Ask a doctor on the topic of Surgery

Is thyroid surgery necessary or can it be treated with medication?

April 13, 2022 | 50,00 EUR | answered by Christian Welsch

Hello,

I have been experiencing symptoms since my second Biontech Covid vaccination in November.
- Burning sensation and pain in the throat
- Ear pain
- Headaches
- Fatigue
- Night sweats
- Severe coughing
- Small swelling on the neck
- Palpitations

I went to my general practitioner but was not taken seriously and was sent for a PCR test.
Of course, it was negative.
The problems got worse when I noticed that the cough disappears as soon as I take ibuprofen.
My doctor found this very strange and advised me to wait it out.
I went to an ENT specialist who performed an ultrasound of my thyroid.
He said there are some nodules and enlargement visible, but that should not be causing the cough.
I was referred for a thyroid ultrasound.

In February, I went for a lung CT scan independently because there was a suspicion of something malignant in my lungs.
The CT was clear.
A comprehensive blood test and saliva sample were also taken.

Bacteria were found in the saliva sample, which caused the coughing.
A week of antibiotics cleared up all my symptoms!
Only my fatigue and palpitations remained.
When measuring my blood pressure, it was 110/68 with a heart rate of 90-100.

I presented myself to a surgeon at the hospital regarding my thyroid.
He wants to remove the entire thyroid because there are a hoarse and several cold nodules present.

My question is whether the surgery is absolutely necessary and if a medical treatment option is ruled out. What should I do?

I do not want to rely solely on the opinion given, as I initially struggled with the cough until the underlying cause was investigated.
If I had not gone to the lung doctor independently, it would probably still be the case now.

Image findings:

[Links to images]

Christian Welsch

Dear questioner, the question of whether to operate on the thyroid gland or not is not easy to answer. You seem to have a tendency towards hyperfunction and also towards a diabetic metabolic condition. Thyroid glands are usually operated on when cold nodules grow (which could hide something malignant) or when there are clear signs of malignancy in the ultrasound image, or when the thyroid function is out of control and cannot be regulated with medication. In your case, I would see an indication based on the cold nodules and the number of nodules. I recommend getting the opinion of an endocrinologist and a second surgeon, but my recommendation would also be surgery.