I have a lump on my neck for close to two months now. Ever since it appeared, I feel weaker and when I speak, it takes a lot of energy out of me. My voice is often hoarse. Is this due to the lump? If yes, should I do a biopsy? And if not, do you think seeing an ENT doctor is the right decision to treat my throat?
Dear Matthew,
Where is the lump in your neck? Is it at one of the sides or is it at the lower part of the front of the neck?
Lumps at the side of the neck are usually enlarged neck lymph nodes. These are usually due to infection or inflammation occurring in the head or neck region.
A lump at the lower part of the front of the neck is likely to be due to a nodule in the thyroid gland. 90 to 95% of thyroid lumps or nodules are non-cancerous, while 5 to 10% can be cancerous.
In both cases, an ultrasound scan will be necessary to check on the size and features of the nodules.
Depending on the size and ultrasound features of the thyroid nodule, a fine needle biopsy may be required to exclude the possibility of thyroid cancer. There is unfortunately no blood test that can be done to check for thyroid cancer.
Fine needle biopsy of thyroid nodules is best performed with ultrasound guidance and this can be done by an endocrinologist. Most ENT doctors are not trained in ultrasound-guided fine needle biopsy.
I am currently taking medications to treat my hyperthyroid issue. I feel like my heart health is affected. I sometimes feel my chest being squeezed and the heart beat is irregular. Is it true that hyperthyroid can lead to heart conditions?
Dear Erwin,
Hyperthyroidism (overactive thyroid gland) that is not treated or controlled can lead to faster than normal heartbeat. Sometimes the heartbeat can become irregular – this will eventually increase the risk of getting a stroke.
If the hyperthyroidism continues not to be controlled, eventually heart failure can result.
You should see a doctor to have a blood test to check your thyroid hormone levels. The doctor may need to adjust your medication to control your hyperthyroidism.
Other medications can be given to temporarily slow down fast heartbeat due to high thyroid hormone levels.
Doctor, my mother is 69 years old and she has hypothyroidism. She has been having difficulty concentrating. She appears to be daydreaming most of the time and it worries me especially when she doesn’t seem to respond to what I’m saying. Would her situation only get worse? Can it be cured?
Dear Lisa,
You should bring your mother for a blood test to check her thyroid hormone level.
If the dosage of her thyroid hormone replacement medication is insufficient and her thyroid hormone level is lower than normal, then there is a possibility that her symptoms may be related to the lower thyroid hormone level.
There is a lump on the back of my neck, near my right ear. Ever since I noticed it there, I have been having mild headaches. Is this a symptom of a hormone or endocrine problem?
Dear Harold,
The lump at the back of your neck (near to your right ear) is not an endocrine or hormonal problem.
You should seek consultation with an ENT specialist for further evaluation.
Doctor, ever since I started taking hyperthyroid medications, I've dropped a lot of hair. Now the top of my head is starting to bald. Is this a natural reaction to the medicines or a sign that my condition is getting worse?
Dear Serina,
The hair loss you are experiencing is related to the change in thyroid hormone levels with treatment of your hyperthyroidism.
It is not a side effect of the medication or a sign that your hyperthyroidism is worsening.
Your hair loss will get better over 3 to 4 months as your thyroid hormone levels stabilize with treatment.
My wife delivered our baby four months ago. She is now experiencing swelling in her neck, rapid heart beat, and hair loss. Her doctor said it is likely postpartum thyroiditis and will only be temporary. However, after four months of this, I am starting to worried. Is it okay for us to seek treatment? Would the treatment or medication affect her breastfeeding?
Dear Fu Shiong,
The symptoms your wife is experiencing may have been caused by postpartum thyroiditis.
However, if the symptoms have persisted for 4 months, then it is unlikely to be related to postpartum thyroiditis.
She may be suffering from an overactive thyroid gland (hyperthyroidism).
She should see a doctor and have blood tests done to confirm if her thyroid hormone levels are indeed higher than normal.
Treatment of hyperthyroidism will not affect her breastfeeding.
Dear Doctor Soh, my 17 year old son has been suffering from a lump in his neck. Initially we thought the lump would go away but it’s been two months and it’s still there. He said the lump causes him pain when he swallows his food. In the mornings, he always feels weak and doesn’t have much of an appetite. Can I have your suggestion on the right treatment for him?
Dear Rahim,
If the lump is at the lower aspect of the front of the neck, it may be a lump arising from his thyroid gland.
He will need to see a doctor for an ultrasound scan to determine the size and features of the lump.
He may also need a blood test to check his thyroid hormone levels.
I am currently consulting an obgyn for PCOS. She mentioned I am showing symptoms of diabetes. I want to ask - does PCOS affect diabetes or diabetes affect PCOS? Would my PCOS improve if I have my diabetes controlled? What treatment would you recommend?
Dear Kristin,
Women with polycystic ovary syndrome (PCOS) have a higher risk of developing prediabetes or diabetes and high cholesterol level.
You will need to do a blood test to confirm if you have prediabetes or diabetes.
If you do have prediabetes or diabetes, starting treatment with a medication called metformin can improve both the PCOS and diabetes.
My daughter is 18 years old but has not started her period. She also seems excessively hairy on her arms, legs and neck. Is this a hormonal problem?
Dear Kym,
It is very late for a girl not to have menstrual period at the age of 18 years.
Excessive hair growth in a girl may also be hormone-related and may be related to the absence of menses.
You definitely should bring your daughter to see an endocrinologist for further evaluation.
Is there any way to boost the growth hormones in children? My son is 7 years old and is shorter than all of his classmates. I am worried he will be too petite.
Dear Charmaine,
Boys usually start to have puberty at around the ages of 12 to 13 years. They will increase in height when puberty starts.
As your son is only 7 years old currently, it is too early to tell if he will grow up shorter than normal.
I will advise continued monitoring of the percentiles of his height-for-age using the growth chart in the HPB Health Booklet.
There is unfortunately no treatment to boost growth hormone level in the body.