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Large multinodular substernal goiter diagnosed. Feeling cold, anxiety attacks. Need surgery?

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General & Family Physician
Practicing since : 2005
Answered : 364 Questions
hi i have a large multinodular substernal physical symptoms are all over the freezinfg most of the time ,cant sleep very well,irritable ,and have frequent anxiety thyroid doc says cut the goiter out but also says that my thyroid is functioning fine?my t4 is 9.3 t3 uptake is 48.3 and tsh faras surgery goes for my thyroid condition earlier stated...I have pretty severe sleep apnea and a compromised airway,which i am told makes me a bad candidate for surgery...what would be my other alternatives based on the information that i provided in my previous posting....thanks again
Posted Sun, 7 Apr 2013 in Thyroid Problem and Hormonal Problems
Answered by Dr. Mamun Kabir 2 hours later
Welcome to healthcare magic.
Thank you for your query.

Your clinical features are consistent with hyperthyroidism.
But your T4 & TSH level are normal.
In case of compression syndrome of the goiter (difficulty in swallowing, breathlessness, voice change etc) & sometimes for cosmetic purpose surgery is usually advised.
In simple multi-nodular goiter surgery is the best treatment option.
If it is associated with hyper secretion of thyroid hormone then drug & radio iodine therapy are another option.
But your hormone level is normal.
So you are an appropriate candidate for surgery.

You have sleep apnea syndrome.
So you are worried about the surgery.
But I think it will help you a lot rather than creating problem.
After operation your airway will be more free.
So you can take a positive decision for the surgery.

I hope I have helped.
Please write if you have any doubt.
Take care.
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