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    What causes enlarged lymph nodes in the neck post a thyroidectomy?

Posted on Sat, 5 Aug 2017 in Thyroid Problem and Hormonal Problems
Question: Enlarged lymph nodes in neck for a few months (sometimes smaller in the morning, gets worse throughout day). No trouble swallowing but esophagus feels elnlarged. History of smoking but no alcohol use. Thyroidectomy 3 years ago (benign multinodular goiter). No weight loss and my blood tests are still slightly in the hypothyroidism levels. Currently take 175mg Synthroid daily. Are my neck symptoms possibly cancer? Or just something fairly routine?
Answered by Dr. Mirjeta Guni 14 minutes later
Brief Answer:
Ultrasound of the neck suggested:

Detailed Answer:
Hello and thank you for asking!
To confirm the lymph nodes and have further information about their nature I would recommend an ultra of the neck.
Meanwhile attach the result of TSH and give some further information regarding to levothyroxine ( when did you increase the dose for the last time? have you been taking it correctly? do you have cardiac pathologies? WHT is your actual weight?).
Will be a pleasure to help you further.
Kind regards,
Above answer was peer-reviewed by : Dr. Kampana
Follow up: Dr. Mirjeta Guni 10 hours later
Thank You, Doctor

It is true that I do not take my medication absolutely accurately. Sometimes an hour late. And I have two different prescriptions, one is for 200 Levothyroxine and one is for 175 Synthroid. I have been finishing up the Synthroid as I do not want to waste the pills. My weight is now 280lbs. I gained 60lbs before my thyroidectomy and 20 more lbs after surgery. I have not gained weight for one year now. I am sorry I do not have my TSH results here. I have no trouble at all with my heart that I am aware of. Thank You
Answered by Dr. Mirjeta Guni 4 hours later
Brief Answer:
About levothyroxine dose adjustment:

Detailed Answer:
Welcome back,

You should take levothyroxine correctly for 6 weeks (175 mcg daily) and then again check the TSH level. That is the best way to judge if the dose is correct.

If it persists high than increase the dose (200 mcg) otherwise continue for 6 months with the same dose.

Unfortunately, taking it incorrectly and not regularly, does not help to find the proper dose.
Once you have a TSH level, please do not hesitate to attach it. Will be a pleasure to help you.

Best wishes,

Above answer was peer-reviewed by : Dr. Arnab Banerjee
Follow up: Dr. Mirjeta Guni 4 hours later
I was hoping for a bit more answer on the neck area. Does it seem like serious symptoms or something that can wait and possibly resolve itself? I do not have the $$ for an ultrasound test.
Answered by Dr. Mirjeta Guni 14 hours later
Brief Answer:
Info about the lymph nodes:

Detailed Answer:
Hi again,
From your information it is very difficult to say rather the lymph nodes you pretend to have are problematic or not.
There is a GP who says that, there are no lymph nodes, it is just a thick neck (as i could understand) and you say that you can palpate lymph nodes.
So, first the presence of lymphnodes should be confirmed by ultrasound. As it is not possible to do it, you can monitor the size, if they have e tendency to increase in size or number, if you will have fever or difficulty in swallowing, you should rule out an infection.
It is a good news that the thyroid biopsy has resulted benign, so the lymph nodes are not due to thyroid cancer.
Keep monitoring them is all you can do for the moment.
Best wishes,

Above answer was peer-reviewed by : Dr. Vaishalee Punj
Answered by
Dr. Mirjeta Guni


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