Is this part of having strep, or something else?

February 17, 2009 12:03 AM

YANMD, but please help. I'm worried I might be developing some sort of Thyroid condition- or is it just that I'm already sick with strep throat? How worried should I be about this?

So on Friday morning I woke up with strep throat. Not so much of the sore throat part really, mostly tired, cold and miserable. (And it was a warm day in the DC metro area, too..) I went to a Minute Clinic as soon as possible, in the afternoon, thanks to reading the advice on a previous askmefi.

The doctor seemed to agree that I had strep throat, although I'm not completely sure, she didn't prescribe me antibiotics (my mother insists she should have) just plenty of rest, hot drinks, ibuprofen and to keep well hydrated. She also told me that the infection(?) would travel down towards my lungs, and she's been right about that.

She checked me out and found I had a low fever, a mild cough, normal blood pressure, and my lymph nodes on my neck were normal. But when she was examining my neck she seemed concerned about my thyroid, which has been a little.. bigger than normal in the past few months. It sticks out a little like a tiny adam's apple (only i'm a girl), and that day my throat was well, you know, hurts to swallow, coughs, sore throat kinda inflamed etc.

She asked if I was unusually tired all the time (answer: yes, but not as much lately and a year ago I was diagnosed with anemia and prescribed vitron-c iron pills, which helped). And if my hair had been falling out. (answer: kinda? It's not falling out on its own, but if I scrub too vigorously when showering it does tend to fall out. (You can see gaps in my eyebrows- from washing my face too close to them. Hair on my head seems fine)

Anyway, she told me to go to my primary care doctor after I got better and get my bloodwork done and thyroid levels checked. No problem right?

Well that brings me to today. I wasn't really coughing much until today. But what's really worrying me is my thyroid. It was just kinda swollen with the rest of my throat on friday, pretty normal the next day (after 15 hours of sleeping) but today its.... well it's really hard. (i'm sure it's my thyroid, the doctor pointed it out to me) It's hard like I have a solid bump in my throat where my thyroid is. If I tilt my head backwards, it sticks out like a walnut.

I'm torn between thinking maybe this is just the strep throat again, nothing to worry about- only this is the first time I've had it and I'm worried that maybe I do have some thyroid condition, what if this is something serious. How worried should I be? How urgent is this?

I did try searching for this issue, but came up with nothing. I will have my doctor look at it eventually, but my primary care doctor, if I made an appointment now, it would likely be a couple of weeks from now. Also any ideas about possible causes would be welcome as well.

(Background information that might be useful: I'm 23, a girl, no real medical history except asthma/allergies when I was little, a tad underweight otherwise pretty average health-wise)

posted by tachikoma_robot to health & fitness (16 comments total)

stupid of me to post this when everyone is sleeping... going to bed myself will check tomorrow.
posted by tachikoma_robot at 12:42 AM on February 17, 2009

How could someone tell you you have strep and not give you antibiotics? Strep and thyroiditis aren't anything to fool around with. If I were you, I'd go to an ER urgent care clinic tomorrow morning. The kinds of thyroid (and adrenal) tests you're likely to need are beyond the scope of a GP, so the sooner you start the better you'll be. If you've read anything about how anemia impacts your thyroid, you'll understand why random "armchair" guesses are stupid and first-class testing is essential!

In the meantime, I'd hate to make any recommendations beyond the standard:

warm salt-water gargle; nightly mouthwash
honey and lemon tea
pedialyte/gatorade
multivitamin
leafy greens
gentle exercise
hot steam showers to clear your head

Keep us posted, good luck!
posted by aquafortis at 2:04 AM on February 17, 2009

I had my thyroid taken out. (i am a guy) my grandmother had it taken out. My mom had it taken out due to thyroid cancer.

Goto an endocrinologist and get it taken care of. thyroid cancer is nothing to joke about. Its easily cured and can spread very easily to your lungs.

They will do a biopsy on it. Even if its not cancerous its still better to get it checked out.

One sunday I woke up with this huge lump on my throat. So I went to the doctor monday he sent me to an endocrinologist . The first one said it wasnt cancer (after doing a biopsy) and said ignore it.

The second endocrinologist said to take the whole thing out. My lump was basically filled with water and not cancer but had to come out anyway.

Since getting my thyroid taken out I am like a whole new person .I have never had so much energy. I do have to take a hormone pill every day now but you get used to it.

So I suggest going to an endocrinolost as soon as possible because if its cancer its better not to wait.

I don't want to scare you but thyroid cancer is easily treated and can spread easily if not.
posted by majortom1981 at 4:39 AM on February 17, 2009

How do you know it's your thyroid and not just a swollen gland or lymph node?

