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What causes difficulty in breathing with choking feeling and husky voice?

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Endocrinologist
Practicing since : 2001
Answered : 1637 Questions
Question
For the past 2 months have difficulty in breathing, feeling choke,very husky voice and weak voice, extreme fatigue recently been having diarrhoea for a week .
Posted Sat, 4 Jan 2014 in Ear, Nose and Throat Problems
 
 
Answered by Dr. Shehzad Topiwala 6 hours later
Brief Answer: Thyroid Detailed Answer: I reviewed the attached FNA report. Essentially, it is an inadequate specimen ie a diagnosis cannot be made owing to lack of sufficient number of cells in the sample. I have also noted the positive antibody tests. I have a few questions for you: Have you had an ultrasound of the thyroid? If yes, what is the size of the nodule? Have you had more than one ultrasound for the thyroid ? If so, are or is the nodule(s) growing in size over time? When was the first time you were told to have a thyroid nodule? Have you ever been exposed to upper body radiation like radiation treatment for head/neck cancer? Have you or an first degree relative of yours had thyroid cancer? When was the last time you had a blood test for TSH and free T4 done, and what was the result?
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Follow-up: What causes difficulty in breathing with choking feeling and husky voice? 23 hours later
last year the right nodule was 8 mm x 6mm and its still the same size when I did the ultrasound again last month but then there was new nodule which is 12 mm x 8 mm on the right side. my Anti thyroid Peroxidase is 1300 and TSh is 5.18 I was suffering hashimoto hypothyroidism since last year
 
 
Answered by Dr. Shehzad Topiwala 51 minutes later
Brief Answer: Hypothyroidism Detailed Answer: As you have surmised, it is likely your thyroid is going to towards under-activity from the hashimotos. Many endocrinologists believe in treating a TSH of 5 ish as is the case with you if there are symptoms suggestive of hypothyroidism. You have fatigue and that is a classic symptom of hypothyroidism. However, the only way to ascertain if it is due to hypothyroidism, is to treat you with thyroid medication and bring the TSH in the range of 0.4 to 2 and assess if your fatigue has mitigated. So consult your doctor and consider a low dose thyroid medication. Secondly, hashimotos can sometimes give a misleading impression of nodules on ultrasound. Regardless, a nodule more than 1-1.5 cm is worth biopsying. You do not seem to have any major risk factors for thyroid cancer.
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Follow-up: What causes difficulty in breathing with choking feeling and husky voice? 5 minutes later
Yes I have done my biopsy on the nodule 12 mm x 8 mm and I have attached that report for you to view. the report file name is FNA1_0001
 
 
Answered by Dr. Shehzad Topiwala 3 minutes later
Brief Answer: Inadequate Detailed Answer: Yes I saw that. It is insufficient for diagnosis. Many endocrinologists will recommend a repeat biopsy while others will adopt the wait and watch approach. Your thoughts are also taken into consideration
Above answer was peer-reviewed by
 
Follow-up: What causes difficulty in breathing with choking feeling and husky voice? 25 minutes later
Thank u doctor
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