Thyroid nodule is pushing on my throat, coughing, hard to swallow, feels awful. dont know size yet, but what indications would it be removed?

Ultrasound first: The first step would be an ultrasound. If a solid nodule is present, surgery is indicated. If it is cystic, you would have a needle aspiration and biopsy. If the biopsy showed suspicious cells or if the aspiration did not improve your symptoms, you would need surgery.

Get evaluated: An indication to remove the thyroid due to a nodule is if it's already causing compressive symptoms. However, you need to get an ultrasound first to make sure it's a thyroid module causing your complaint and not something else.