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Thyroid Nodules

Thyroid nodules are abnormal cells which grow together to form one or more small lumps in the thyroid. Many thyroid nodules are found when a healthcare provider examines a person’s neck. Some are discovered by chance on a scan done for another reason. Most thyroid nodules are not cancer.

Thyroid nodules are classified based on characteristics such as:

  • Whether they produce extra thyroid hormone. A hot nodule does make extra thyroid hormone, while a cold nodule does not.
  • Whether they are solid or filled with fluid (cystic)
  • Whether there is only one nodule or several nodules

Symptoms

A lot of the time, thyroid nodules do not cause any symptoms. If a nodule or group of nodules does cause symptoms, they can include:

  • A lump on the neck if the nodule grows large enough
  • Voice hoarseness or feeling of something pressing on the throat
  • Pain in the neck
  • A feeling of something stuck in the throat or the oesophagus (tube that connects the mouth to the stomach)
  • Difficulty breathing

In thyroid nodules that produce thyroid hormone, a person can have too much thyroid hormone in the body. They can then start to show symptoms associated with high thyroid hormone, including:

  • Tremors
  • Heart beating too fast
  • Feeling anxious or very energetic
  • Sleeplessness
  • Loose stools

Causes

The exact cause of thyroid nodules is not known. However, some thyroid nodules are associated with the following:

  • Low levels of iodine, a nutrient which helps with making thyroid hormone
  • Hashimoto’s thyroiditis – a condition where the immune system attacks the thyroid gland by mistake
  • Thyroid cancer

Risk Factors

Thyroid nodules are more common in:

  • Older adults
  • Women
  • People whose diets do not have enough iodine
  • People who have had radiation exposure to the neck
  • People with a family history of thyroid problems or thyroid cancer
  • Smokers
  • People who drink large amounts of alcohol

Diagnosis

If a healthcare provider is concerned about a patient’s thyroid, they will first do a thorough examination of the area. They will then request further testing, such as:

  • Bloods to check thyroid hormone levels in the body
  • Ultrasound scan – a painless scan using soundwaves to better evaluate the thyroid
  • Biopsy – if there is concern on either the bloods or the scan, a biopsy of the nodule may be requested. This is performed with a very small needle. The samples are then sent to the lab for a pathologist to look at them under the microscope
  • Nuclear medicine scan – a scan done at the hospital where radioactive imaging dye helps show what the nodule and surrounding thyroid tissue looks like

Complications

Many thyroid nodules do not cause complications. In those that do, some complications include:

  • The need to take medication to help regulate thyroid hormone levels in the body
  • Complications related to surgical treatment
  • The nodule grows so large that it causes difficulty breathing, swallowing, or speaking

Treatment

Treatment of a thyroid nodule depends on the type the person has. For some thyroid nodules, no treatment is needed. A clinician will continue to periodically check the patient for further developments. Other treatment options can include:

  • Prescribed thyroid hormone supplements (medication)
  • Radioactive iodine treatment – radioactive iodine can destroy some types of nodules
  • Surgical removal of a nodule

Prevention

Since the true cause of most thyroid nodules is unknown, it is difficult to know how to prevent them. Researchers have suggested that people with a family history of thyroid cancer get screened on a regular basis. Other general suggestions include quitting smoking and getting enough iodine in the diet (either by the foods they eat or via supplements).

 
 
 

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