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Thyroid nodule and hoarse voice

After having an ultrasound back in December they found a 0.9cm nodule on the right side of my thyroid. All bloodwork has been within normal ranges.

Shortly after the US my voice got hoarse and I thought I was getting a cold. No real cold came and within a week or so my voice was back to normal.

The beginning of January my voice went hoarse again. I didn't think anything of it at first but it hasn't come back.  It started off as gravelly like I was getting a cold, but now it is much more breathy and raspy and it's sometimes hard to talk.

Last week I noticed that when the nodule is compressed (when I turn to the right to speak or press lightly on the nodule) my voice is completely normal but as soon as I release the pressure it goes back to being raspy and hard to talk.

I saw the Endocrinologist just before my voice went in january and then again in february. Said the nodule was too small to interfere with my voice. said to follow up in a year.

Endo referred me to an ENT who I saw at the end of January. He said that even though I don't have any symptoms of reflux that I have reflux. Said other than that he "sees no reason for my vocie".

I have now met with a neurologist who has sent me for a head MRI (done last week) and a neck MRI (happening next week).

As I wait for results I'm wondering if anyone else with a nodule that was deemed not suspicious has had similar voice problems?

Any advice? I'm a teacher and would REALLY like my voice back.
(I have been off on medical leave since the beginning of March. We thought that vocal rest would bring my voice back but so far no luck. I am scheduled to go back to work on the 23rd of April and I still have no real voice)

3 Responses
649848 tn?1534633700
Nodules can cause hoarseness, as can hypothyroidism.  Have your thyroid hormone levels been tested?  If so, what were your actual levels of Free T4 and Free T3?  Please post reference ranges with any lab results as ranges vary lab to lab and have to come from your own report(s).

In addition to hypothyroidism, nodules can press on the vocal cords and they can't always tell that unless they've actually gone and looked.  Don't let them just say "the nodule isn't large enough" because it doesn't take a large nodule to cause trouble.  

You always have the option of getting a second opinion and should exercise that option whenever you don't feel comfortable.  

The head/neck MRIs might show something, but if you've had thyroid blood labs, we could start there for now.
Thank you for your response. I am asking my doctor today for a new ENT referral. I am also trying to remember to be the squeaky wheel, since being quiet doesn't solve anything. Luckily I have a good rapport with my primary care physician.

I has my thyroid levels tested twice. The first time just my TSH levels were checked and were 1.23 (range of 0.32-4.00).
Second time my TSH was 0.9
T4 - 12 (normal range 9-19)
T3 -4.6 (normal range 3.1-6.2)
649848 tn?1534633700
How long ago did you have those thyroid levels tested?  Were the T4 and T3 Free T4 and Free T3 or are they Total T4 and Total T3?  If it doesn't specify on the lab report they will be Total T4 and Total T3, which are considered obsolete.  Ask your doctor to test Free T4 and Free T3...

Sometimes it works to be the greasy wheel; sometimes not.  

You could have acid reflux; that's a classic symptom of hypothyroidism.  What treatment was recommended?
Acid reflux has been ruled out. Had a chest x ray and the upper GI test which both came back clear. I have also has 2 ultra sounds. Neck MRI is next week.

The T3 and T4 were free. I was tested back in february for those. My voice was hoarse at the time of testing.
649848 tn?1534633700
Free T4 and Free T3 were far from optimal when you had the tests done in Feb.  Most of us find that we feel best with Free T4 about the midrange point and Free T3 in the upper half to upper third of its range... Your Free T4 is only at 30% of its range and your Free T3 is only at 48% of range.  In my opinion, you could well be having hypo symptoms even though your levels are well within the normal ranges.  This is not unusual at all.

The problem is going to be getting a doctor to start any kind of treatment, especially. with your TSH where it is.

You can try talking to your doctor about this, though and see if you get anywhere.
I appreciate all of your help. I tried to self advocate with the endocrinologist but he seemed to focus soley on bloodwork results. When I mentioned some of the hypo symptoms that I have now and have had for years, he just seemed to dismiss it. He had the paperwork for the annual follow up printed before I was even done talking. I'm finding that my primary care physician tends to defer to what the endo said whenever I bring anything like that up.  Needless to say I'm getting frustrated.

Saw my primary care doc today. I found out (on my own) that if I use the KT tape for athletes on my neck then my voice is normal. This is our temporary fix until the results of the MRI come in
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