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Have a lump on thyroid. Not cured by antibiotic. What could be the problem?

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Practicing since : 2001
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I have a lump on my thyroid which started about the size of a half of a ping pong ball now its about the size of half a golf ball. It was hard when small but now as it got bigger it is more mushy with pits in it (I can feel distinct circles like where a pit is). My doctor gave me antibiotics but nothing changed until about 3 days after stopping taking the antibiotics. Just as fast as it grew it shrank and you couldn't see it anymore (took about 2 days to completely shrink) but if you felt my neck if felt like a flat pancake was still in there. About 10 days later it started back up and grew up just like before and now its sticking out the side of my XXXXXXX XXXXXXX again. I take 50mg of Vyvanse and wondering if this is the issue. Been taking it since May and started at 30mg and up 10mg each month till 50mg and now 2 months on 50mg. Is this a thyroid issue or a Vyvanse issue or is one causing the other.
Posted Tue, 9 Oct 2012 in Thyroid Problem and Hormonal Problems
Answered by Dr. Shehzad Topiwala 9 hours later
Vyvanse has not been reported to have any such effect on the thyroid.
There are a few things we need to ascertain here. Is this lump truly in your thyroid? The best way to determine this is to undergo a thyroid ultrasound. Once it is certain that this is indeed a thyroid lump then one of several options exist:
1 Simply monitor because most of these 'nodules' are benign statistically
2 Fine Needle Aspiration biopsy, preferably ultrasound guided
3 Surgery to remove a part or the whole thyroid gland.

There are several factors that suggest the next best step. For example if you have risk factors for thyroid cancer such as a positive family history or radiation exposure to the neck, or a hard rapidly growing neck lump, then a more aggressive approach is justified

However, the final plan is best individualized and that's why I strongly recommend you see a thyroid specialist in person as soon as it is confirmed that this is definitely a thyroid swelling. Some blood tests like TSH are in order too.

For more information please read WWW.WWWW.WW
Above answer was peer-reviewed by
Follow-up: Have a lump on thyroid. Not cured by antibiotic. What could be the problem? 1 hour later
Thanks ... I just have read several forums where people taking Vyvanse say they were told by their doctors that it lowers (sorry don't know the term) but it lowers the output of whatever a thyroid does and they have been put on low dose of medicine. I do not know if its in my thyroid I just am saying that cause its in the same area. But from what I read about Thyroid Cancer and Nodules they are usually hard in touch. And I don't have any other symptoms (no nausea, no tenderness, no sore throat, nothing) its just sitting there. If I didn't see it in the mirror I would not know it was there. But back to the feeling of it. Like I said in the first part when it first came up both first time and second it was hard to the touch but small then stayed that size for a few days then it just doubles in size almost over night but then it is soft and as stated above I can feel definite little circles like there are pits.

The feeling reminds me of when I got bit by a spider on the leg and it grew to about baseball size and was liquidy except for the bite section that was indented where from what I was told where the venom killed the tissue in that spot or something like that. So you could almost push your finger into a circular spot of the wound. They had to cut open, drain and pack then I had to go back a bit after to have the packing taken out.

But this has several spots where I can distinctly feel pits and if I push on the lump itself those pits then grow as if whatever is inside is trying to come out of those spots. I went to my doctor the first time and like I said he gave me antibiotics and said it was just a Absess (which confused me cause I read on WebMD that antibiotics doesn't do anything for an Absess). But since he is a doctor I went with it. But he did say if it was still there in 2 weeks he would get an ultrasound. But now its been over 2 weeks and its a new one or at least the old one starting over so not sure if he will try to give me medication again or go for ultrasound. I have Great Insurance and fine with jumping to ultrasound just to take care of it and peace of mind.

