Dear user Thank you Hi and thank you for asking on HCM! I read carefully all your concerns and I can say as follows : How long its been that you are diagnosis with Multinodular Goiter? Multinodular Goiter i a goiter simply means an enlarged thyroid. Allso Multinodular Goiter can be either a toxic multinodular goiter or non-toxic. May i know all the bllod test that you have done? MAY i know if you are taking therapy or not? --First of all is very important physical exam findings includie a goiter that can be felt, growth down into the chest,and enlarged neck veins. --You must t o check bllod test for thyroid hormon level TSH,FT3,FT4(Multinodular goiter is toxic or non-toxic) ---After a complete history and physical exam , a thyroid ultrasound (USG) should be done.Is the test to see the size of thyroid and specific features of the noduls,including :size , number of noduls,if there re are calcifications(calcium deposits)echotexture (how broght or dark it looks on USG),borderds,shape, and it is solid or cystic. ---It it nesesery fine -needle aspiration biopsy.FNAB(test)the best test to determine if the thyroid nodule is beningn or cancer. ---Your concern is @very times before it grows i feel pain under in the tonsils: Dear User my answere is YES its happening :The lymph channels of thyroid and lymph glands of the neck can spread and affect the sympathetic nervus system which servis the neck and ear. I suggest to you to check a)Complete bood count (CBC) b TSH,FT4 FT3 (Thyroid hormon level) cUSG,FNAB, then to consoult an endocrinologis and surgery (if your multinodualr goiter is growing fast, if the FNAB results,risk of cancer also if they are compressive symptoms) Hopoe i hve answered your questation .if you have futher questions i willl be happy to help. Best regards Dr Klodiana Poshi