What are thyroid nodules and who is at risk?
Thyroid nodules are growths in the thyroid gland. They are very common in adults, particularly in women and the elderly. It is estimated around 5 in 100 people have a thyroid nodule that can be felt, while up to 70 in 100 older people (61 years or older) have a thyroid nodule detectable by ultrasound. Most nodules are noncancerous (benign), but 5 in 100 nodules may be cancerous. Thyroid nodules are less common in children and teens, but, if a child or a teen has a nodule, it is more likely to be malignant (cancerous).
Some nodules may affect the hormones produced by the thyroid gland, causing symptoms of hypothyroidism (underactive thyroid gland) or hyperthyroidism (overactive gland).
The cause of most benign nodules is not known, but they are often found in members of the same family. Worldwide, lack of iodine in the diet is a very common cause of nodules.
What are the symptoms of thyroid Nodule?
Many thyroid nodules do not cause symptoms until they are large enough to affect the surrounding tissues and organs or to be visible on the neck.
Large nodule may cause difficulty swallowing, hoarseness or other voice changes, pain in the neck and a swelling in the neck that can be seen or felt (goiter).
Sometimes, a nodule can be associated with hyperthyroidism (producing too much thyroid hormone) or hypothyroidism (producing not enough thyroid hormone). Overactive nodule may cause sudden rapid weight loss, fast or irregular pulse, nervousness or anxiety, heat intolerance, sweating and fatigue. Underactive symptoms include cold intolerance, fatigue, dry skin and weight gain.
How are thyroid nodules diagnosed?
- Physical examination
- Ultrasound of the neck
- Blood tests to determine if thyroid is functioning normally. The blood tests are not enough to test for thyroid cancer.
- Biopsy of the nodule using a thin needle and examining the cells under a microscope. This test may be recommended if the nodule is larger than 1.5cm or if it has any concerning features on ultrasound. This is the best way to determine whether a nodule is benign or cancerous. This is usually done with the help of ultrasound guidance.
- Thyroid scan using a small amount of radioactive iodine and a special camera to get a picture of the thyroid. This procedure is usually done when the blood tests show hyperthyroidism (overactive thyroid).
What should you do if you think you have a thyroid nodule?
If you think you have a thyroid nodule, see your doctor. Your doctor may refer you to an Endocrinologist for diagnosis and treatment.
How are thyroid nodules treated?
Treatment will depend on the type and cause of the nodule. Sometimes observation (watchful waiting and regular follow-up) is all that is needed. If the biopsy shows cancerous or suspicious cells, surgery to remove the thyroid gland may be necessary. Some benign nodules may need to be removed with surgery if they are very big and are causing problems with swallowing or breathing.