Chapter 1: Janet's Story

In 1983, while she was in law school, Janet visited her ear, nose, and throat doctor (ENT) because of a persistent sore throat.

My ENT prescribed antibiotics, but my throat still hurt. While I was on vacation visiting my parents, I saw an ENT there who said he thought my thyroid was at the back of my throat. When I came home from vacation, I went to see another ENT who confirmed that I did indeed have a lingual thyroid. He referred me to [an endocrinologist].

Janet recalled that the doctor who performed her tonsillectomy when she was three years old had told her mother "something" about a lingual thyroid. However, since she had had no problems with it, she had forgotten about it until this episode of sore throats.

To confirm her diagnosis, Janet's ENT ordered a CAT scan and esophagram, which revealed a long, flat, broad~based sublingual thyroid projecting into her throat. He also performed a biopsy, which confirmed that the mass at the base of her tongue was a non cancerous lingual thyroid. Later on, Janet consulted an endocrinologist who diagnosed mild hypothyroidism and prescribed levothyroxine.

I never really had any problems with it other than the sore throats in 1983. I've been taking [levothyroxine] since then. Somewhere between 1992 and 1995, I had to increase the dosage twice. I get tired sometimes, but I really don't sleep a lot. I don't think it has any thing to do with my thyroid.

Lingual thyroids are not always apparent at birth. Although Janet's congenital thyroid abnormality did not cause her difficulty, other congenital defects, such as neonatal hypothyroidism, can cause irreversible damage if not detected at birth. Fortunately, neonatal screening programs have markedly reduced the consequences of congenital hypothyroidism..