I hope this helps. My mom had a sub-sternal goiter. The surgeon Dr. told her it was very large. I suggest you talk to a surgeon. I had nodes that were cancer. Both my mom and myself had a total thyroidectomy this year. My sister has a goiter also.
The surgeon said it's not if you will need surgery, it's when. Sounds like yours is already causing you problems. It only gets worse. My mom went hypothyroid and ended up in the ER.
We both had blood tests that showed our thyroids were working. I would save the trip to the Endocrinologist for after you find out about surgery. Get a name from your Dr. for a highly recommended surgeon, one he would go to. It's worth a consult.
Not everyone who has a prominent thyroid has to have it removed. My thyroid was very large and I had multiple nodules when I was first diagnosed with hypothyroidism. I have Hashimoto's, which is what was causing this to happen. The thyroid antibodies have now completely destroyed my thyroid, so it produces nothing. My endo can't even feel it anymore.
Have you had any thyroid blood work done? Not everything can be seen from the ultrasound and CT scans. They won't tell you how much hormones your thyroid is producing. You need to get the Free T3, Free T4 and TSH tests done. You should also ask for thyroid antibody tests to confirm/rule out Hashimoto's. Those tests are Thyroid Peroxidase Antibodies (TPOab) and Thyroglobuliln Antibodies (TGab).
I'd suggest that you go on to the endo and make sure you get the proper testing done. In most cases, TT is not needed. The low density regions are most likely nodules, which many of us have and are usually no cause for concern. A 4 mm nodule is quite small.
Hypothyroidism can cause your thyroid to be swollen and inflamed. It can also cause hoarseness, as well as other symptoms. You may only need replacement medication to alleviate your symptoms.
I have had all the thyroid blood work done. It has all come back with in normal ranges. My primary care doctor says my thyroid is working fine. He also tested for thyroid antibodies and that result was normal aswell.
Was the uptake normal, as well, I take it? Do you have any symptoms of thyroid problems besides the voice and problems swallowing? Also, how long have you been having these problems? I don't think it's a bad idea going to an endocrinologist, and for what it's worth, my thyroid was twice the size it should of been when I had Graves', but I had no cancer-it was just swollen.
Could you post the actual results of the thyroid blood work; often results are in the "normal" range, but they aren't always "normal" for the individual. Be sure to include reference ranges, as well, since reference ranges vary lab to lab.
T4, Free .93 (.82-1.77)
TSH .951 (.450 - 4.50)
Thyro Perox 21 (0-34)
Barb135 is right. Check on your actual test results.
I also forgot to tell you my mom's nodles were about your size, biopsy normal. Dr. could not feel or see her goiter. Her blood tests were normal range. She had the ultra sound and that didn't show it either. One year later while in ER for sleeping to much, in a fog, speech not right they thought it was a Corrated Artery and did a MRI and found the huge goiter. She had TT and did not have cancer. The Dr. said it was very large like a small football. It was shifting her Larynx to the right. Her symptoms for a few years were hard time swallowing (pills, bread), a very dry mouth that made her need water even to talk some of the time, and hoarseness, a lot of weight gain, bulging eyes. But she did live with it and did not know the symptoms were thyroid related.
The uptake was normal for both the 6 and 24 hr. The only other problems I have that the Dr says maybe related is I have lost 8 lbs in 3 weeks. I was having trouble with swallowing and catching my breath so I went to the ER which is when I had the first CT Scan Oct 6th of this year and since then the symptoms have gotten worse. I feel like I have a constant lump in my throat and when I go to bed at night it feels like something is sqeezing my wind pipe.
Hopefully Barb135 can help with test results. You may want to sleep at an angle.
I would think an appointment with the Endo to get a consult would be good.
Have you looked up your diagnosis? Almost sounds like two different problems?
Your FT4 result clearly shows that your thyroid is not functioning optimally. At only 11% of its range, it's not nearly high enough.
Have you had a Free T3? FT3 is the hormone that's actually used by the individual cells; with your FT4 at only 11% of the range, I'd probably expect your FT3 to be equally low. Just because levels are "in range", doesn't mean they are good enough for you. You should ask your doctor for the FT3 test.
Was that a Thyroid Peroxidase test or Thyroid Peroxidase Antibody test? There's a difference and judging from the range, I'm guessing the antibody test. In addition to the TPOab, you also need a Thyroglobulin Antibody (TGab) to rule out Hashimoto's Thyroiditis. Some people only have TPOab, some only have TGab and others have both, so not testing for one of them, leaves a chance for misdiagnosis.
While Hashimoto's is, typically, associated with being hypo, it can be characterized in beginning stages with periods of hyper, as well. With your FT4 as low as it is, I can't really connect your weight loss with it, but some people do lose weight even when hypo.
If your doctor thinks there's a chance you might have Graves Disease, the definitive test for that is Thyroid Stimulating Immunoglobulin (TSI).
Hi, Just checking on you.
Did you decide to see a Endo?
Did you try sleeping at an angle?
Thank you for checking on me. I have been sleeping in a raised postion with my head on extra pillows it has been helping. I am going to see the Endo on Dec 4th since that is his first available appt. My ENT set it up, he said that the nodules are small but being that the lymph nodes are starting to swell he wants the Endo to have a look to see if he believes I should have a biopsy.