Written by Samantha C. Shapiro, MD | Reviewed by Mandy Armitage, MD
Key takeaways:
– Thyroid nodules are lumps on the thyroid gland. They’re extremely common.
– Most thyroid nodules don’t cause symptoms and are found by accident.
– Treatment depends on the type of thyroid nodule. Many don’t need any treatment at all.
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Thyroid nodules are small lumps on the thyroid — a gland that sits at the front of the neck. The thyroid gland produces hormones that help control metabolism and various other organ functions.
Lumps anywhere on the body might sound scary. But thyroid nodules are actually quite common, and most are benign (noncancerous). Up to 65% of people have thyroid nodules. They’re more common in women than men and more common with age.
Most thyroid nodules don’t cause any symptoms. Some can be ignored, some need monitoring over time, and some need a biopsy to check for cancer. That leaves room for quite a bit of uncertainty. So we’ll cover the symptoms, diagnosis, and treatment of thyroid nodules.
What causes thyroid nodules?
Experts don’t know exactly what causes all thyroid nodules. But some risk factors for thyroid nodules include:
– Older age: Thyroid nodules are more common as you get older.
– Hashimoto’s hypothyroidism: This condition causes an underactive thyroid gland.
– Iodine deficiency: Iodine is a mineral that the thyroid needs to make thyroid hormones.
– Prior radiation therapy: Radiation increases the risk of both benign and cancerous thyroid nodules.
What are the symptoms of thyroid nodules?
Most people with thyroid nodules don’t have any symptoms. That’s why they’re typically found by accident — on imaging tests a healthcare provider orders for a different reason.
But large thyroid nodules may cause symptoms, like:
– A lump at the front of the neck
– Trouble swallowing
– Hoarse voice
– Neck pressure or pain
Less than 1% of thyroid nodules can increase the production of thyroid hormones, causing hyperthyroidism. Symptoms of this condition include:
– Heart racing
– Weight loss
– Feeling nervous or easily irritated
– Sweating
– Shakiness (tremors)
– Constipation
A simple blood test (thyroid function test) can diagnose hyperthyroidism. Your healthcare provider will always order this test if they find a nodule.
How are thyroid nodules diagnosed?
About 5% of thyroid nodules are diagnosed just by feeling the neck during physical examination. Most of them are found by accident on other imaging tests (like CT scans).
For example, let’s say your provider orders a CT scan of the chest to check for lung disease. The radiologist (a doctor who interprets imaging tests) reviews your CT scan and reports everything they see. They describe the lungs as well as information about stuff nearby. So even though the care team wasn’t specifically looking for thyroid issues, they’ll be sure to note if they find a nodule.
If a CT scan uncovers thyroid nodules, your provider will order a thyroid ultrasound to take a better look. An ultrasound provides more information about the size and appearance of the nodule. It’s a cheap, quick, and painless test that doesn’t use radiation.
The next steps depend on how the thyroid nodule looks. Your provider may not need to order more tests. But some types of nodules look more concerning for cancer than others. So possible next steps include:
– Repeat ultrasounds: This is to check for changes in the nodule. About 15% of nodules grow over time, but less than 1% of them become cancerous.
– Fine needle aspiration: In this minor procedure your provider inserts a thin needle into the thyroid gland and removes a small piece of tissue. Then a specialist checks the tissue for cancer cells.
What’s the treatment for thyroid nodules?
It depends. Some thyroid nodules don’t need treatment at all. Some just need monitoring over time to make sure they aren’t changing. Some might need treatment (like surgery).
The following types of nodules may need treatment:
– Cancerous nodules
– Large nodules that cause symptoms (like pain or swallowing problems)
– Nodules that release too much thyroid hormone (causing hyperthyroidism)
How serious are thyroid nodules?
The good news: Most thyroid nodules aren’t anything to worry about. Only about 10% of thyroid nodules are at risk of turning into cancer. And repeat ultrasounds help catch riskier nodules earlier, so you can get treatment quickly.
The bottom line
Thyroid nodules are extremely common. Most nodules aren’t cancerous, don’t cause symptoms, and don’t need treatment. Together with your provider, you’ll come up with a plan to keep an eye on thyroid nodules that look concerning.
References
American Thyroid Association. (n.d.). Hyperthyroidism.
American Thyroid Association. (2017). Thyroid nodules.
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