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[teejanddeej]

Hi all, I'm new to the group so thank you for accepting me.
I was diagnosed last June 2020 with a Benign Thyroid Cyst, I was told it was completely innocent and to get back in touch if it got bigger. I haven't really felt well since that time, nothing I could put my finger on just a general yuk feeling. I had a few digestive issues and had a colonoscopy which was all clear and lots of different blood tests always coming back normal. I wondered if it could be menopause linked even though it had been 4 years since my last period and I'd been okay during the peri menopause stage. 3 Drs at my surgery said I couldn't have it for various different reasons so I went privately and started on HRT in April 2021. I'm using Oestrogel and utrogestan. I started on half a pump and have gradually increased it this week to 2 pumps. It has helped with my anxiety but nothing else really and some days I think I might even feel worse than before.
Anyway last week my cyst started to get bigger and yesterday it was much bigger and my throat was sore so I went across to the drs and they have urgently referred me to ENT, I have an appointment on 21/6/21.
What I'm wondering is if the HRT could in anyway be causing the Cyst to grow? Has anyone had a similar experience?
My thyroid function is always normal when I have my meds done.
Thank you in advance and apologies for the long message!

[Wrensong]

Hi    So sorry to know you have the worry of a growing thyroid cyst after starting HRT, but it's good that you don't have long to wait to see someone to get expert insight into what's going on, though I'm a bit surprised the referral is to ENT rather than an Endocrinologist.  Did your GP say why that specialty?

In common with several other members, I have a longstanding thyroid condition (past surgery for a benign thyroid mass with Hashimoto's thyroiditis) and also take HRT, but not knowing the answer to your question I just had a quick google & seems there is a documented association between oestrogen & the growth of thyroid cells, both benign & malignant, but I couldn't find a specific reference as to whether this includes cysts.

https://academic.oup.com/jcem/article/86/3/1072/2847534

https://www.btf-thyroid.org/thyroid-nodules-and-swellingsleaflet

There is also an article from a small study showing no change to thyroid volume, size or number of nodules in postmenopausal women on HRT, but again I don't know whether this includes cysts.

https://pubmed.ncbi.nlm.nih.gov/17998883/

Sorry, this is probably not much help but I couldn't read & not reply, knowing the worry thyroid issues can bring.  Hopefully someone with more closely comparable experience will be along to offer advice. 

If you only started HRT in April it is quite early days to know whether your current regimen is right in terms of symptom relief, but I think you need to get the ENT referral over with for now & come back to that issue later.  I hope you manage to get to the bottom of it quickly.  Please let us know how it goes with ENT & we will be in a better position to think about your HRT then.
Wx

[teejanddeej]

Hi Wrensong, Thank you for your reply. I assume I was referred to ENT because that's where I was sent last year for my ultra sound, also I think the doctor took one look and thought that needs to come out so referred me there as they are the ones who would do the surgery? I'm not familiar with what an Endocrinologist  does so I googled it and sounds like they deal with hormone related disorders, maybe the dr thought it had gone past that, I'm not sure. When they rang yesterday to book the appointment they said it was for the head and neck department so I'm assuming that's ENT too??
Thank you for looking up the articles for me, I had a quick look yesterday and in my brain fuddled state I found it hard to read, just saw Oestrogen a few times and panicked and thought I shouldn't be taking it. I'm too scared to just stop completely though as my anxiety was bad before and I feel anxious already because of the lump. I've gone back down to 1.5 pumps though just in case that helps.
Yesterday afternoon the lump started to feel tender and I'm wondering if it's infected, I've read the thyroid can become infected (google again!) and that it should go down after a few days. Now I'm wondering whether it could be anything to do with getting my second Covid vaccine last Thursday, whether that has made my immune system react? Unfortunately my anxiety before I started HRT was health anxiety so any little thing sends my head into overdrive.
I will let you know how I get on at the ENT on the 21/6/21 and thanks again for your reply.
Dx

[Wrensong]

Hi again, thanks for the info on the ENT referral.  Yes, Endocrinologists usually deal with thyroid disorders, but ENT should be able to refer you if they think that's sensible. 

A general surgeon with a special interest in thyroid surgery did my thyroid lobectomy, but please don't assume you will need surgery for the cyst.  I'm wondering whether they will want to aspirate it (a fine needle procedure to draw off fluid) which might be enough for it to resolve without surgery.  I've had breast cysts treated in this way & my Mum had a large recurrent cyst beside her ear repeatedly drained of fluid without any need for surgery.

