Thyroid nodules are solid lumps that form within your thyroid, a tiny gland at the bottom of your neck. A majority of thyroid nodules don't cause symptoms or pose threat to life. Only thyroid cancer accounts for small percentage of thyroid nodules.
You will not be able to notice a thyroid nodule until your doctor discovers it during a routine medical exam. Some thyroid nodules may become large enough to be clearly visible. These large nodules may make it difficult to swallow or breathe.
Symptoms related to Thyroid nodules
Most thyroid nodules don't cause signs or symptoms. However, some nodules become so large that they can:
- Be felt
- Be seen as a swelling at the base of your neck
- Pressurize your windpipe leading to shortness of breath or difficulty swallowing
Sometimes, thyroid nodules make excess thyroxine, a hormone secreted by your thyroid gland. This can result in
hyperthyroidism, symptoms of which include:
A few thyroid nodules are malignant in nature, but it’s difficult to identify them on the basis of symptoms alone. Although size is not an exact indicator of a cancerous nodule,
malignant thyroid tumors are more likely to be large fixed masses that grow quickly.
Factors causing thyroid nodules
- Iodine deficiency: Lack of iodine in your diet can sometimes lead to the formation of thyroid nodules. But iodine deficiency is common in countries where iodine is not routinely added to table salt and other foods.
- Overgrowth of normal thyroid tissue: Overgrowth of normal thyroid tissue is sometimes referred to as a thyroid adenoma which is benign and not considered serious unless it causes troublesome symptoms from its size.
- Thyroid cyst: Cysts in the thyroid is commonly the result of degenerating thyroid adenomas. Cysts are generally non-cancerous, but they sporadically contain malignant solid components.
- Thyroiditis: Hashimoto's Thyroiditis can cause thyroid inflammation resulting in nodular enlargement. This often is linked with hypothyroidism.
- Thyroid cancer: Although the chances that a nodule is cancerous are small, you are at risk if thyroid or other endocrine cancers run in the family.
Available treatments for thyroid nodules
Treating benign nodules
There are various treatment options, if your thyroid nodule is benign:
- If a biopsy examination shows that you have a benign thyroid nodule, your endocrinologist may recommend simply watching your condition, which normally means having a physical exam and thyroid function tests at regular intervals.
- Thyroid hormone suppression therapy involves treating a benign nodule with Levothyroxine, a synthetic form of thyroxine that you take in pill form. The objective is to supply additional thyroid hormone that will stimulate the pituitary to produce less TSH, the hormone that stimulates the growth of thyroid tissue.
- In some cases, a nodule that's clearly benign may require surgery, especially if it's so large that it makes it hard to breathe or swallow.
Treating nodules that cause hyperthyroidism
If a thyroid nodule is overpowering your thyroid gland's normal
hormone production levels, your endocrinologist may suggest treating you for hyperthyroidism:
- Doctors often use radioactive iodine to treat hyper-functioning adenomas or multinodular goiters. Taken as a capsule or in liquid form, radioactive iodine is absorbed by your thyroid gland, causing the nodules to shrink and signs and symptoms of hyperthyroidism to drop.
- In some cases, your doctor may recommend an anti-thyroid medication like Tapazole to lessen symptoms of hyperthyroidism. Treatment is usually long-term and can have side-effects on your liver.
- Surgery might be the last option if radioactive iodine or anti-thyroid medications fail to work.