If you hoarse or lose your voice, it could be a thyroid problem. Just as well, the cause of dysphonia could be related to certain vices, or to infections in the ENT sphere. A visit to the doctor is required.
A sore throat or the feeling of a lump in the throat can hide serious problems PHOTO: Pixabay
Dysphonia, or hoarseness, means a change in the voice and can occur for a lot of reasons, some of them related to the thyroid, explains endocrinologist Ruxandra Dobrescu on her Facebook account. “We know that the thyroid is located at the base of the neck, in front of the trachea, which it “dresses”, coming into close contact with the recurrent laryngeal nerves, which are the nerves that innervate the vocal cords. When the thyroid is occupied by bulky thyroid nodules, they can put pressure on the recurrent laryngeal nerves, a change that is manifested by a change in the voice. explains dr. Ruxandra Dobrescu.
When we are faced with hoarseness that appears suddenly, without an apparent cause, and persists for a long time, it can be the sign that draws attention to potentially dangerous thyroid nodules. More thorough medical investigations are necessary for a correct diagnosis. “It could be an evolving thyroid cancer. In this situation, a visit to the endocrinologist and a thyroid ultrasound is required.” continued Dr. Dobrescu.
Voice change may also occur after some thyroid surgeries, indicating recurrent laryngeal nerve paresis. “This is one of the possible complications of thyroidectomy and occurs more frequently in the case of complicated operations, involving a form of thyroid cancer with local invasion, or in the case of operations for large (even benign) thyroid nodules.” details the endocrinologist.
The cause of dysphonia may, however, be unrelated to the thyroid. It can occur as a result of vocal overload (in people who talk a lot, such as teachers, the doctor mentions), it can occur due to smoking or alcohol consumption, it can be caused by ENT infections, but it can also be caused by nodules /tumors affecting the vocal cords or larynx.
The sensation of a lump in the throat, the most common reason that brings patients to the endocrinologist’s office
Probably the most common reason for going to the endocrinologist, says the doctor Ruxandra Dobrescu in a video posted on her YouTube channel, is the sensation of a lump in the throat, a tight throat, drowning or lack of air. There are manifestations in the neck that lead us to think of a thyroid problem. The doctor also explains what such symptoms indicate.
“We know that the thyroid is a butterfly-shaped gland located at the base of the neck, in front of the trachea and in front of the esophagus. It is also very close to the great vessels of the neck, i.e. the common carotid artery and the internal jugular vein. These are all very important structures that connect the head and the chest to the rest of the body, so it becomes somewhat obvious that if there is a problem, a nodule, a large tumor in the thyroid, it begins to grow and press on the surrounding structures – on the trachea, on the esophagus – and begins to cause compression phenomena. If we take into account the compression at the level of the trachea, the trachea being the tube through which we breathe, dyspnea begins to appear, i.e. lack of air. If the thyroid tumor presses on the esophagus, swallowing problems can occur, that is, we start to drown. At first we choke on solid food, then we can end up drowning on water as well,” explained the doctor.
A large nodule, as the previous doctor explained, can also cause hoarseness by compressing the recurrent laryngeal nerves.
“These are all signs of compression in the neck, which make us think of a compressive formation, so these are all important signs, which we look for and which are important to know, because they are signs of gravity, that is, they attract our attention that there is a serious problem there”, draws the attention of Dr. Dobrescu.
In a first phase, these symptoms should lead us to see an endocrinologist, who will most likely perform a thyroid ultrasound. The doctor who carries out the investigation, says Dr. Dobrescu, it is important to note these compressions, because they are, in general, arguments that can indicate a thyroidectomy (surgical operation by which the thyroid gland is partially or completely removed. The operation is to be taken into account because a nodule, in this situation, may indicate a potentially fast-growing thyroid cancer. Even if the nodule is not malignant (i.e., not cancerous), it may grow over time and cause compression manifestations, and by growing there is a risk of worsening symptoms, finally reaching surgical intervention, but possibly in a more complicated situation.
What can pain in the neck indicate?
Another symptom we can face in the neck is pain. Although the thyroid does not hurt, says doctor Ruxandra Dobrescu, a little bleeding can occur that causes the nodule to expand, increase in size and cause compression around it manifested by pain.
“It appears suddenly, possibly after a physical effort, and sometimes it can be accompanied by the appearance of a formation that we did not know about. Ultrasound will be seen as a partially cystic formation”, explains Dr. Dobrescu.
Another situation in which we can feel pain is subacute thyroiditis, an inflammation of the thyroid after a viral upper respiratory tract infection. The pain can radiate upwards, towards the ear, towards the mandible, and thus can be confused with an otitis-type pain, a dental problem or an ENT problem. It is a strong pain and is accompanied by an important inflammatory syndrome, the doctor also says, which is highlighted by increased values of certain important markers (increased VSH, increased fibrinogen). In addition to pain, the patient has a bad condition, possibly fever or low-grade fever. Prompt treatment is required, says the doctor, in order to be able to intervene in time and correct the problem.
We can still feel pain even in the worst case, that of thyroid cancer.
“If there is pain in the neck, it is an important sign. We don’t neglect and go to the doctor”, the doctor advises us.
“Often these manifestations are not directly related to the thyroid”
However, patients do not come to the endocrinologist’s office only when they are faced with manifestations such as those described above, but symptoms such as a lump in the throat or a feeling of cervical constriction often lead them to request such an examination. Patients feel that they can no longer tolerate anything in the neck area, clothing or accessories.
“Many times, these manifestations are not directly related to the thyroid, but rather can appear in the context of an anxiety syndrome. They are generally accentuated during periods of intense stress and generally diminish or disappear when we are quiet – in our free time, at weekends or on holiday”says the doctor, and this is the sign that it is most likely not a problem for the endocrinologist to treat.
The first doctor we should consult, when we face one of the problems described above, is the family doctor, who can refer us further to the specialist. If he refers us to the endocrinologist, the latter will in turn do his own evaluation and probably an ultrasound. If something serious is suspected, further investigations will be called for. If, on the other hand, it is found that it is not a problem with the thyroid, the patient can be referred to the gastroenterologist (it may be esophageal reflux disease), or to the ENT specialist.
“In principle, we do not neglect, that is, at any sign of suspicion we go and talk to a doctor, explain what the problem is and see what we have to do next”concludes the doctor.
