Thyroid nodules are surprisingly common. According to the American Thyroid Association, about half of Americans will develop a thyroid nodule (or two or three) by the time they reach 60. Some of these nodules are solid, while others are filled with fluid. But according to Shivangi Lohia, M.D., an ear, nose and throat specialist at Henry Ford Health, most thyroid nodules are harmless.
“Thyroid nodules usually don’t cause any problems. In fact, many people don’t discover they have a nodule until it’s picked up during a routine physical or after testing for a separate health issue,” she says.
What Are Thyroid Nodules?
The thyroid is a small gland at the base of the neck, shaped like a butterfly. It impacts everything from temperature control to weight, heart rate, brain function and muscle control. Thyroid nodules are small growths of cells that develop on the thyroid gland.
If nodules grow large enough, they may become visible from the outside or interfere with swallowing and breathing. A small number of thyroid nodules can contain thyroid cancer.
What Causes Thyroid Nodules?
Doctors don’t know what causes thyroid nodules, but researchers have uncovered a link between thyroid nodules and thyroid disease.
“Certain conditions such as Hashimoto’s thyroiditis, where the gland attacks itself, can be associated with thyroid nodule development,” Dr. Lohia says. “Other conditions such as those linked to iodine deficiency, which is rare in the United States, are also linked to a higher risk of thyroid enlargement.”
Symptoms Of Thyroid Nodules
Thyroid nodules may change the amount of thyroid hormones the thyroid produces. “These are called ‘hot nodules’ because they cause the thyroid to produce more thyroid hormone.” With hot nodules, you may experience symptoms of an overactive thyroid, including:
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- Anxiety or nervous energy
- Enlarged thyroid
- Fast or irregular heartbeat
- Hot flashes and sweating
- Weight loss
Cold nodules, on the other hand, don’t have any impact on thyroid function. They’re also more likely to be cancerous than hot nodules.
What Treatments Are Available For Thyroid Nodules?
More than 90% of thyroid nodules are not cancerous and don’t require invasive testing or treatment. “So having a thyroid nodule is not a reason to panic,” Dr. Lohia says.
But thyroid nodules can grow and change over time, and even a benign (noncancerous) thyroid nodule can cause problems. If you have nodules, your doctor may choose one of the following treatment approaches:
- Watch and wait: Your doctor may order an ultrasound (to measure and assess the nodule) and then watch the nodule for signs of growth or change. “Depending on the results of the ultrasound, your doctor may order a biopsy to collect samples of cells from the nodule to assess cancer potential,” Dr. Lohia says.
- Radiofrequency ablation (RFA): With RFA, doctors use a probe guided by ultrasound to access a benign nodule, then blast the nodule with an electrical current so it shrinks. It’s a quick procedure that allows most people to return to their usual activities within 24 hours.
- Radioactive iodine: If you have several nodules, your doctor may recommend a treatment called radioactive iodine. With this treatment, you swallow a capsule or drink containing radioactive iodine. When your thyroid absorbs the substance, the nodules shrink.
- Thyroidectomy: If a thyroid nodule is cancerous or interferes with your ability to eat, breathe or swallow, your doctor may recommend surgery to remove your thyroid, called a thyroidectomy. They may even be able to perform the procedure without leaving a scar (by accessing the gland through the inside of your lower lip).
What If A Nodule Shows Signs Of Cancer?
Fortunately, thyroid cancer is among the most treatable forms of cancer. Nodules that contain cancer are almost always removed surgically. Depending on how much of the thyroid is removed and how it responds to surgery, you may need to take thyroid hormone to keep your body in balance.
“Up to 30% of the population might have a thyroid cancer that will never grow or spread,” Dr. Lohia says. Recurrence of these cancers is rare, and most forms don’t spread anywhere else in the body.
When To See A Doctor About Thyroid Nodules
If you notice a lump on your neck that isn’t going away (or getting bigger), or if you have consistent trouble swallowing, it’s important to see your healthcare provider. You may be at increased risk of developing thyroid cancer if you fall into the following categories:
- You have a very strong family history of thyroid cancer, meaning multiple members of your family from every generation.
- You have had radiation to the head or neck for a previous cancer.
“Even though most thyroid nodules aren’t cancerous, it’s important to have your doctor evaluate any lumps or discomfort in your neck, especially if it interferes with your ability to swallow,” Dr. Lohia says. If you do have a nodule, your doctor will likely monitor it yearly to keep an eye on any changes.
Reviewed by Shivangi Lohia, M.D., an ear, nose and throat specialist who sees patients at Henry Ford Health Center - Brownston and Henry Ford Medical Center - Templin.
