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Diagnosed with hypothyroidism. On levothyroxine. Biopsy saw cysts. Why can I feel lumps in neck?

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General & Family Physician
Practicing since : 1980
Answered : 1 Question
I have a question about my thyroid. I have been diagnosed with hypothyroidism and am on 50 mcg of levothyroxine. I still have pretty severe symptoms and my TSH is .481. I am always tired no matter how much sleep I get, I have unbearably itchy skin. Also as of last night my throat is totally swollen on outside and internally feels really tight. That is how my whole battle began and I had sonograms and a biopsy and it was just a cyst. I also have a couple of small lumps on the sides of my neck towards the back that do not go away. Are these related and is this going to damage my thyroid and with current issues what should I be asking doctor to do in order to feel better? Should I be concerned about any of this?
Posted Thu, 14 Jun 2012 in Thyroid Problem and Hormonal Problems
Answered by Dr. Rahul Tawde 8 hours later
The symtoms you are having cannot be attributed to hypothyroidism or its treatment. Hypothyroidism is basically a problem where thyroid hormone levels in blood are low. Thje treatment is to give thyroid hormone from outside. With this the thyroid levels in the body will be maintained at normal levels. Your hypothyroidism is very well controlled as reflected by your TSH. So the symptoms are not due to hypothyroidism.

Couple of small lumps on the sides of your neck maybe lymphnodes or fat lumps. Since sonography of neck has nto detected anything apart from cyst you can ignore them. These or cyst in thyroid are not damaging your thyroid- don't worry.

There are few things that can still be done to feel better. Taking a small dose of cytomel (another thyroid hormone) after discussing with your doctor. You can also ask your doctor to supplement you with multivitamins, vitamin D, vitamin B12 and minerals. You can see a physician and get tested to see if there are any other medical issues apart from hypothyroidism which could be causing problems.


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Follow-up: Diagnosed with hypothyroidism. On levothyroxine. Biopsy saw cysts. Why can I feel lumps in neck? 34 hours later
Sorry, this did not really answer my question, I think you misunderstood some of my issues/questions.

I do understand your recommendation in regards to trying to make myself feel better by taking additional supplements etc since I still feel awful even on thyroid medication. However I am confused that you said my levels are very good because recommended levels are .3-3.0 or .5-5.0 depending on who you ask. With mine at .481 I am either not in the range at all or barely above it.

AS far as teh cysts, what I had years ago that kicked this whole thing off was tested and ok and also went away. I was told that it was because of that lump it damaged teh thyroids ability to produce the TSH etc. The new lump and tightness as well as several small lumps have not been checked. Since starting this though the big lump that was causing tightness has gone down but why wouldn't that do the same thing that the first one did?
Answered by Dr. Rahul Tawde 15 hours later
Ok. You have some misunderstanding about thyroid and its function. Thyroids don't produce TSh but T3 and T4 two thyroid hormones. TSH is produced by pituitary. In primary hypothyroidism T3 and T4 will be low and TSh will be high. In hyperthyroidism T3 and T4 will be high and TSh will be low. Since now your TSh is towards the lower limit of its normal it actually means you have been adequately treatment maybe slight overdosage thats all. T3 is more inportant for metabolism than T4 - so many times instead of taking T4 alone if you take t3 and T4 in combiination it works. Cytomel is T3 and levothyroxine is T4.
Single cyst wouldnt interfere with function of thyroid gland. if there are many they can but these would have been picked up by a sonogram. if a big cyst filled with fluid is there in yur gland then it should be aspirated which will collapse the cyst and relieve the pressure on thyroid gland.
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