Yes, sorry about the long oestrogen article - it is heavy going I agree.  Please try not to worry about your HRT, it may have no bearing on the cyst, but as you posted asking whether there could be a link I felt you would want to know.  I think you were right not to stop it at this stage as going cold turkey could bring withdrawal symptoms you could do without.  I would wait & see what they advise at ENT as it's only just over a week until your appt.

Can't answer the COVID vaccine question I'm afraid, but it seems possible it could have fired up any immune response already ongoing in your thyroid.

Easier said than done I know, but try to get as much R&R as you can between now & your ENT appt to bring your stress levels down.  Please do let us know how you get on.

[teejanddeej]

Thank you Wrensong, I will definitely let you know how I get on with my consultation.
My mum also had a goiter on her neck when she was younger and had it removed but none of her thyroid was taken with it, or if it was she’s never taken tablets and she’s 92 now! She did have a lot of breast cyst thought that she had to have drained so maybe it’s hereditary?
It would be good if they were to drain my cyst at my appt even if it’s only temporary just to give some relief from it.
The letter for my appt came yesterday which said I’d been fast tracked in the 2 week cancer rule but that it doesn’t necessarily mean it’s cancer, must admit seeing it in writing made me feel anxious but I’m trying not to worry about it until the appt - easier said than done🥴
Did you have a partial thyroid removal? And do you have to take medication for it?
Thanks again for taking the time to respond.
Dx

[Iris67]

I had a thyroglossal cyst, which I was told was different to a thyroid cyst...? If you have one - try everything before surgery. I had something called the Sistrunk procedure which is a brutal removal of the cyst but also the mid section of the hyoid bone. It has caused neck instability in later life - they don't bother to follow up this aspect. I was 18 years old and slone in London and just 'did as I was told'. Wish I had been more careful but I was pretty much a child.

Take it all slowly. I didn't have any malignancy (for once!)

[Wrensong]

Bless you D, only natural to be apprehensive & like you I've had 2 week referrals for issues that have thankfully turned out to be  nothing serious.  Yes, thyroid probs can be hereditary, though none known in my family before me  .  Even with thyroid cancer there is usually a very good outcome, but your lump has been scanned & found to be a cyst so the fast track referral will just be a precaution within current guidelines.  If your Mum is 92, sounds like you have very good genes  .

Like you, I think I inherited a tendency to develop cysts from my Mum.  As well as those in the breasts, I had a couple of ovarian cysts, one quite large that resolved on its own, the other smaller with concerning characteristics that led to removal of both ovaries. Thankfully turned out to be benign, but there was no way to be sure without whipping out the ovary & postmenopause they usually take both if there's any suspicion of malignancy.

Yes I had a hemithyroidectomy to remove what was thought to be a single suspicious nodule in one side of the gland.  Again, luckily for me, it turned out to be benign, but rather than the single nodule they'd thought, histology showed it to be a multinodular goitre.  While waiting for surgery I was started on a low dose of Thyroxine to try to damp down the associated autoimmune activity.  After surgery the dose was raised to 100mcg.  Dose has changed over the years & I now take less, together with a second type of thyroid hormone, but that's not typical - most people do well on Thyroxine alone.

Your cyst sounds so painful D, I do hope they can drain it for you to give you some relief.  The recurrent one Mum had by her ear was, at its worst, angry looking & painful, but it did eventually resolve after being drained a few times.

Hope you have some of the fab weather we have here today & the leisure to relax & enjoy it.
Wx

[teejanddeej]

Hi wrensong, just to update you. I went to the hospital this morning and it looks like everything is fine. The ent dr put a camera down my nose into my throat (which was surprisingly not uncomfortable!) and it all looked okay. Then he sent me for an ultrasound which showed that the cyst was full of fluid. The dr carrying that out said she could drain it for me to make it more comfortable, although there was no guarantee it wouldn’t fill back up again so I went for that, even if the relief is only short lived! She’s sending the fluid off for testing but she didn’t see anything suspicious in it. The ent dr said the growth in the cyst was not linked to hrt at all so I’m going to up my gel to 2 pumps starting tomorrow😊.
Thank you for all your advice and for taking the time to reply to me. Dx

[Wrensong]

Thanks so much for the update D. That all sounds good  .  Yes I've had the scope through the nose & into the throat (not for thyroid issues though), expecting it to be horrendous but as you say it's quite comfortable & thankfully not at all gag-inducing.

Like you, I'd have had it drained.  I hope you're more comfortable now.  With any luck that'll be the end of it for you. 

So glad to know they don't think the HRT implicated  .  I'd hoped it wouldn't be.
Wx