Thyroid Nodule – Causes, Diagnosis and Treatment

What are thyroid nodules?

Thyroid is the gland located at the base of the neck. Thyroid nodules are an unusual growth or lump in the thyroid gland. These are fluid-filled or solid, and most of them are not severe or cause serious symptoms. Only a small percentage of these nodules turn cancerous and should be treated immediately.

The doctor mostly notices thyroid nodules during a routine scan or examination. But certain types of thyroid nodules become large and make it difficult to swallow or breathe.

What are the symptoms of thyroid nodules?

There are no symptoms caused by most thyroid nodules, but some nodules can show the following signs:

• Can be felt
• Can be seen
• Cause shortness of breath
• Cause difficulty in swallowing

In addition to this, some of the thyroid nodules can overproduce the hormone thyroxine, which produces other symptoms such as:

• Weight loss
• Tremors
• Nervousness
• Irregular heartbeat
• Increased sweating

When to see the Doctor?

Your doctor would examine your neck for swelling if you experience difficulty swallowing or breathing. You must immediately visit the doctor if you observe sudden unexplained weight loss, increased heartbeat, difficulty sleeping, weakness in the muscles, and nervousness. You must also consult your doctor if you feel excessively cold, have dry skin, and experience memory problems. These symptoms usually indicate the lack of production of the thyroid hormone by the thyroid gland.

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What are the causes of thyroid nodules?

There are many causes of thyroid nodules. Some of these causes are:

1. Thyroid tissue overgrowth: Overgrowth of the thyroid tissue known as adenoma is considered one of the causes. An adenoma is not usually cancerous and is not considered severe unless severe symptoms arise.
2. Cysts: Fluid-filled cavities or cysts in the thyroid gland develop from the degenerating thyroid adenomas. Moreover, these include both the solid and the liquid components. While most of these are non-cancerous, some of them occasionally contain cancerous elements.
3. Chronic inflammation: A thyroid disorder that results in the inflammation of the thyroid and enlarged nodules is Hashimoto’s disease. It is often associated with hypothyroidism.
4. Thyroid cancer: A large hard nodule that causes pain and discomfort needs the doctor’s immediate attention. Such nodules are usually cancerous and should be treated immediately.
5. Goiter: Goiter is generally referred to as the enlarged thyroid, but a multinodular goiter consists of distinct nodules within the goiter. The cause of such goiters is unknown.
6. Iodine deficiency: In some cases, lack of iodine also results in thyroid nodules,

How is the diagnosis of thyroid nodules made?

For a confirmed diagnosis, your doctor would perform the following tests and examinations:

1. Physical examination: Your doctors would assess your swallowing and breathing and examine the thyroid gland. He would also check other symptoms of hypothyroidism or hyperthyroidism.
2. Thyroid function tests: These blood tests reveal whether you have hypothyroidism or hyperthyroidism.
3. Scan: Your doctor may also recommend a thyroid scan that would help evaluate the thyroid nodules. This is done using a radioactive isotope of iodine that is injected through the vein of the arm.
4. Ultrasound: This technique produces high-frequency sound to generate the image of the thyroid gland. This provides information regarding the thyroid nodules and helps your doctor judge the treatment.
5. Fine needle aspiration biopsy: Your doctor would also retrieve a small sample using very thin needles to analyze for cancerous growth. This helps determine if the thyroid nodule is cancerous.

What are the treatment plans available for thyroid nodules?

The treatment plan for thyroid nodules depends on the type of nodules you have.

Benign nodules

If the thyroid nodules are not cancerous, then your doctor would advise you the following:

1. Waiting: If your nodules’ biopsy results declare it non-cancerous, then your doctor would only ask you to observe the nodules and notify the doctor if it grows larger. This would determine if you would need surgical resection later on, depending on the growth.
2. Thyroid hormone therapy: If the thyroid function tests show that your thyroid is not producing enough hormones, your doctor will put you on thyroid hormone therapy.

Surgery

Sometimes, non-cancerous thyroid nodules would require surgery if the nodules make it difficult to breathe or swallow. These thyroid nodules are surgically removed, followed by treatment and therapy.

Hyperthyroidism

If your thyroid is producing excess hormones, your doctor recommends one of the following.

1. Radioactive iodine: In this treatment, the iodine is ingested as a liquid or tablet. The radioactive iodine causes the nodules to shrink and the symptoms to subside within a few months.
2. Anti-thyroid medications: Your doctor may also recommend anti-thyroid medications to reduce hyperthyroidism. This is generally prescribed for the long term.
3. Surgery: If radioactive iodine and anti-thyroid drugs do not resolve the problem, your doctor would recommend the organ’s surgical resection.

Cancerous thyroid nodules

Treating cancerous thyroid nodules usually requires surgery.

1. Observation: Very small cancers grow very slowly and have a low risk of growing large; therefore, your doctor would advise you to observe your thyroid regularly for unusual growth.
2. Surgery: Your doctor may perform a partial or complete removal of the thyroid.. You would also require thyroid hormone replacement therapy for life.
3. Alcohol ablation: In this form of treatment, small amounts of alcohol are injected into the nodule to shrink it. This treatment requires multiple sessions.

Conclusion

Thyroid nodules are often non-cancerous. These can also become more worrisome if they disrupt breathing and swallowing. The primary factors that cause thyroid nodules are unexplained growths, cysts, and lack of iodine. You must always lookout for any unusual change in the thyroid and visit your doctor immediately for treatment.

Frequently Asked Questions (FAQs)

What is molecular testing?

For certain types of thyroid nodules  in which a definite diagnosis is difficult to make, molecular testing is employed to provide more information. This test details the type and characteristics of the cells declaring the growth either cancerous or non-cancerous.

What is a colloid nodule?

A colloid nodule is one or more nodules that grow out of the thyroid. These are usually benign, grow large but do not overgrow the thyroid.

How can I prevent myself from having thyroid nodules?

In general, there is no way to prevent thyroid nodules from developing. If you are diagnosed with thyroid nodules, then your doctor would guide you through the treatment plan. You must also always monitor your nodule carefully.