Thyroid nodules are benign though suspicious. Examination through elastography technique is beneficial as it provides real time and first hand evidence about the tissue stiffness by providing a strain value on comparing suspected and normal tissue. Until now, there is no established method that allows to categorise strain ratios whether tumour or normal. Changes in gain settings can significantly alter measurement and ultimately the clinical findings. The objectives of this study are to assess the effect of gain settings on strain ratios of isoechoic stiff lesions in a thyroid gland phantom, and the difference in strain ratios with first order texture parameters at different gain settings. In this study we have reported the effect of gain setting parameter on strain ratios of the thyroid tumour. Furthermore, first order texture parameters (mean and variance) were discussed with respect to increase in gain settings. Higher strain ratios were observed as gain increased. Significant differences in first order texture parameters can be observed for mean of tumour when compared with normal thyroid tissue. Variance did not demonstrate any significant difference. It was concluded that gain parameter effect the strain ratios and texture parameters. This may affect the interpretation of results. It is advised to use elastography in combination with B-mode ultrasound, and sonographers must use a balanced approach when changing equipment parameters.