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Night sweats, enlarged tonsils, difficulty in swallowing, feeling of thickness in tongue, fluctuating TSH, prescribed synthroid, family history of thyroid<br>

I ve been suffering from night sweats and an enlarged tonsil for 8 months. Strong family history of thyroid problems . Identical twin sister underwent complete thyroidectomy in Nov. due to suspicious pathology after FNA of thyroid nodule. Final results were benign enlarged thyroid that had been causing compression of esophagus . My mother was diagnosed with Grave s and was treated with RAI. Maternal Aunt diagnosed with parotid tumor (benign) and also underwent complete thyroidectomy . Maternal Grandmother diagnosed with malignant pheochromocytoma (deceased 5 yrs after initial diagnosis). Maternal great aunt with parathyroid adenoma who underwent removal of thyroid. Maternal 2nd cousin with fetal adenoma of thyroid and subsequent thyroidectomy. Maternal second cousin wih Huerhle Cell carcinoma of thyroid. Maternal second cousin with malignant parotid tumor (metastatic and resulted in his death). I began suffering heat intolerance, spells of tachycardia, extreme pressure in neck and head (all on right side and same side as enlarged tonsil) 3 months ago with increased severity and number of spells each day. US revealed multiple sub-centimeter nodules. TSH was 1.9 with anti-tpo of 59 in December. 3/12 bloodwork showed TSH of 2.45 and negative antibodies. Elevated lymph and low GRAN. WBC was 6.4. T4 on low normal range. On 3/15 I was suffering from an extreme spell and went to urgent care. Doc referred me to ER with concerns that I was suffering from thyrotoxicosis due to findings of tachycardia (resting HR was 132 and 149 when checked). BP was 143/89. ER doc treated me like I was a psych pt but did a CBC and cascading TSH. WBC was 11.7 and cascading TSH was 1.89. Yesterday my endo wrote rx for Synthroid and refused my request of diagnostic test to determine involvement in my neck and reason for compression. FNA of largest nodule .7 cm on 3/8 showed benign colloid nodule based on two pre smears and one cell block which was paucicellar in watery colloid background with scant follicular epithelium. Question: is synthroid appropriate when my TSH is fluctuating? Question #2: am I wrong in being concerned that my endo isn t looking at the whole picture? I m symptomatic and having difficulty with swallowing, feel like my tongue is thick at times when I speak, having trouble finding my words, etc
Asked On : Sun, 25 Mar 2012
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Emergency Medicine Specialist 's  Response
Since you and your family show up a genetic history of events and diseases related to thyroid disorders, and since you have difficulty on oral and breathing symptoms, I would strongly recommend you to go to a higher academic institute like a hospital which has a medical college attached to it.It is here that a lot of doctors can sit up and discuss your case. When a Endocrinologist+ a medical physician+ a radiologist+a sonologist+ a surgeon+ a anesthesiologist will sit up for case presentation, i am sure you would get the right treatment.This is very challenging at a level when you run from a doctor to doctor ..All this what you have has to be done all at once at a medical college which is famous and has a hospital attached with a endocrinologist in house.
Answered: Sat, 29 Mar 2014
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