Strep throat has a fairly obvious way of presenting itself. If the doctor really suspected it, they would have taken a culture and given you antibiotics.
posted by gjc at 6:14 AM on February 17, 2009

It sounds like your physician and you did not communicate well. You do not mention what, if any, tests were done to confirm that you have strep throat; many people use the term as a catch-all for any severe sore throat, when it specifically refers to streptococcal pharyngitis. Most sore throats are due to viruses, in which case antibiotics do more harm than good, but for confirmed or strongly suspected strep throat penicillin or erythromycin are indicated not so much to stop the infection (sometimes they help, sometimes they don't) but to prevent a number of uncommon but potentially serious complications that are listed in the Wikipedia link. Here are the CDC guidelines for the diagnosis and treatment of strep throat; you can decide for yourself how well they were followed.

As for your thyroid, it may be swollen of the lymph nodes in that area may be what you are feeling. Or it may be something else entirely. A quick physical exam would help with that. If there is any reason to think there may be a thyroid problem there are a number of straightforward tests that can sort that out; which tests are needed depends on what your physician thinks might be going on. I would see how soon you can go to your primary care doc, otherwise you need to head to someone who can see you in the next couple of days and who will hopefully explain why antibiotics are indicated or not.
posted by TedW at 6:14 AM on February 17, 2009

The good things about thyroid disorders are that they are rather slow moving in women. Men tend to have more aggressive types (with regards to cancer). Yes, go get checked. They will probably first run your T3, T4, and TSH levels. Then you might get a neck ultrasound, and depending on the outcome of those two things, you might get a biopsy. It might be cancer, but there are a number of other things it could be, all of them highly treatable.

I was diagnosed with thyroid cancer last year (I'm 35) and based on the size of my tumor had likely had it for 3-4 years. Even cancer is easily treatable in most cases with an extraordinarily good prognosis (especially in someone your age). I had surgery to remove my thyroid, and one dose of radioactive iodine. Six months later I can tell you that the whole experience was more of a pain in the ass than some terrifying, life-altering experience.
posted by kimdog at 6:29 AM on February 17, 2009

If you are in the DC area, I urge you to see Dr. Ace Lipson!
1120 19th Street, N.W.
Suite 200
Washington, DC 20036
202-296-3443
202-296-8760 fax
posted by jgirl at 6:29 AM on February 17, 2009

Can't help with much, but your mother is right, if you have strep you should have been prescribed something. I'd go to another clinic if I were you.
posted by legendarygirlfriend at 6:45 AM on February 17, 2009

Strep throat is testable, and (every time I've been tested at least) there's a delay of a few days or so before the test results come back. They won't prescribe you antibiotics without seeing the test results, as many other causes of similar symptoms are viral infections and do not respond to antibiotics (and you don't want them to prescribe you antibiotics unless you need them). You can't really distinguish it from a sore throat caused by a bad cold on the basis of symptoms (there are times when I've been certain I must have had strep throat because my sore throat was so bad, and I was wrong). Hopefully the doctor took a culture from your throat, though that isn't very clear from what you say.
posted by advil at 7:10 AM on February 17, 2009

I had a benign tumor removed from my thyroid. I had no hormonal indications; a blood test is not necessarily going to show a tumor, as it doesn't always affect thyroid function. I had half my thyroid removed and a I still have no hormonal changes. If you have a primary care physician, go to her, ask if you need a head-and-neck ultrasound; if they find something on your thyroid or elsewhere, they will give you next steps. Don't go to a doctor and tell her what you need; just tell her what you are finding/feeling/fearing. She'll figure out what you need.

In the meantime, please stop going to the minute clinic. Please find a competent primary care physician associated with a major hospital and get regular (annual or 6 month) check ups.

To all the immortal young people here in the green, please get a primary care physician, please devote a portion of your budget to health insurance, please do not rely on the minute clinic for your primary medical care. /grandma
posted by nax at 7:30 AM on February 17, 2009

You said it may take weeks to get in to see your doctor. You need to call them and explain everything to the doctor to see if he/she can fit you in today. If not, then you need to go to an urgent care clinic. Either way, this is not something you want to put off for several weeks.
posted by GlowWyrm at 8:07 AM on February 17, 2009

Just wanted to add that a rapid strep test can be done and the results known in about 20 minutes. No more waiting days for results.
posted by GlowWyrm at 8:10 AM on February 17, 2009

Alright guys, I guess I'll call and try and see a doctor asap. Thanks, everyone!
posted by tachikoma_robot at 11:23 AM on February 17, 2009

Oh yeah, and she didn't swab my throat, but at the time I thought maybe because the infection was still starting, maybe it wouldn't have said anything?
posted by tachikoma_robot at 11:25 AM on February 17, 2009

OK, so i'm clueless. I do have health insurance. But I recently moved closer to DC (to Bethesda) and my primary care doctor is an hour away- how do I go about finding a doctor closer to me? Or do I just have to suck it up and go there?
posted by tachikoma_robot at 11:45 AM on February 17, 2009

Nevermind, called my mom...
posted by tachikoma_robot at 12:07 PM on February 17, 2009 [1 favorite]