How can my brother manage his Hashimoto’s thyroiditis at 34?

Question

Hello doctor,

My brother had an ultrasound of his thyroid, which showed multiple ovoid pseudo-nodules with increased vascularity. The radiologist suggested Hashimoto’s thyroiditis. Could this presentation also indicate cancer?

He is having a blood test next week to check his thyroid function. His main symptom is a feeling of pressure in his throat. He is a 34-year-old male. Should I book an ENT appointment, or can a GP manage this?

He has asthma and recently had an endoscopy due to acid reflux. He is currently on inhalers and Lansoprazole.

Kindly advise.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I completely understand your concern.

Thyroid swellings are more common in females, but they need careful evaluation when they occur in males. Hashimoto’s thyroiditis is an autoimmune disorder, meaning the body’s immune cells attack normal thyroid tissue.

Please try not to panic; cancer is less likely, but a fine-needle aspiration cytology (FNAC) is needed to confirm the status. I would suggest undergoing the following tests to confirm the diagnosis:

FNAC with Bethesda scoring.
X-ray neck (lateral view).
Thyroid hormone levels: FT3 (free triiodothyronine), FT4 (free thyroxine), and TSH (thyroid-stimulating hormone).
2D echocardiography and sleeping pulse rate evaluation (if indicated).

The probable causes in your case are:

Genetic factors.
Dietary and lifestyle influences.
Radiation exposure (like some occupational settings).

The probable diagnosis in your case is multinodular goitre. The differential diagnosis in your case is thyroid swelling under evaluation, which could be a multinodular goitre (MNG). The treatment plan includes surgery if FNAC confirms MNG or any other lesion.

I suggest you follow a few preventive measures, such as avoiding excessive consumption of goitrogenic vegetables, such as cabbage, cauliflower, and broccoli, and using iodized salt in your diet.

I hope this helps you.

Thank you.