Medically reviewed by
Dr. Minako Abe, M.D., Board-certified emergency medicine physician researching the relationship between lifestyle and disease onset in relation to the immune system and cancer, Japan
Imagine you’re getting ready for the day, standing in front of the mirror, and then you notice a weird lump in your neck that you haven’t really noticed before. It can be pretty alarming! And it’s absolutely normal to wonder what it might be and whether it’s serious. The truth is it could be anything from a swollen lymph node (due to an infection) to an allergic reaction. But what if it’s thyroid-related?
Your thyroid is a butterfly-shaped gland in your neck that helps regulate various bodily functions by producing and storing thyroid hormones. These hormones influence your body’s metabolism and its response to other hormones. Sometimes, lumps can develop in this gland. They are known as thyroid nodules. These are fairly common especially in older people, affecting up to half of adults by the age of 60, according to the American Thyroid Association. Thyroid nodules can indeed sometimes be a cause for concern, but you really shouldn’t panic, and we’ll explain why in the rest of this article.
What are thyroid nodules?
Simply put, thyroid nodules are abnormal growths of cells in your thyroid. They can be solid, fluid-filled (cysts), or a mix of both (complex nodules). The good news is that an overwhelming majority (over 95%) of thyroid nodules are benign, meaning they’re not cancerous.
Do thyroid nodules cause symptoms?
Most nodules are asymptomatic, meaning they do not cause any symptoms. When symptoms do occur, they may include a noticeable swelling in the neck, difficulty swallowing or breathing, and hoarseness. Sometimes thyroid nodules can also cause changes in thyroid hormone levels leading to symptoms of hyperthyroidism (such as weight loss, increased heart rate, sweating) or hypothyroidism (such as weight gain, fatigue, cold intolerance).
How are thyroid nodules diagnosed?
Most nodules are found during a routine physical examination by your doctor feeling a lump in your neck, or incidentally on imaging tests done for other reasons (such as a carotid ultrasound or CT scans of the neck). But, to determine the size, number, and characteristics of thyroid nodules, a thyroid ultrasound is performed.
Depending on the size and characteristics of the nodules and on your individual risk factors, your doctor may recommend a fine-needle aspiration (FNA) biopsy. An FNA biopsy is a simple procedure where a thin needle extracts a small sample of cells from the nodule for examination under a microscope to assess the risk of cancer.
How are thyroid nodules treated or managed?
The management of thyroid nodules mainly depends on their size, whether they are causing symptoms, and the risk of cancer. If the FNA biopsy performed confirms a benign (non-cancerous) nodule, you might not need any treatment. Your doctor will likely recommend monitoring it with regular checkups and ultrasounds.
However, in some cases, medication or even minimally invasive procedures may be recommended. Let’s say the biopsy biopsy showed that the nodules are cancerous, your doctor will discuss with you a treatment plan, which might involve surgery (thyroidectomy) or radioactive iodine (RAI) therapy. These treatments will most likely result in hypothyroidism as they reduce thyroid function due to the removal or destruction of thyroid tissue, therefore necessitating lifelong thyroid hormone replacement therapy (usually levothyroxine) to manage the hormone deficiency.
A relatively newer procedure known as radiofrequency ablation (RFA) may be recommended in the cases of large, benign thyroid nodules. RFA involves the use of high-frequency radio waves to heat and destroy abnormal thyroid tissue. The goal is to reduce the size of the nodules without affecting the surrounding thyroid gland.
Can thyroid nodules be prevented?
Thyroid nodules are idiopathic in nature. This means that they can develop without any clear underlying reason. This makes it hard to pinpoint specific prevention strategies for this condition. That said, a healthy lifestyle and regular medical checkups can help manage the risks. If thyroid problems run in your family, it’s a good idea to be watchful for any changes in your thyroid. Other risk factors for thyroid nodules include radiation exposure (particularly in childhood), smoking, and certain hereditary syndromes (such as Cowden syndrome and Pendred syndrome).
Key takeaways
- Thyroid nodules are abnormal growths of cells in the thyroid.
- Thankfully, over 95% of them are benign, meaning they’re not cancerous.
- They can be solid, fluid-filled cysts, or a mix of both.
- Most people don’t even realize they have a nodule because they often cause no symptoms.
- If you do notice a lump in your neck or experience any concerning symptoms, don’t hesitate to seek medical attention. Your doctor can perform a physical exam and may recommend an ultrasound to get a better picture of the nodule.
- Most cases of thyroid nodules do not require treatment.
- Advances in diagnostic techniques and treatment options continue to improve outcomes for individuals with thyroid nodules.
