Hypothyroidism, Thyroid Nodules, and Throat Discomfort

Hypothyroidism, thyroid nodules, and the sensation of a foreign body in the throat?

Hello Doctor: I would like to inquire about my health.
During my health check-up in October 2019, I was diagnosed with hypothyroidism and thyroid nodules: A) 0.3 x 0.4 cm, B) 0.2 x 0.4 cm, C) 0.5 x 0.8 cm (suspected).
I started treatment with Levothyroxine that same month, currently taking 100 mcg daily.
Additionally, I have elevated cholesterol levels at 337 mg/dL, but my TSH levels have consistently exceeded the normal range in blood tests every three months.
In July 2021, my TSH was 5.84, and my cholesterol levels were slightly above the upper limit of normal at 117-131 mg/dL.

For the past six months, I have experienced a persistent sensation of a foreign body in my throat, hoarseness, and lymphadenopathy.
I consulted an ENT specialist, but there has been no improvement.
In April 2021, I had another ultrasound, which showed thyroid nodules: A) 0.3 x 0.7 cm, B) 0.3 x 0.6 cm, C) 0.3 x 0.5 cm, D) 0.6 x 1.1 cm (suspected).
My prolactin levels have also been gradually increasing, from 29.12 ng/mL in 2020 to 33.68 ng/mL in July 2021.
I would like to ask if there is a correlation between my thyroid condition and my throat issues.
Despite being on medication for some time, I have not seen any improvement.
Do you have any recommendations regarding the thyroid nodules?

IRENE, 40~49 year old female. Ask Date: 2021/08/16

Dr. Yuan Tianmin reply Breast and Thyroid

If you have already been undergoing follow-up examinations for your thyroid at a specialized clinic, you should ask your attending physician about your current condition, as they will have a better understanding of your situation than I do.

Reply Date: 2021/08/16

More Info

Hypothyroidism, thyroid nodules, and throat discomfort can indeed be interconnected, and understanding these relationships is crucial for effective management and treatment.
Hypothyroidism occurs when the thyroid gland does not produce enough thyroid hormones, which can lead to various symptoms, including fatigue, weight gain, and sensitivity to cold. In your case, the diagnosis of hypothyroidism was made during a health check-up, and you have been prescribed Levothyroxine (昂特欣) at a dosage of 100 mcg daily. This medication is typically used to replace or supplement the thyroid hormone, helping to normalize TSH (Thyroid Stimulating Hormone) levels. However, it seems that despite treatment, your TSH levels remain elevated, indicating that your hypothyroidism may not be adequately controlled.
The presence of thyroid nodules, as you mentioned, adds another layer of complexity. Thyroid nodules are common and can be benign or malignant. The sizes of your nodules (A: 0.3*0.7 cm, B: 0.3*0.6 cm, C: 0.3*0.5 cm, D: 0.6*1.1 cm) suggest that they are relatively small, but the fact that one is suspected (D: 0.6*1.1 cm) warrants careful monitoring. Regular ultrasound evaluations are essential to track any changes in size or characteristics of these nodules.
Your throat discomfort, including the sensation of a foreign body and hoarseness, could be related to several factors. First, the thyroid gland is located in the neck, and any enlargement or nodular growth can exert pressure on surrounding structures, leading to discomfort or changes in voice. Additionally, thyroid dysfunction can sometimes lead to changes in the voice due to muscle weakness or swelling in the throat area.
The persistent lymphadenopathy (swollen lymph nodes) you mentioned could indicate an inflammatory process, possibly related to the thyroid condition or another underlying issue. It is essential to follow up with an ENT specialist, as they can perform a thorough examination and possibly recommend imaging studies or biopsies if necessary to rule out any malignancy or other causes of your symptoms.

Regarding your elevated prolactin levels, it is worth noting that hyperprolactinemia can also cause symptoms such as galactorrhea (milk production) and menstrual irregularities. Elevated prolactin can be caused by various factors, including stress, medications, and pituitary disorders. It is advisable to discuss these findings with your healthcare provider, as they may require further evaluation.

In summary, the relationship between your hypothyroidism, thyroid nodules, and throat discomfort is complex. It is crucial to ensure that your thyroid hormone levels are adequately managed, monitor the nodules for any changes, and address the throat symptoms with appropriate specialists. Regular follow-ups and communication with your healthcare team will be essential in managing your condition effectively. If your symptoms persist or worsen, do not hesitate to seek further medical advice.

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