What Causes Lingual Thyroid?

Posted on Thu, 30 Oct 2014

Question: I have a cousin in her late 40th years old. She is having a thyroid inside of her throat. What do you think the CAUSE of a person having a thyroid in the throat. She is slightly overweight for her 5 ft 2 inches height frame.

What kind of medication do you think she should take for this problem?

Answered by Dr. Binu Parameswaran Pillai (1 hour later)

Brief Answer:
Lingual Thyroid

Detailed Answer:
Good day,
Noted your concern.
Your cousin has a Lingual Thyroid. I will try to explain in it in simple way.

Our organs are developed from structures called pharyngeal arches and pharyngeal pouches in intrauterine life during early pregnancy. They look like the gills in a fish.

Thyroid and many other structures in throat and neck develop from these structures and migrate later to their final position. If there is an arrest in the migration of thyroid or parathyroid glands, they end up in wrong places ( ectopic sites) like back of tongue, inside the chest wall, sometimes inside heart etc. Lingual thyroid ( like in your cousin) is the most commonest ectopic site of thyroid gland.

Sometimes, there is no thyroid tissue in neck and lingual thyroid is the only functioning tissue. Accidental removal of this during childhood ( many doctors get confused it for a mass during childhood) may lead to hypothyroidism.

If your cousin's thyroid blood works ( FT4 and TSH) are normal, she doesn't need any medicines. But if they are abnormal, she may need medicines ( Levothyroxine).

It is a complex thing and difficult to understand. I hope you understood at least partially what I explained.

Regards XXXXXXX

Regards XXXXXXX

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Binu Parameswaran Pillai (2 days later)

"If your cousin's thyroid blood works ( FT4 and TSH) are normal, she doesn't need any medicines. But if they are abnormal, she may need medicines ( Levothyroxine). "

Do you think are the causes of this thyroid lump in the throat due to: GENETIC, overweight, eat junk food, getting OLD aging... ?

Answered by Dr. Binu Parameswaran Pillai (2 hours later)

Brief Answer:
Not due to food or old age

Detailed Answer:
Hi,
Yes, if the TSH and Free T4 are normal, she doesnt require medications. However, if the TSH is elevated and Free T4( Ft4) low, she will need levothyroxine.

As i explained, the cause of a lingual or etopic thyroid is due to an arrest in the natural migration of thyroid from the original area of development in the embryo stage to the final position at birth. It could be genetic or a mutation in the genes which helps in migration. There is no relation of this to overweight. junk food , old age etc. ( this is a thyroid developmental defect while inside mother's womb and not an acquired defect later in life)
Regards
Binu

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Binu Parameswaran Pillai (20 hours later)

My cousin she should be in the age of 50 years old. She was in her mother's womb 51 years ago. Are you saying it takes 51 years for this thyroid problem to show up ? Thank you for your patience; I am not trying to annoy you. Just want to UNDERSTAND your paragraph message listed below.

"There is no relation of this to overweight. junk food , old age etc. ( this is a thyroid developmental defect while inside mother's womb and not an acquired defect later in life),"

Answered by Dr. Binu Parameswaran Pillai (5 hours later)

Brief Answer:
Hello

Detailed Answer:
hi,
No problem at all.
What i meant is that, Lingual thyroid and ectopic thyroid are developmental problems. She probably was born with that. It was identified only now. They are not found as long as they produce hormone normally and there are no other issues.

Food and being overweight has no relation to this particular Thyroid problem

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar