All You Need To Know About Thyroid Nodules

The thyroid is a small gland in the base of your throat that plays an important role. It releases hormones and helps to regulate bodily functions, including heart rate and metabolism. Sometimes, the thyroid can develop a lump known as a thyroid nodule. 

What is a thyroid nodule?

Thyroid nodules can be caused by various elements and can also be formed from different biological materials. The definition of a thyroid nodule is broad and is simply a lump in the thyroid gland in your neck.’

These lumps can be solid, fluid-filled, or a mix of both. Although most people think of cancer whenever they hear the word 'lump,' thyroid nodules are almost always (90%) non-cancerous.¹

However, you should always see a doctor any time you notice a lump. 

How common are thyroid nodules? 

Thyroid nodules are more common than you may think. Almost half of all Americans will have had a thyroid nodule by the time they turn 60. Some people don’t even notice that the thyroid nodules are present, particularly if they are small. Thyroid nodules are also more common in women and can run in families.  

What are the causes of thyroid nodules?

Not all causes of thyroid nodules are well established. However, they have been linked to other medical conditions. If you have been diagnosed with any of the following conditions, you could likely develop a thyroid nodule as a result.

• Over or underactive thyroid conditions

• Thyroid cysts (fluid-filled sac)

• Overgrowth of the thyroid tissue

• Multinodular goiter

• Inflammation of the thyroid, particularly if a chronic inflammatory issue is observed

• Thyroid cancer

• Iodine deficiency.

Why did my thyroid nodules disappear?

In some cases, thyroid nodules can disappear over time with no treatment. Iodine is essential for making the thyroid hormone and is sometimes deficient in the diet of people who live in countries without iodine salt. Iodine deficiency often leads to thyroid nodules, goiters, or hypothyroidism. 

When someone moves to an iodine-enriched diet, they can, in essence, treat their nodules without even realizing it. If the nodule is caused by a chronic lack of iodine over a long period, it may disappear once iodine is regularly included in their diet. 

What are the symptoms of thyroid nodules?

The first and most obvious symptom of thyroid nodules is an enlarged thyroid gland. This is known as goiter and can cause difficulty swallowing, breathing, or pain at the base of the neck. It can also cause a hoarse voice, so you should check your thyroid if you notice a change in the pitch of your voice. 

If your thyroid nodule also increases the hormonal production of the thyroid gland, then you could end up with other associated symptoms, such as:

• Anxiety or feeling nervous unexpectedly

• Unexplained weight loss

• Muscle weakness

• Increase how much you sweat

• Rapid or irregular heartbeat

• Difficulty sleeping.

Other autoimmune conditions can also change the hormonal output of the thyroid gland to be less than usual. This produces other symptoms such as:

• Brittle nails

• Persistent fatigue

• Constipation

• Unexplained weight gain

• Dry skin and hair

• Sensitivity to cold.

How are thyroid nodules diagnosed?

Physical examination

The first test you will likely be given at the doctor's office is a simple physical examination. This is when the doctor has a feel around the thyroid gland to see if they notice any enlargement. They will often ask you to swallow as they do so. 

Your doctor may also use other instruments in their office, such as their stethoscope, to check your heart rate. This is to see if you are experiencing any other symptoms listed above that are also associated with thyroid nodules. 

Ultrasonography

If you have a thyroid lump, your doctor may do an ultrasonography or an ultrasound. This is when they use sound waves to look at the thyroid in the neck. The procedure can help to determine if the nodule is solid or filled with liquid, identify the cause of the thyroid lump, and the appropriate treatment. 

Thyroid function tests

Another common test is a blood test to check the function of the thyroid. One of the most common biomarkers of thyroid function is thyroid stimulating hormone (TSH). A blood test helps your doctor to understand if your thyroid is producing too much or too little thyroid hormones.

Fine-needle aspiration biopsy

This is another test that your doctor may perform. A very small needle will take a biopsy (a small tissue sample) from your thyroid gland. This is then examined under the microscope and can help to determine if there is any chance of cancer. 

Thyroid scan

The final test used for thyroid nodule diagnosis is a thyroid scan. This involves the injection of radioactive iodine into your arm, which is absorbed by the thyroid. This can then be seen by the appropriate camera and then used to see how much or how little iodine is being absorbed by your thyroid, indicating whether or not there is a problem.

When to worry whether thyroid nodules are cancerous?

It’s important to remember that 90% of thyroid nodules are not cancerous. The above tests can help to determine if the nodule is likely to be cancerous.

How long does it take for thyroid nodules to go away?

Most thyroid nodules will only go away with surgery. A very small amount may disappear over time if they are caused by iodine deficiency. 

When should I worry about thyroid nodules?

Although it can be very scary to discover a lump, a thyroid nodule is an extremely manageable condition. Even if it does turn out to be cancer, thyroid cancers are among the most treatable. 

Treatment

Treating benign nodules

If you have a benign (non-cancerous) nodule, you may watch and wait to see what happens. Most of the time, treatment is not required. 

Treating nodules that cause hyperthyroidism

If your nodule causes an excessive amount of thyroid hormones, your doctor may put you on hormonal suppression, radioactive iodine treatments, or suggest surgery. 

Treating cancerous nodules

For cancerous nodules, your doctor may consider either surgery to remove the thyroid gland or inject a small amount of alcohol into the thyroid to stop its growth at regular intervals. 

How do you get rid of thyroid nodules without surgery?

Some thyroid nodules can be shrunk with medicine. Fluid-filled nodules can also be shrunk by removing the fluid with a needle. 

The lowdown

Although finding a lump on your thyroid may seem scary, it’s most likely harmless. 90% of thyroid nodules are non-cancerous and don’t require treatment. However, you should consult your doctor and follow their recommendations for diagnosis and treatment.