loss of singing voice, have thyroid nodules

[artfemme]

Because of my low TSH, I was told I didn't have a thyroid problem for a long time, to the point that my voice was so hoarse I could barely talk on the phone. This was ignored as a symptom, even after an ultrasound showed I had nodules on both lobes. They are deemed benign by ultrasound and have reduced under thyroid medication, even before I was on the proper doses. I haven't had a scan in about a year (had three, a year apart each) and they have never been biopsied. I do not have elevated Hashi's antibodies.

The hoarseness in my speaking voice went away fairly rapidly once I was on T3 as well as T4, but where I once had perfect pitch and was told I had a lovely singing voice, now I have  a rasp at the high and low ends, lack of octave range, and my pitch is off. I thought once I got my FREE levels up where they needed to be, this would go away but sadly it has not. I feel like I'm missing a limb, as singing is something I've done since I was old enough to speak. I miss it.

Has anyone else had this experience ? Were you able to correct it ?

Thanks

[Barb135]

Usually, if the nodules are going to affect your voice, it will become more hoarse.  

Thyroid nodules are quite common and are usually nothing to worry about, unless they have unusual characteristics or they change. Have you been diagnosed with Hashimoto's?  

Have you had thyroid blood tests done?  Those should include TSH, Free T3 and Free T4.  You should also have antibody tests done.

[RimBass]

I have just had my ultrasounds this morning after a doctor asked me to take them, and it turned out I do have a thyroid gland and nodules on both lobes.
Other than this, I sing very often but I have always experienced a lack of range, I don't know if this has something to do with it and I hope that any treatment will not effect my voice since singing is something I have been doing since a very early age. Any ideas?

[Barb135]

The growths I had on my vocal cords were not attached to, nor did they come from my thyroid - totally unrelated.

The growths were so large that instead of my vocal cords vibrating when I talked, the only sound came from the growths vibrating.  Of course, it took many years to build up to the point where I could barely speak.  They were NOT cancer.

In MY case, part of the reason for the growths was irritation from smoking, but GERD/acid reflux was a major contributor, also.  I had severe acid reflux for 15-20 yrs before I was dx'd hypo/Hashi; always on very strong medication for it.

My pcp became concerned about my voice, because it was getting harder and harder to talk.  He sent me to an ENT, who did tests, and determined the cause of my voice issue........ the growth on my vocal cords.  I quit smoking, then had 2 surgeries to remove the growths and my voice is now very clear.  I've never been able to carry a tune, so I don't sing (except in the shower), but at least I can talk (and be heard) without pain.

I do put the GERD, at least partially, down to my thyroid, since I rarely have it, since my thyroid levels have come up.  That's not to say it's 100% gone, because I do still get it, on occasion.

[artfemme]

Dear Barb,

I can't blame this on smoking, never really smoked. I get respiratory diseases all the time though, and this has been going on ever since before I was found to have nodules and low circulating hormone levels. So I cough, sometimes really hard for months at a time. The latest bout was determined to be a pseudomonas infection and I was sick for over two months....who gets that ? I somehow feel it must be related to my thyroid but doctors just look at me like I'm crazy when I ask if that's possible. Maybe my vocal chords are shredded from that.

When you say "excess growth on your vocal chords", do you mean separate from any kind of impingement from the thyroid itself ? Did you do anything about the excess growth ? what kind of doctor diagnosed that ?

I was told I had GERD back in 2007 or 2008 when I was battling to be put on thyroid medication...low TSH was enough for them to say I didn't need any. I was told I had a slight amount of esophageal erosion. Before I was on dual thyroid meds, my stomach was so distended I looked 7 months pregnant. I had many symptoms of myxedma. But that went away rather dramatically following taking T4 and T3. But  I have had a spastic stomach for years, which causes the  iliocical valve to stick open and a hiatal hernia. It is caused by a related spasm in the psoas muscles and I have to have it fixed by the kinesiologist. In the last two weeks I've had a re-occurence for the first time in years and though I went and had it adjusted, it came right back. I was relating it to stress. Perhaps it is thyroid. I'm on my 4th (!!) round of antibiotics because I have yet another bacterial infection, a different one, and I think those plus the inhaled steroids I was on for two months (which didn't even help me) my have thrown my thyroid medication off.

I had labs drawn last week because even though I seemed finally stable on my thyroid meds since April or so  in terms of maintaining FREE levels and cessation of gross symptoms like depression, blurry vision, low attention span, dramatic hair fall, etc. I am experiencing what might be a return of symptoms. I haven't had elevated Hashimoto's markers in the past. I'm very discouraged. I was hoping that once my FREE levels were in the upper levels of the normal ranges, the few lingering symptoms such as the excess weight and  edema would go away. That didn't happen, and now painful dry skin has returned in spades. And I REALLY thought once the hoarseness went away (which it did fairly quickly once I added T3) and once the nodules shrank, that my singing voice would return. Alas. I have never been able to find an endocrinologist in LA who doesn't want to fight with me about T3, and my PCP is out of her depth. I've spent SO much money trying to get well, I don't really know where to turn or what kind of doctor to consult any more. Exhausting.

[Barb135]

At one point, my voice became so hoarse, I could barely make sound, and when I did, it was very painful and I got to the point where I only spoke when necessary (I might note that some people preferred this...... lol).  It turned out to be excess growth on my vocal cords.  

In my case, a lot of that was caused by smoking (no longer do), but a good share of it was caused by GERD, which I later learned was thyroid related.

[Barb135]

Many of us (including  myself) have nodules on our thyroid that are of no concern, so long as their characteristics are not out of the ordinary. It's the characteristics of the nodules that determine whether or not they may be malignant. These characteristics show up on ultra sound, but of course, are not conclusive.

Nodules showing microcalcification, vascularity, irregular borders, etc are more likely to be cancer. These characteristics can be determined via ultra sound.  Once a nodule is discovered that doesn't meet the characteristics of a benign nodule, an FNA/biopsy must be performed in order to definitively determine whether or not cancer is present, and even then, it can be inconclusive.

[artfemme]

While I appreciate your responding to my question, it is in fact not true that nodules cannot be diagnosed as benign by ultrasound, and in fact many feel that invasive needle aspiration or biopsy is often over-prescribed. Most thyroid nodules are in fact benign and increasingly common in the wider population. Nodules have a variety of specific properties and the ones that are usually benign are identifiable as to pattern. Of course if the thyroid is grossly swollen or causing pain, or had there been a highly elevated TSH accompanying them, or a blood test with cancer markers, a doctor might want to explore further, but that was not the case with me. The fact that thyroid medication alone caused them to shrink was another indication that it was not necessary for me.  Here is a paper on the subject that you might find interesting.

http://www.ajronline.org/content/193/1/207.full

[5higgins]

I don't know a lot about thryoid function problems, other on here are very knowledgeable though.  There is no way, however, that any dr. can tell benign or malignant nodules just on ultrasound, they have to be biopsied for that and then sometimes that isn't conclusive either.  I'd find another dr. if possible, an endocrinologist.