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What Causes Recurring Thyroid Nodules Along With Hoarse Voice?

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Posted on Wed, 12 Aug 2015
Question: I had surgery in the early 1980s to remove a cold lump-benign. Took thyroid med. 2011, family doctor lowered dose of med and lumps began to grow on thyroid. Watched them grow. Had biopsy and drained some fluid-filled cysts. Others on right side went away. One large lump on same site as surgery on left side has blood flow to it. Have had 3 biopsies. Not cancer. Another one scheduled in XXXXXXX 2016 to check for cancer. I have almost no voice now because I am hoarse. I cough. Lump can be seen on outside and there is sometimes pain down deep inside where lump is. Should I ask for surgery? I am at the point where I have a sore throat from pushing my voice past my vocal cords. I also have sinus drainage and have seen an ent doctor. Can you suggest anything further to help me. My voice is a whisper now.
I take 88mcg levothyroxin every other day alternating with 44mcg. Drs. agree that is proper dose. Lumps started to grow at that dose. I have blood work done, ultra sound done and now wil have another biopsy, my third. Drs. seem happy with blood work.
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Answered by Dr. Shehzad Topiwala (1 hour later)
Brief Answer:
Thyroid

Detailed Answer:
Sorry to learn about the challenges with managing your thyroid nodules and the hoarseness of voice. I follow the historical trends of your thyroid lumps. The practice of prescribing Levo thyroxine for keeping nodules from growing has largely been abandoned. It was fairly common practice up until about 2006 or thereabouts at which time published scientific literature showed lack of significant benefit in the majority of cases. Regarding your other question as to whether or not you should undergo surgery for the thyroid nodules, that will require a thorough decision making discussion between you and your doctor. Emdocrinologists are typically trained in the specialized management of thyroid problems. An in-person physical examination will be required in addition to a comprehensive evaluation to present the options before you after which a call has to be taken with regards to surgical removal of part/whole of your thyroid versus non-surgical choices such as continued ultrasound monitoring over time. For example, if you have some risk factors for thyroid cancer such as past upper body radiation exposure or certain worrisome characteristics on ultrasound then generally surgery is recommended.
Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Shehzad Topiwala

Endocrinologist

Practicing since :2001

Answered : 1663 Questions

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What Causes Recurring Thyroid Nodules Along With Hoarse Voice?

Brief Answer: Thyroid Detailed Answer: Sorry to learn about the challenges with managing your thyroid nodules and the hoarseness of voice. I follow the historical trends of your thyroid lumps. The practice of prescribing Levo thyroxine for keeping nodules from growing has largely been abandoned. It was fairly common practice up until about 2006 or thereabouts at which time published scientific literature showed lack of significant benefit in the majority of cases. Regarding your other question as to whether or not you should undergo surgery for the thyroid nodules, that will require a thorough decision making discussion between you and your doctor. Emdocrinologists are typically trained in the specialized management of thyroid problems. An in-person physical examination will be required in addition to a comprehensive evaluation to present the options before you after which a call has to be taken with regards to surgical removal of part/whole of your thyroid versus non-surgical choices such as continued ultrasound monitoring over time. For example, if you have some risk factors for thyroid cancer such as past upper body radiation exposure or certain worrisome characteristics on ultrasound then generally surgery is recommended.