Large Multinodular Substernal Goiter Diagnosed. Feeling Cold, Anxiety Attacks. Need Surgery?

Posted on Mon, 18 Mar 2013

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Mon, 18 Mar 2013 Answered on

Wed, 10 Apr 2013 Last reviewed on

Question : hi i have a large multinodular substernal goiter....my physical symptoms are all over the place...im freezinfg most of the time ,cant sleep very well,irritable ,and have frequent anxiety attacks...my thyroid doc says cut the goiter out but also says that my thyroid is functioning fine?my t4 is 9.3 t3 uptake is 48.3 and tsh is.82.as faras surgery goes for my thyroid condition earlier stated...I have pretty severe sleep apnea and a compromised airway,which i am told makes me a bad candidate for surgery...what would be my other alternatives based on the information that i provided in my previous posting....thanks again

Answered by Dr. Mamun Kabir (2 hours later)

Hello,
Welcome to healthcare magic.
Thank you for your query.

Your clinical features are consistent with hyperthyroidism.
But your T4 & TSH level are normal.
In case of compression syndrome of the goiter (difficulty in swallowing, breathlessness, voice change etc) & sometimes for cosmetic purpose surgery is usually advised.
In simple multi-nodular goiter surgery is the best treatment option.
If it is associated with hyper secretion of thyroid hormone then drug & radio iodine therapy are another option.
But your hormone level is normal.
So you are an appropriate candidate for surgery.

You have sleep apnea syndrome.
So you are worried about the surgery.
But I think it will help you a lot rather than creating problem.
After operation your airway will be more free.
So you can take a positive decision for the surgery.

I hope I have helped.
Please write if you have any doubt.
Take care.

Above answer was peer-reviewed by : Dr. Vaishalee Punj