Thyroid Enlargement and Throat Discomfort: What to Know

Q: Thyroid Enlargement and Throat Discomfort: What to Know

Hello： The sensation of a lump in the throat is commonly associated with chronic pharyngitis. <br>It is advisable to consult an otolaryngologist to check for any issues in the pharynx. <br>If there are no problems, most of the foreign body sensation is related to gastroesophageal

Thyroid enlargement with a sensation of throat tightness?

Hello Doctor, I have been feeling a persistent sensation of something stuck in my throat for a long time, but in the past month, the discomfort has become particularly pronounced, and I have also experienced some hoarseness.
About a month ago, I underwent an upper gastrointestinal endoscopy, which revealed mild gastroesophageal reflux, but no other abnormalities were found.
Recently, during a health check-up, the doctor noted that there was a lump in my thyroid upon examination, and the blood test results indicated that my T3 levels were low.
I am very worried, so the next day I went to a clinic for a thyroid ultrasound.
The doctor said there was nothing abnormal, just that my neck was a bit enlarged, and that the low T3 levels were not a significant concern.
Since the ultrasound showed no abnormalities in the thyroid, I am still feeling a very noticeable sensation of something stuck in my throat, which is quite uncomfortable.

Could you please tell me if a thyroid ultrasound can be inaccurate? Did the upper gastrointestinal endoscopy also assess the larynx and hypopharynx? I am feeling mentally and physically exhausted, and I am worried about my health, especially since I just gave birth three months ago.
I am afraid that I might have some illness.
Could you please advise me on what other specialties I should consult for further examination? Thank you.

Ms. Lin, 40~49 year old female. Ask Date: 2019/01/17

Dr. Zheng Jueyi reply Otolaryngology

Hello: The sensation of a lump in the throat is commonly associated with chronic pharyngitis.
It is advisable to consult an otolaryngologist to check for any issues in the pharynx.
If there are no problems, most of the foreign body sensation is related to gastroesophageal reflux disease (GERD), and it is recommended to continue managing GERD with a gastroenterologist.
As for the ultrasound examination of the thyroid showing no abnormalities, you can be reassured and simply monitor the situation.
Wishing you peace and good health.
Sincerely, Dr.
Cheng Jue-Yi, Director of the Department of Otolaryngology, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2019/01/17

More Info

Understanding thyroid enlargement and throat discomfort can be quite complex, especially when symptoms like a sensation of something stuck in the throat, hoarseness, and concerns about thyroid function arise. Your situation involves several important aspects that need to be addressed.

Firstly, it’s essential to understand that the thyroid gland, located in the neck, can become enlarged due to various reasons, including autoimmune diseases (like Hashimoto's thyroiditis), iodine deficiency, or even nodular growths. In your case, the ultrasound indicated that there are no nodules, but the thyroid is slightly enlarged, which is often referred to as a diffuse goiter. This enlargement can sometimes cause discomfort or a sensation of pressure in the throat, leading to symptoms like the feeling of something being stuck in the throat (often described as "globus sensation").

The low T3 level you mentioned is also significant. T3 (triiodothyronine) is one of the hormones produced by the thyroid gland, and low levels can indicate that the thyroid is not functioning optimally. However, it’s important to note that thyroid function tests should be interpreted in conjunction with clinical symptoms and other tests. The fact that your doctor found no nodules on the ultrasound is reassuring, but it’s understandable that you are still concerned about your symptoms.

Regarding your throat discomfort, it’s possible that the sensation you are experiencing could be related to several factors. Since you mentioned having gastroesophageal reflux disease (GERD), the acid reflux can irritate the throat and lead to symptoms like hoarseness and a feeling of tightness or discomfort. The esophagus and throat are closely linked, and issues in one area can often manifest symptoms in the other.

As for your concerns about the accuracy of the ultrasound, while no test is perfect, thyroid ultrasounds are generally reliable for detecting nodules and assessing the size of the thyroid gland. If the ultrasound did not show any abnormalities, it is less likely that there is a significant issue with the thyroid itself. However, if your symptoms persist or worsen, it may be worth discussing further evaluations with your healthcare provider.

Given that you recently gave birth, hormonal changes can also play a role in how you feel physically and emotionally. Postpartum thyroiditis, which can occur after childbirth, may lead to fluctuations in thyroid hormone levels and could contribute to your symptoms. It might be beneficial to have your thyroid function monitored over time, especially since you are experiencing symptoms that are affecting your quality of life.

In terms of next steps, I recommend the following:
1. Follow-Up with an Endocrinologist: Since you have concerns about your thyroid function, it would be prudent to consult an endocrinologist who specializes in thyroid disorders. They can provide a more detailed evaluation of your thyroid function and consider additional tests if necessary.

2. Gastroenterology Consultation: Since you have a history of gastroesophageal reflux, a follow-up with a gastroenterologist may help address your throat discomfort. They can assess whether your reflux is adequately managed and if it could be contributing to your symptoms.

3. Voice Evaluation: If hoarseness persists, a consultation with an otolaryngologist (ENT specialist) may be beneficial. They can evaluate your throat and vocal cords to rule out any other potential issues.

4. Monitor Symptoms: Keep a diary of your symptoms, noting when they occur and any potential triggers. This information can be helpful for your healthcare providers in determining the best course of action.

5. Mental Health Support: Given the stress of new motherhood and health concerns, consider seeking support for your mental well-being. Stress and anxiety can exacerbate physical symptoms, so addressing these aspects is crucial.

In summary, while your thyroid ultrasound results are reassuring, your symptoms warrant further investigation. Collaborating with specialists in endocrinology and gastroenterology will provide a comprehensive approach to your health concerns. Remember, it’s essential to communicate openly with your healthcare providers about your symptoms and any worries you may have.

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