Thyroid nodules are lumps that develop in the thyroid gland, which are either in the form of hardened, solid masses or soft bulges filled with fluids. This is a very commonly occurring health anomaly of the thyroid – the butterfly-shaped gland situated internally at the foot of the neck, close to the larynx i.e. voice box and anterior to the trachea or windpipe. The thyroid gland primarily synthesizes two key hormones – triiodothyronine (T3) and thyroxine (T4), which perform vital operations including regulating digestion, body temperature, heart functions, immunity and metabolism. When thyroid nodules develop in the body, they are categorised into three distinct types – cold, warm and hot, based on their ability to produce the thyroid hormones – T3 and T4. While cold thyroid nodules do not form thyroid hormones, warm nodules work as normal thyroid cells and hot nodules generate excessive amounts of thyroid hormones.

The majority of instances of thyroid nodules are essentially harmless, non-cancerous or benign in nature, do not hamper the functioning of the thyroid glands and hormones in any way and cause no discomforting indications such as pain or bleeding. Yet, at times, such as when multiple nodules form owing to goitre, they give rise to difficulty in breathing, swallowing, sudden weight loss. In rare situations, thyroid nodules are even oncogenic in nature, implying the onset of thyroid cancer, all of which require professional medical care. It is hence necessary to understand the causes, symptoms, complications of thyroid nodules, to ensure the precise diagnosis and timely treatment of the condition in the affected person.

Also Read: Goitre: Causes, Symptoms And Treatment

Causes Of Thyroid Nodules

Numerous ailments result in the development of thyroid nodules. Mostly, the surplus proliferation of thyroid cells triggers the enlarged size of the thyroid gland, giving rise to nodules. This is referred to as thyroid adenoma but is not cancerous and can be easily treated. Cysts i.e. voids packed with fluids that occur in the thyroid gland also result in thyroid nodules.

At times, thyroid nodules arise from pre-existing thyroid health conditions, such as the autoimmune disorder Hashimoto’s Disease, or Goitre, that prompts the undue enlargement of the thyroid gland. Only in rare cases, iodine deficiency or thyroid cancer is the reason behind the occurrence of thyroid nodules.

Symptoms

Thyroid nodules are usually not a very serious illness and when the size of the nodules is small, they cause no noticeable external signs. Only when the thyroid nodules grow to an abnormally large extent, they are prominently visible on the outside of the neck, can be felt as a protuberance and even give rise to discomforting indications of breathing difficulty and inability to swallow food easily.

In some cases, thyroid nodules result in a surplus synthesis of thyroid hormones, particularly thyroxine, leading to hyperthyroidism and when it worsens, even a thyroid storm. This hampers the intrinsic metabolism in the system and leads to more serious symptoms of irregular heartbeats, abrupt weight loss and sensations of shivering, tremors, nervousness in the body.

Also Read: Thyroid Storm: Causes, Symptoms And Treatment

Diagnosis

The doctor conducts a series of procedures to determine if the patient has developed any thyroid nodules. Firstly, they perform a thorough external examination of the thyroid gland, by instructing the patient to swallow some food, which helps to see if any thyroid nodules are present and moving during that process. The physician also studies if any visible signs of hyperthyroidism are demonstrated by the patient, such as tremors, rapid heartbeat or uncontrolled movement of the muscles.

Thyroid function tests are also performed, to measure the amount of thyroid hormones – T3 and T 4, as well as thyroid-stimulating hormone (TSH) in the blood sample of the patient. Ultrasound scans and fine-needle biopsies are carried out, to examine the size, shape and attributes of the thyroid nodules, such as if it contains cancerous cells or is benign.

Treatment

Treatment for thyroid nodules depends on the cause, as well as the size and number of inflamed cavities present in the thyroid gland. In minor instances, when one or a few small nodules do not grow larger in size or gradually shrink on their own, no specific medical treatment is required. The healthcare provider only regularly monitors the size and shape of the nodules present in the thyroid gland.

In case thyroid nodules obstruct the functioning of the thyroid glands in producing hormones, then thyroid hormone therapy is essential for the patient. When the size of the thyroid nodules is massive and poses problems in breathing normally and swallowing food smoothly, then surgery is performed, to remove the nodules.

Sometimes, thyroid nodules result in hyperthyroidism. In these circumstances, appropriate antithyroid medications, radioactive iodine therapy are given, to rectify the operations of the thyroid gland. In more serious instances, surgery is performed, to eliminate the enormous thyroid nodules. When thyroid cancer is the reason behind thyroid nodules, which only occurs in seldom instances, then surgical removal of a major portion of thyroid tissues, a procedure known as near-total thyroidectomy, is done, to excise and completely delete the enlarged cancerous thyroid nodules.