasound results -- I am scared....

Nodule on Right side is:
2.5cm X 1.7cm X 1.5cm

It is solid and irregular shaped.  Hypoechoic and non - heterogeneous.

The Dr. said her concern is moderate to high and is sending me to have a biopsy ASAP with an endocrinologist.  She said that it is possible it is Hashimoto's and not cancer and that the irregular shape is characteristic of Hashimoto's... but we also know that a solid, hypoechoic and large mass is not a good thing...

[Barb135]

Hi... A lot of people don't realize that ranges vary from lab to lab.

I'm sure you posted it correctly, but can you please verify they Free T4 and Total T4 results and ranges?  Your TT4 is below range and your Free T4 is at 67% of its range.. that's really odd.  Usually, if TT4 is low, FT4 will be, also.

Does the ultrasound report say anything about calcification in the nodule? I agree that biopsy is necessary, but your doctor is right. Nodules are very common with Hashimoto's - I have quite a few of them, myself; my diagnosis, following ultrasound was "Hashimoto's with multi-nodular goiter", confirmed with antibody tests.  Sometimes nodules can be shrunk with thyroid hormone medications... mine were.

Did your doctor order the antibody tests?

Do you know when you'll be having the biopsy?  I know it's hard not to worry and be scared, but please try to relax - yeah, easy for me to say, huh?  No, it really isn't, because I know how you feel.  Please let me know when you're having the biopsy and I'll be here for you to talk to or ask questions.