Thyroid nodules are solid or fluid-filled lumps that form within the thyroid gland and most nodules don’t show any symptoms and are not dangerous. A few percent of thyroid nodules are cancerous. In most cases, a person may not know that they have a thyroid nodule until doctors find it during a regular medical examination. However, some thyroid nodules may become large to be visible or can make it hard to swallow or breathe. Treatment usually depends upon the type of nodules.
Symptoms
Most thyroid nodules don’t cause any signs or symptoms, but rarely some nodules become so big that they can be:
- Sensed
- Nodules are seen as swelling at the base of the neck
- Breathing difficulty
- Swallowing problems
In some cases, thyroid nodules make extra thyroxine, a hormone secreted by the thyroid gland, and these can cause symptoms of hyperthyroidism like:
- Sudden weight loss
- Increased perspiration
- Tremor
- Nervousness
- Irregular heartbeat
Although most thyroid nodules are noncancerous and don't cause any problems. However, consult your doctor to evaluate any unusual swelling in your neck, especially if you have breathing or swallowing issues. As it’s important to evaluate the possibility of cancer.
Also Read: Thyroid Stimulating Hormone (TSH): Structure, Crucial Functions And Adverse Effects
If you develop any of the below signs and symptoms, then seek immediate medical advice.
- Sudden weight loss even if appetite is normal
- Rapid heartbeat
- Trouble sleeping
- Muscle weakness
- Nervousness
Also, consult your physician, if you have symptoms that may indicate your thyroid gland isn’t making adequate thyroid hormone (hypothyroidism), which include:
- Feeling cold
- Feeling exhausted more easily
- Dry skin
- Memory issues
- Depression
- Constipation
Causes
Several medical conditions can cause nodules to develop in the thyroid gland, including:
Overgrowth Of Normal Thyroid Tissue: An overgrowth of thyroid tissue is known as thyroid adenoma, however, it’s not evident why it develops. And it’s not cancerous and not considered severe unless it causes troubling symptoms due to its size. Some thyroid adenomas may lead to hyperthyroidism.
Thyroid Cyst: Fluid-filled cysts in the thyroid commonly result from degenerating thyroid adenomas, where solid components are mixed with fluid. Usually, cysts are noncancerous but rarely contain cancerous solid elements.
Chronic Inflammation: Hashimoto’s disorder can result in thyroid inflammation and enlarged nodules, which are often linked to hypothyroidism.
Multinodular Goiter: A multinodular goiter contains several distinct nodules within the goiter, but its cause is not clear.
Thyroid Cancer: The chances that a nodule is cancerous are very thin. But if the nodule is large and hard or causes pain or discomfort then it is worrisome. In such cases, get it examined by a doctor.
Certain factors can elevate the risk of thyroid cancer including a family history of thyroid or other endocrine cancers and any history of radiation exposure from medical therapy or nuclear explosion.
Iodine Deficiency: Iodine deficiency can at times cause the thyroid gland to develop nodules.
Diagnosis
The main goal of the physician, while assessing a nodule in the patient’s neck is to rule out any chance of cancer. Also, the doctor may want to check if the thyroid gland is functioning normally. Some of the tests recommended include:
Physical Exam: The doctor will ask the patient to swallow while examining, as nodules in the thyroid gland will move up and down during swallowing. They will also check for signs and symptoms of both hypothyroidism and hyperthyroidism.
Thyroid Function Tests: This test measures the blood levels of thyroid-stimulating hormone (TSH) and hormones produced by the thyroid gland, which can confirm if the patient has hyperthyroidism or hypothyroidism.
Also Read: Thyroid Function Tests: Why It Is Done and What To Expect
Ultrasound: This imaging scan uses high-frequency waves to create pictures of the thyroid gland. The scan offers accurate information about the shape and structure of nodules. Helping the doctor to distinguish between cysts from solid nodules or check if multiple nodules are present.
Doctors may also use the scan as a guide in performing a fine-needle aspiration biopsy.
Fine-Needle Aspiration Biopsy: Nodules are often biopsied to ensure no cancer is present. During the procedure, the doctor inserts a very thin needle in the nodule and removes a sample of cells. It is done in the doctor’s clinic or scan centers take about 20 minutes and has minimal risks. The samples are sent to a laboratory to have them examined under a microscope.
Thyroid Scan: The doctor may recommend a thyroid scan to help evaluate thyroid nodules, where an isotope of radioactive iodine is injected into a vein in the arm.
Nodules that make excess thyroid hormones are called hot nodules, which show up on the scan, as they take up more of the isotope than normal thyroid tissue. Hot nodules are almost always noncancerous.
While nodules that take up less of the isotope are called cold nodules, which are cancerous. However, a thyroid scan can't differentiate between cold nodules that are cancerous and those that aren't cancerous.
Treatment
Treatment depends on the type of thyroid nodule the patient have and treatment options for benign nodules that are noncancerous include:
Watchful Observation: If a biopsy shows that the patient has a noncancerous thyroid nodule, then the doctor may suggest simply observing the condition.
This means having regular physical exams, thyroid function tests, and ultrasounds. The patent may need another biopsy if the nodule grows larger. If a benign thyroid nodule remains unchanged, the patient may never require any treatment.
Thyroid Hormone Therapy: If the thyroid gland is not making adequate hormones, then the doctor may suggest thyroid hormone therapy.
Surgery: A noncancerous nodule at times need surgery if it’s too large which makes it difficult to breathe or swallow. Doctors may also consider surgery for patients with large multinodular goiters, mainly when the goiters impede airways, esophagus, or blood vessels. If nodules are diagnosed as indeterminate or suspicious by a biopsy, then it needs to be surgically removed and analysed for any signs of cancer.
