Thyroidectomy for compression symptoms - benign nodules - surgery or not?

[icouldusesomehelphere]

l have been through a tough 2025 with a bunch of unexpected health things, one of which was an incidental finding of multi-nodular thyroid goitre.
I knew they were there from an ultrasound years ago.
A recent biopsy on a suspicious one was benign. Two extensive US concluded they are all assessed as benign.
I’m in my late 40’s.

I have 4 on one side, all in the 2.5cm to 3.5 range and a 2cm on the other side. Some are solid or semi-solid. All blood tests show thyroid function is fine, so not hyper or hypo. Inconclusive on whether there is some deviation if my trachea as a result of the nodules.

When discussing with consultant (who I will see again in the new year), he has offered surgery for compression symptoms; I think he will recommend I have it, but ultimately it’s my choice.

I have moderate/severe sleep apnoea, use c-pap & sleep on three pillows or I stop breathing.
If I lie flat I struggle as I snore & choke a bit.
I have a bit of a chronic cough (also asthmatic) & mouth-breathe otherwise I get ‘air-hunger’.
I didn’t know this all might be to do with nodules in thyroid, and just thought it was due to being overweight.

The surgeon said it would be total surgery; they won’t leave any behind, so this means life-long medication - is it levothyroxine?

Question for me to think about is should I have surgery or not?
I can carry on with the adaptations I make currently for sleep apnoea, etc. Or have major surgery with all the symptoms that this might involve & life long medication. Would it improve my quality of life?

Has anyone had this surgery where it isn’t due to cancer or ‘toxic’ thyroid, but just for compression symptoms? Would you do it again?
Thank you!!

not In response to your specific question but my DH had a thyroidectomy for Graves’ disease - most people are fine but it took him about 4 years to get his t4/t3 hormone levels back to a balanced state where he felt well. This does happen to a small % of people.

He takes a pig thyroid (armour) along with levothyroxine now. The armour thyroid is not cheap.

Id recommend reading up on people who have had their thyroids removed or radiated and are now hypothyroid (health unlocked is a good forum for this) and make an informed decision.

https://healthunlocked.com/thyroiduk/posts

a few thoughts thinking only of the airway implications... if you're really thinking of not having surgery I would ask very specifically what the natural course of the goitre might be and how easy you might be to anaesthetise if it gets much bigger/becomes inflamed. I would also ask about the risk if you were to need incidental surgery for something else while you have a large MNG if you decide not to proceed - it can have very real anaesthetic implications. Far better to have surgery involving possible airway compromise done as a planned procedure than when you have acute stridor or a wildly deviated/compressed trachea (particularly if you're overweight as well). Finally, I'd ask if they think it might reduce the severity of the sleep apnoea (and therefore reduce the complications sleep apnoea can cause).