Hello, From your description, I can deduct that probably you have a Multinodular Goiter. The enlarged lymph nodes in your neck can be due to a local infection but can be caused even by other diseases like thyroid cancer. For this reason, if you were my patient I will suggest doing some tests like TSH, fT3, fT4, thyroglobulin test, thyrocalcitonin test, a thyroid ultrasound, and a thyroid scintigram. All these tests will clarify the situation of your neck lymph nodes and your thyroid gland and are decisive for the treatment and the follow up of your thyroid condition. About the surgery, I can say that for a nodular goiter with lymph nodes in the neck, it is the best solution. It is true that after surgery, you should take levothyroxine for the rest of your life but this medicine has not terrible side effects that you be so worried about. The potential side effects of Levothyroxine are temporary hair loss, allergic reaction, increased sweating and tiredness. These side effects are very rare, so you should not be afraid. Another alternative of treatment is Radioactive iodine therapy but my advice is to discuss carefully with your a local endocrinologist about your exact diagnosis and the alternative of treatment that is most appropriate for your specific case. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Elona Xhardo, Endocrinologist