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Thyroid Nodules: Symptoms, Diagnosis, Treatment, and More!

Thyroid Nodules

The thyroid is a powerful gland found at the base of the neck. It has notable influence over bodily function through the production and regulation of various thyroid hormones. Although typically not a cause for serious concern, thyroid nodules, growths on the thyroid gland, may disrupt thyroid activity resulting in widespread bodily dysfunction. Having an understanding of thyroid nodules, their impact on the body, and common approaches for treating them may help you protect your thyroid and overall wellness.

What Is a Thyroid Nodule?

A thyroid nodule is a tumor or lump that develops on the thyroid gland due to improper cell growth. Thyroid nodules are quite common, and it is estimated that most people will develop at least one before they reach the age of 50. In most cases, thyroid nodules do not have a dramatic impact on overall health. However, depending on nodule type, they may interfere with thyroid activity, prompt the occurrence of various symptoms, and contain malignancies.

The Impact of Thyroid Nodules on Thyroid Function

Thyroid nodules may occur in a variety of forms. They can be a solid mass of tissue, a liquid filled cyst, a large growth, or seemingly imperceptible. Depending on their specific qualities, a nodule may increase or decrease thyroid activity thereby influencing overall bodily function.

Toxic Nodules

Nodules that increase the production of thyroid hormone are considered to be toxic. These growths are concerning as they can lead to an undesirable increase in thyroid activity called hyperthyroidism. An overly accelerated thyroid is associated with dangerous hastening of various areas including metabolism, cardiovascular function, and stress response.

Enlarged Nodules

Thyroid nodules that grow to a prohibitive size can press against the neck and constrict the windpipe making it difficult to breathe or swallow. Enlargement of nodules is typically triggered by inflammation of the thyroid. These types of nodules are called thyroid adenomas. An adenoma may require intervention if it becomes physically intrusive or inhibits thyroid activity to a degree that causes hypothyroidism.

Thyroid Cysts

In some cases, thyroid nodules form as cysts that contain blood, debris, or leftover cell material. These cysts are typically the result of injury or inflammation of the thyroid gland. What separates a cyst from other nodules is their contents which may need to be drained or biopsied in order to acquire an accurate diagnosis.

Are Thyroid Nodules Cancerous?

Nodules are classified as benign, malignant, suspicious, or inconclusive. Data suggests that more than 90 percent of thyroid nodules fall into the benign or non-threatening category. Although the vast majority of nodules are benign there is an ever-present risk of malignancy in thyroid nodules. Fortunately, even if a nodule is malignant, thyroid cancer is treatable and has an impressively high survival rate. However, regardless of the low risk of malignancy and high treatability, it is always best to pursue assessment and testing by a trained physician if a thyroid nodule is present.

Identifying and Diagnosing Thyroid Nodules

There are several physical characteristics and symptoms associated with thyroid nodules. If you experience some or all of the following issues, speak with a doctor about testing for thyroid nodules

Signs and symptoms of thyroid nodules include:

  • Symptoms of hyperthyroidism (palpitations, insomnia, weight loss, anxiety, diarrhea, tremors, etc.)
  • Symptoms of hypothyroidism (weight gain, fatigue, depression, changes in skin texture, difficulty thinking clearly, etc.)
  • Difficulty swallowing
  • Sensations of fullness
  • Pain in the neck
  • Hoarseness
  • Neck tenderness
  • Shortness of breath
  • Physical lump or growth on or around the neck

A doctor may run various tests including a physical exam, x-ray, CT scan, MRI, or ultrasound to confirm the presence of a nodule. Doctors may also run a series of blood test to assess thyroid hormone levels. This may provide an image of how much the nodule is affecting thyroid activity. If cancer is suspected, a more involved Fine Needle Aspiration (FNA) or needle biopsy may be employed. All of these assessments help to accurately identify thyroid nodules and reasonably assess their threat allowing for a more informed decision regarding treatment.

Regular self-examination is recommended to be aware of any changes or growths on the thyroid gland. Here’s a step-by-step guide to perform a thyroid neck check.

Treating Thyroid Nodules

Depending on the type of nodule and diagnosis of its threat potential, different approaches may be used to treat a thyroid nodule.

Benign nodules often require little to no treatment. However, some doctors may prescribe thyroid hormone or iodine supplementation to help shrink the thyroid nodule or prevent its growth. If this treatment proves to be ineffective a doctor may recommend a biopsy or surgical removal of the nodule.

Toxic nodules may be treated through the use of anti-thyroid drugs to counteract the increase of thyroid activity and excess thyroid hormone. If the case is severe, a doctor may suggest surgical removal of the toxic nodule, one of the two lobes of the thyroid, or complete removal of the gland also known as a thyroidectomy. In the case of a thyroidectomy, the patient must remain on thyroid medication for the rest of their life.

If a nodule is inhibiting thyroid function, the patient may be prescribed thyroid medications to make up for the deficit. Typically, doctors recommend synthetic T4 drugs in the form of levothyroxine. However, studies have found that treatment with bioidentical thyroid hormones, T3 formulations, and/or combination T4/T3 medications can provide substantially better results – learn more about why T4-only medication doesn’t work for most patients here. Surgical intervention to remove the nodule may also be recommended.

Suspicious, inconclusive, or malignant nodules are almost always removed surgically as soon as possible. During the removal process, thyroid cells are tested for cancerous growth and the decision to perform a thyroidectomy can be made during the same procedure. The procedure itself is simple and recovery typically takes less than two weeks.

Take the Appropriate Precautions with Thyroid Nodules

Thyroid nodules are a common occurrence that typically pose no substantial threat to our health. However, in some cases, thyroid nodules may cause thyroid dysfunction, induce physical pain, and significantly increase the risk of thyroid cancer. Fortunately, nodules are easily diagnosed through a variety of methods allowing for a well-informed decision regarding treatment. Treatment of thyroid nodules is considered exceptionally safe and effective while requiring minimal effort on behalf of the patient. If you suspect you have a thyroid nodule, protect your health by speaking with a doctor about further testing and treatment.  

Resources

1. Popoveniuc, G. and Jonklaas, J. “Thyroid Nodules.” Medical Clinics of North America, 96(2), pp.329-349.
2. Menzilcioglu MS, Duymus M, Avcu S. “Sonographic Elastography of the Thyroid Gland.” Polish Journal of Radiology. 2016;81:152-156.

3. Holtorf Staff. “Thyroid Nodules: A Growing Concern.” Holtorf Medical Group.

4. Hotze Health. “Understanding Thyroid Nodules.” Hotze Health and Wellness Center.

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