Thyroid nodules

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Overview

Thyroid nodules are lumps that occur in the thyroid gland. Thyroid nodules may be solid, cystic (fluid filled), or a combination of both and can develop in any location within the thyroid gland. At least 85% of thyroid nodules are benign thus thyroid cancer accounts for only a small percentage of all thyroid nodules. Thyroid nodules are generally not considered a serious condition and most often detected without producing any symptoms whatsoever. Thyroid nodules can produce symptoms and most commonly this is a lump or sensation of fullness in the neck. This page will tell you when we worry about thyroid nodules, and when we don't.

Thyroid nodules are most commonly found when a doctor examines a patient's neck, feeling the thyroid gland. Sometimes thyroid nodules are found when a patient gets x-rays or scans of the neck for some other reason. Sometimes it is a screening x-ray or scan for carotid arteries or neck pain that shows nodules in the thyroid. Thyroid nodules that are large, develop in women with thin necks, or are present in the middle portion of the thyroid gland (called the isthmus) may be visible and discovered as a lump in the neck.

Symptoms

Most thyroid nodules do not have symptoms. Those nodules that don't have symptoms are usually found when a doctor gets some form of x-ray or ultrasound test on a patient for some other reason and that scan shows the nodule. A good example would be somebody that is getting x-rays on their neck because of neck pain, or to look at the carotid arteries. About 30% of thyroid nodules DO cause symptoms and this is the complete list of those symptoms. Below, we will examine each of these symptoms in detail and discuss what it means, and how this may affect the need for a biopsy or surgery.

Symptoms of Thyroid Nodules

A lump in the front of the neck that you can feel.

A lump in the neck that you can see when looking in the mirror. Usually somebody else notices it first.

A sense or feeling like you need to swallow something.

A cough that just won't go away. Frequent coughing during the day and a need to keep clearing your throat.

Uncomfortable pressure sensation on the breathing tube (trachea)

Problems with swallowing. A feeling like things get stuck in your throat sometimes when eating.

Symptoms of hyperthyroidism; symptoms of too much thyroid hormone (discussed below).

Causes

It’s not always clear why a person gets thyroid nodules. Several medical conditions can cause them to form. They include:

Thyroiditis: This is chronic inflammation of the thyroid. One type of thyroiditis is called Hashimoto’s disease. It’s associated with low thyroid activity (hypothyroidism).

Iodine deficiency: A diet that lacks iodine can result in thyroid nodules. This is uncommon in the U.S., since iodine is added to many foods.

Thyroid adenoma: This is an unexplained overgrowth of thyroid tissue. Most adenomas are harmless, but some produce thyroid hormone. This leads to an overactive thyroid (hyperthyroidism).

Thyroid cancer: Most thyroid nodules aren’t cancer, but some can be.


Risk factors

History of thyroid radiation.

Family history of thyroid nodules or thyroid cancer.

Increasing age.

Iron-deficiency anemia.

Smoking.

Obesity.

Metabolic syndrome.

Alcohol consumption.

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Complications

Complications associated with some thyroid nodules include:

Problems swallowing or breathing. Large nodules or a multinodular goiter can interfere with swallowing or breathing.

Hyperthyroidism. Problems can occur when a nodule or goiter produces thyroid hormone, leading to an excess amount of the hormone in the body. Hyperthyroidism can result in weight loss, muscle weakness, heat intolerance, and anxiousness or irritability.

Potential complications of hyperthyroidism include an irregular heartbeat, weak bones and thyrotoxic crisis, a rare but potentially life-threatening intensification of signs and symptoms that requires immediate medical care.

Problems related to thyroid nodule surgery. If your doctor recommends surgery to remove a nodule, you may need to take thyroid hormone replacement therapy for the rest of your life.

Prevention

Since researchers don’t know what causes the majority of thyroid nodules, you can’t prevent them in most cases.

You can, however, try to decrease your risk of developing them by managing certain risk factors. For example, if you have obesity, talk to your healthcare provider about attaining a healthy weight for you. If you smoke cigarettes, try to quit. It’s also important to make sure you get enough iodine in your diet. If you use iodized table salt, you’re likely consuming enough.

Studies have shown that people who take oral birth control and/or statins may have a reduced risk of developing thyroid nodules.