Thyroid nodules are lumps that can appear in the thyroid gland at the front of the throat. Thyroid nodules may cause no symptoms, but people can sometimes feel a lump in their neck. Most are harmless, but some may be cancerous and require treatment. Thyroid nodules develop when thyroid cells build up in the thyroid gland. Some people discover a cyst by feeling it in their neck. However, most people don’t know they have a thyroid nodule until a doctor identifies it. The thyroid gland produces hormones that have a variety of functions, including helping organs function properly and creating energy to keep the body warm. In some cases, a thyroid nodule can disrupt the normal production of thyroid hormones. A nodule can develop for different reasons. It can be a cyst or, more rarely, a tumor.
This article reviews the possible causes and types of thyroid nodules, symptoms, diagnosis, and treatment.
- 1 What is a thyroid nodule?
- 2 Symptoms of thyroid nodules
- 3 Conventional treatments for thyroid nodules
- 4 Common causes of the occurrence of thyroid nodules
- 5 When to perform a biopsy
- 6 Are thyroid nodules cancerous?
- 7 Do thyroid nodules go away on their own?
- 8 Diagnostic
- 9 what to remember about thyroid nodules
What is a thyroid nodule?
Thyroid nodules are lumps that develop in or around the thyroid gland. A person may have one or more nodules. Thyroid nodules are common in Europe. It is estimated that they affect 50% of adults before the age of 60. Some nodules are easy to feel, but nodules smaller than one centimeter (cm) may not be noticeable or located deep in the thyroid gland.
Nodules can be cystic or solid. A type of solid nodule is a colloidal nodule that develops due to an accumulation of thyroid cells and is not harmful. Cancerous thyroid cells are another type of solid nodule. Other nodules are functional or self-sustaining, meaning they can produce thyroid hormones, while others are not. If a nodule affects the production of thyroid hormones, it can cause symptoms of hypothyroidism or hyperthyroidism. An example of this phenomenon is toxic multinodular goiter, which occurs when nodules growing in the thyroid gland affect thyroid hormone.
Symptoms of thyroid nodules
In most cases, a thyroid nodule has no signs or symptoms. If symptoms are present, they may include:
– pain in the neck
– difficulty swallowing
– swelling of the neck
– unexplained weight gain or sudden and rapid weight loss
– irregular or increased pulse
– anxiety or nervousness
– cold intolerance
– dry skin
– swelling of the face
Symptoms may also depend on the size of the nodule. The thyroid gland is located at the front of the throat, next to the trachea and digestive tract. If a nodule presses on the trachea or food pipe, the person may experience the following symptoms:
– swallowing problems
– a tickling sensation in the throat
– difficulty in breathing
In rare cases, the person may feel pain at the site of the nodule that spreads to the ear or jaw.
Conventional treatments for thyroid nodules
Treatment for thyroid nodules depends on their type and cause. If a doctor has determined that a lump is benign based on the tests performed, they will monitor the person closely with physical exams and an ultrasound every 6 to 12 months. If large nodules cause difficulty swallowing or breathing or affect thyroid hormones, surgery may be needed to remove the nodule. If doctors suspect a thyroid nodule is cancerous, surgery and radioactive iodine therapy may be done to remove the thyroid gland and destroy the harmful cells.
Surgery may be needed if a nodule is:
– too big
– causes difficulty in breathing or swallowing
– difficult to distinguish as benign
In some cases, a surgeon may remove the entire thyroid gland. In this case, the surgeon makes an incision inside the lower lip to operate on the thyroid. Some people may choose to have an incision in the neck instead.
Some people with benign thyroid nodules may undergo a procedure called radiofrequency ablation. Doctors use a probe and ultrasound to shrink the nodule using an electric current. Most people recover quickly from this procedure and return to their usual level of activity the next day.
Common causes of the occurrence of thyroid nodules
The cause of thyroid nodules is unknown. However, the possible causes are as follows
– Iodine deficiency
Iodine is an essential part of the diet. Without it, the body cannot make enough thyroid hormones. If a person is iodine deficient, goiter, or an enlarged thyroid, may develop. Nodules may also form. Iodine deficiency is very rare.
To prevent it, use iodized salt. It may also be necessary to take an iodine supplement during pregnancy.
Iodine deficiency can also lead to the appearance of toxic thyroid nodules, that is, nodules that lead to an excess of thyroid hormones, causing hyperthyroidism.
