A thyroid nodule is a lump that can develop in
your thyroid gland. It can be solid or filled with fluid. You can have a single
nodule or a cluster of nodules. Thyroid nodules are relatively common and
Your thyroid is a small butterfly-shaped
gland located near your larynx (voice box) and in front of the trachea
(windpipe). Your thyroid produces and secretes two hormones that affect your
heart rate, body temperature, and many body processes — a group of chemical
reactions that, together, are called “metabolism.”
Thyroid nodules are classified as cold, warm,
or hot, depending on whether they produce thyroid hormones or not. Cold nodules
don’t produce thyroid hormones. Warm nodules act as normal thyroid cells. Hot
nodules overproduce thyroid hormones.
According to the Hormone Health Network, more than
90 percent of all thyroid nodules are benign (noncancerous). Most thyroid
nodules aren’t serious and cause few symptoms. And it’s possible for you to
have a thyroid nodule without even knowing it. Unless it becomes large enough
to press against your windpipe, you may never develop noticeable symptoms.
What are the symptoms of a thyroid nodule?
You may have a thyroid nodule and not have
any noticeable symptoms. But if the nodule gets large enough, you may develop:
- an enlarged thyroid gland, known as a goiter
- pain at the base of your neck
- swallowing difficulties
- breathing difficulties
- hoarse voice
If your thyroid nodule is producing excess thyroid
hormones, you may develop symptoms of hyperthyroidism, such as:
- rapid, irregular heartbeat
- unexplained weight loss
- muscle weakness
- difficulty sleeping
In some cases, thyroid nodules develop in
people with Hashimoto’s disease. If you have this condition, you will
experience symptoms of hypothyroidism, such as:
- persistent fatigue
- unexplained weight gain
- sensitivity to cold
- dry skin and hair
- brittle nails
What causes thyroid nodules?
The majority of thyroid nodules are caused by
an overgrowth of normal thyroid tissue. The cause of this overgrowth is usually
In rare cases, thyroid nodules are associated
- Hashimoto’s disease, an
autoimmune disease that leads to hypothyroidism
- thyroiditis, or chronic
inflammation of your thyroid
- thyroid cancer
- iodine deficiency
Iodine deficiency is rare in the United States
due to the widespread use of iodized salt and iodine-containing multivitamins.
What are the risk factors for developing thyroid
You’re more likely to develop thyroid nodules
- you had X-rays performed on your thyroid
in infancy or childhood
- you have a preexisting thyroid
condition, such as thyroiditis or Hashimoto’s disease
- you have a family history of
- you’re 60 years of age or older
Thyroid nodules are more common in women.
When they develop in men, they’re more likely to be cancerous.
How is a thyroid nodule diagnosed?
You may not know you have a nodule until your
doctor finds it during a general physical exam. They may be able to feel the
nodule. If they suspect you have a thyroid nodule, they will probably refer you
to an endocrinologist. This type of doctor specializes in all aspects of the
endocrine or hormone system, including the thyroid.
Your endocrinologist will want to learn if you:
- underwent radiation treatment on
your head or neck as an infant or child
- have a family history of thyroid
- have a history of other thyroid
They will use one or more of the following
tests to diagnose and assess your nodule:
- thyroid ultrasound, to examine the structure of the nodule
- thyroid scan, to learn if the nodule is hot, warm, or cold
- fine needle aspiration, to collect a sample of the nodule for
testing in a laboratory
- blood tests, to check your levels of thyroid hormones and thyroid
stimulating hormone (TSH)
How are thyroid nodules treated?
Your treatment options will depend on the size
and type of thyroid nodule you have.
If your nodule isn’t cancerous and isn’t
causing problems, your endocrinologist may decide it doesn’t need treatment at
all. Instead, they will closely monitor the nodule with regular office visits
Nodules that start as benign rarely turn
cancerous. However, your endocrinologist will likely perform occasional
biopsies to rule out the possibility.
If your nodule is hot, or overproducing
thyroid hormones, your endocrinologist will probably use radioactive iodine or
surgery to eliminate the nodule. If you’ve been experiencing symptoms of
hyperthyroidism, this should resolve your symptoms. If too much of your thyroid
is destroyed or removed in the process, you may need to take synthetic thyroid
hormones on an ongoing basis.
As an alternative to radioactive iodine or
surgery, your endocrinologist may try to treat a hot nodule by giving you
synthetic thyroid hormone. Your pituitary gland should detect the extra thyroid
hormone and signal your thyroid to lower production.
Your endocrinologist may also use fine needle
aspiration to drain your nodule, if it’s fluid filled.
There’s no way to prevent the development of
a thyroid nodule. If you’re diagnosed with a thyroid nodule, your
endocrinologist will take steps to remove or destroy it or simply monitor it on
an ongoing basis. The majority of noncancerous nodules aren’t harmful, and many
people don’t need treatment.