What is the prognosis of Hashimoto's thyroiditis?

Question

Hello doctor,

I have Hashimoto's thyroiditis, and I felt like a lump in my lower throat. The doctor did a physical examination and noticed two nodules, and sent me for an ultrasound. The result came back that the thyroid as a whole was hyperemic and heterotrophic in the background appearance.

The left lobe contained two nodules for which he then sent me to an ENT to do an FNB. Right now, the usual symptoms of hypothyroidism are present, such as extreme fatigue and dry hair. But in the last couple of weeks, I have not been able to sleep on my back or side or put my chin down, as it feels like the air is restricted.

My question is, what does this sound typical of: thyroid cancer or a goiter? I am not an overreactor; I just wish I had more information or knew the prognosis of cases that were similar to mine. Does this sound like a higher risk of cancer or more like a goiter? And if I am already on thyroid medication, what can they do to treat it?

Kindly guide.

Answer 1

Hello,

Welcome to icliniq.com.

I had gone through all the data posted. From the details posted, it appears to be autoimmune hypothyroidism (Hashimoto's). Kindly tell us the thyroid blood reports to know the control. Do you hear any sound while breathing (stridor), which indicates pressure on the trachea? Breathlessness on lying back or on the side is unlikely due to thyroid unless it has a significant retrosternal extension, which needs to be decided by clinical examination.

Do you get breathlessness while taking the stairs? How long have you had Hashimoto's? For how long have you noticed the increase in the size of the swelling? Do you have a family history of thyroid cancer?

For definitive distinction of benign vs malignant FNAC (fine needle aspiration cytology) is important. If we have any doubt on FNAC, we go ahead and do thyroidectomy and send thyroid tissue for histopathology examination, which is the most confirmatory test.

Ultrasound is not so sensitive to differentiate between benign vs malignant. So kindly wait for the FNAC report. Kindly get a complete physical examination in view of symptoms of shortness of breath before attributing those to thyroid problems.

Kindly review with further details so that I can help you better.

Thank you.