Toxic thyroid nodules can cause symptoms such as:
– unintentional weight loss
– rapid or irregular heartbeat
– heat intolerance
– increased perspiration
Hashimoto’s thyroiditis is an autoimmune disease in which the body’s immune system attacks the thyroid gland. Hashimoto’s thyroiditis increases the risk of thyroid nodules.
Possible risk factors for Hashimoto’s thyroiditis include:
– have a family member with thyroid disease
– be between 40 and 60 years old, although the disease can also affect younger people
– be a woman
– have an existing autoimmune disease, such as rheumatoid arthritis or type 1 diabetes.
Over 90% of nodules are benign, but some may be cancerous. There are several types of thyroid cancer, each with different treatment options and outlooks. The risk factors for thyroid cancer are:
– be a woman
– be between 25 and 65 years old
– exposure to any type of radiation to the head or neck during childhood
– a family history of thyroid cancer, goiter or other thyroid disease
– certain genetic conditions, such as familial medullary thyroid cancer.
Thyroid cancer may not cause any signs or symptoms initially, but if the tumor grows larger, it may cause the following symptoms
– difficulty in breathing
– difficulty or pain when swallowing
– a hoarse voice
People with any of these symptoms should see a doctor to find the underlying cause.
When to perform a biopsy
Doctors usually cannot tell if a thyroid nodule is cancerous by a simple physical exam and blood tests. This means that the doctor may often decide to biopsy the nodule using a fine needle biopsy procedure. Fine needle biopsy usually takes place in the doctor’s office. During the fine needle biopsy, the doctor uses a tiny needle to extract several samples of cells inside the thyroid nodule. A lab will then examine the cells under a microscope to determine if the nodule is benign.
Are thyroid nodules cancerous?
Most thyroid nodules are not cancerous. In 80% of biopsies of thyroid nodules, the result is benign. This means that the nodule is not cancerous and the doctor will not need to remove it unless it is causing symptoms, such as difficulty breathing or swallowing. However, it is not always possible to detect cancer in a thyroid nodule by biopsy. Doctors may recommend removal of the nodule if in doubt.
Do thyroid nodules go away on their own?
Thyroid nodules due to iodine deficiency can go away on their own over time if people increase their iodine intake. In 618 study participants with thyroid nodules, approximately one-third of the single nodules were no longer present at the 11-year follow-up. The researchers concluded that increasing iodine intake through iodized salt may be the cause of the disappearance of the nodules. In other cases, benign thyroid nodules may grow larger over time, and affected individuals may need treatment to remove them.
In most cases, people have no symptoms of thyroid nodules. A doctor may discover a thyroid nodule during a routine physical exam or imaging of the neck to check for another condition. Doctors may recommend tests for people with symptoms or risk factors.
Tests to investigate unusual thyroid activity include
– an ultrasound to see if a nodule is present, how big it is and if it contains fluid.
– a blood test to assess the level of thyroid hormones
– a biopsy to remove and analyze a small piece of tissue
– a nuclear thyroid scan, which uses radioactive medicine to get a picture of the thyroid gland.
A biopsy or fine needle aspiration can tell if a nodule is cancerous or not. The doctor inserts a thin needle into the thyroid gland and sucks out some cells for analysis. The doctor may recommend surgery to remove the nodule and examine the tissues more closely.
A thyroid nuclear scan can show if the thyroid gland is working properly. For this test, the person takes radioactive iodine orally or intravenously. She then undergoes a scan to check the functioning of the thyroid gland and the possible presence of nodules.
what to remember about thyroid nodules
Over 90% of thyroid nodules are benign. Even if thyroid cancer is present, most cases are curable and rarely life-threatening. However, some forms of thyroid cancer can be more aggressive than others. The 5-year relative survival rate for people with thyroid cancer between 2011 and 2017 was 98.3%. If a nodule is not cancerous, it may still require treatment, monitoring, or both. If people have to have surgery to remove the thyroid gland, they may need to take medicine to supply the body with enough thyroid hormone.
A thyroid nodule is an abnormal growth in the thyroid gland due to a buildup of thyroid cells. Most thyroid nodules cause no symptoms and can be discovered during a routine exam. In some cases, people may feel a lump in the front of the throat and have other symptoms, such as fatigue or mood changes. Most thyroid nodules are harmless and non-cancerous. A person will need treatment for a lump if it is causing difficulty in breathing or swallowing, or if it is causing too much thyroid hormone. In some cases, a thyroid lump can be cancerous, and affected individuals will need to undergo surgery to remove the harmful thyroid cells.
A person should always contact their doctor if they think they have a thyroid nodule.