Background on my Doctor Visit: So far many times I have went to him he keeps his back to me and doesn't ask me if I have any symptoms he just literally asked what was wrong and I stated I am just wanted to check this lump out to make sure not cancer. He turned around put his finger on it for literally 2 seconds and turned around and said well I am not going to prick it today just take this 10 days of Antibiotics and come back in 2 weeks if not gone. The two weeks was up on a Thursday and was out of town so planned on going in on Monday but Friday and Saturday it went completely down. Although did not disappear just felt like a deflated balloon or pancake with a thicker wall enough to feel it easy. So since it went down I figured the remaining part would just slowly disappear so didn't go back to doctor. About 10 days later I woke up to it being the small lump again (Hard feel to it) then about 2 days later it jumped double its size just like last time and is now soft with the pits in it again. So its like it just repeated itself. It stays the same size and only grows twice once when starting and hard to the touch then couple days later it doubles and becomes soft. Then last time after almost 2 weeks it just went down almost in 24 hours just completely went down. But even with my Vyvanse my doctor never talks to me more than 5 min and his back is too me while he is on his computer. Just asks how am I and then says well here is your perscription and see you in a month. I just think that is very impersonal and not asking if I have any symptoms or problems just seems he is not interested. I am new here and don't know anyone to ask so what is your recommendation on finding a doctor with better bed side manners and someone who genuinely seems concerned. Luckily I am moving to other side of town next month so I have a good reason to change doctors. When I was in the waiting room the nurse announced peoples names and he always has his appointments in 15 minute intervals and there was two of us scheduled for 8am and 2 there for 815am which tells me he is a revolving door doctor who just wants you in and out and your money. I almost never have any questions and keep it short and simple but I want a doctor to at least ask a couple questions and look at me to show they are truly concerned. Like I said above growing up I was always healthy and never had to go to the doctor so this is new to me. Any suggestions.

Oh and back to your comment just there is no history of Thyroid in my family. And I have been a Customer Service Rep for 20 years in Retail (Bestbuy, Lowes, etc) so never been around anything radiation wise. My Grandfather died at age 74 and had Throat Cancer and had to have his bottom jaw and part of his throat removed last two years of his life but we were always told it was cause he smoked cigarettes and pipe (ALWAYS) and for over 50 years he also dipped snuff. So I think its unrelated. My cousin (Moms sisters daughter) just had some sort of cancer where they got it taken care of but she is going in to have part of her (bowel or intestine not sure which) cause even though they got the cancer taken care of it already did the damage.

Let me know what you think my next step should be with my neck?
Should I go to my doctor and see if he goes for Ultrasound or tries to five me that TSH test you talked about?
(and alot of people in the forums I mentioned talked about their TSH being low - but not sure what that is).
Should I just go to different doctor or a specialist?

Like I said there is no tenderness although will mention my gums hurt and jaw hurts and I feel like something is stuck in my throat on the side that its on but usually only in the evening especially around bed time. But like now when I wake up nothing at all no jaw or gum issues or throat problems. Its really just annoying cause I work with customers and have to talk to them with this red lump on my neck. Last time luckily happened after i went a few days without shaving so was able to let hair grow to cover it but I had just shaved so its out in the open LOL.

Family History:
Everyone is reasonable weights no one overweight.
Dad is extremely healthy except he did have heart attack twice so takes medicine daily for that. He also only gets sick about once a year when weather changes and it hits him pretty hard but after a few days its over.
Mom is healthy except 2 years ago she was diagnosed with Diabetes but it was the low kind where she just monitors and eats or drinks something to correct no shots.
Brother is like me healthy and never sick not even a fever or anything. Me and him both if we get a cold or anything it might last over night but we wake up fine. I contribute it to me and him and my parents being the type to not take drugs for any reason not even aspirin. I think it helps our bodies not be dependent on aspirin or any other medication so our immune system is good. Keeping fingers crossed it stays that way.
Grandfather (Mothers side) only person with cancer but told it was his lifestyle not hereditary.
Grandmother (Mothers side) not sure why she passed but believe it was a heart attack.
Dads Parents - Don't know his Dad so not sure and his mom just ended up having a heart attack but in the end there she didn't know who she was or anyone around her and had alot of issues at home living.
Just went to get ready for work and its getting smaller again. Its about half way from full size to the first growth that was hard to touch. Now before I had it for almost two weeks but seems its getting smaller so not sure if I need to just wait it out and see what happens or still go see anyone.

Will say though sometimes it gets bigger during the day but I think its not that its getting bigger its my water retention.

Before Vyvanse I (seriously literally) NEVER drank water except occasionally I would have Kool Aid but rare. I always drank sodas. Since Vyvanse I have been drinking water ALL day and alot of it. But don't drink sodas except maybe once or twice a week with dinner. So not sure if that is a factor either.

But its now not red looking and now half the size of yesterday and hard to touch around outer edge but directly on the top it is still mushy (feels like full of puss).

Let me know THANKS again for your Time and Help ... Its Greatly Appreciated !!!ust to reference update from earlier ... it seems to be smaller and tighter in the morning and as the day goes it gets bigger but I am sure its cause of the water consumption. Never really paid attention in the morning of it only afternoon.

Thanks for all your help and discussion. Sorry so long but wanted to give a back history.
Answered by Dr. Shehzad Topiwala 23 hours later
My recommendations to you are the same as before. I have reviewed your updates but my advice is unchanged because there is often a standard systematic evidence-based scientific approach to thyroid nodules.
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