In October 2009 I was diagnosed with hyperthyroidism and multinodular goiter. I am 43 and female. My TSH was .098. The thyroid ultrasound in 2009 revealed a multinodular goiter. The right lobe of the thyroid gland measures 5.3 x1.8 x 2.6 cm and the left lobe measures 5.2 x 1.9 x 2.1 cm. There is a heterogeneous acoustical architecture involving the thyroid gland diffusely. Scattered tiny hypoechoic thyroid nodules are seen throughout both right and left lobes. The largest nodule within the right lobe of is 4 mm in diametre. The largest nodule within the left lobe is 6 mm. Within the isthmus there is also a 1.4 x 0.8 x 1.3 cm complex hypoechoic thyroid nodule with both mixed cystic and solid components. This nodule is predominantly cystic. A biopsy of the isthmus nodule was normal. Thyroid scan and uptake finding: Six hour uptake 20.8. Twenty four hour uptake 37.2. I have been on Methimazole since oct 2009. My TSH level have been normal since. My symptoms are lightheadedness, chest pain, feeling sluggish and the feeling of a ball stuck in my throat. (I don't have acid reflux). My endocrinologist now recommends a thyroidectomy because of the size of my thyroid and the nodules and maybe a new nodule he hadn't seen before, he also think that my thyroid might be pressing on a vein causing the lightheadedness. My questions are 1) Is my thyroid really that big that I should have it removed? 2) Could a thyroid of that size be compressing a vein in my neck causing lightheadedness and chest pain? 3) Once a thyroid is removed, how long does it take to get back to normal with synthroid? 4) Is surgery a good recommendation or should I get a second opinion? 5) Is a consultation with a ENT surgeon a good idea at this time? 6) What would be the best scan to see if my thyroid is pressing on a vein or wind pipe? Thank you for your help