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Expert Thyroid Nodules Review & Diagnosis|
King's College

What are Thyroid Nodules?

Thyroid nodules are solid or fluid lumps formed within your thyroid, which is a small and very important gland located in the front part of your neck, that creates some crucial hormones: triiodothyronine (T3) and thyroxine (T4); responsible for maintaining the body metabolism regulation. Most cases of thyroid nodules don’t cause any problems and they usually affect women.

Thyroid Nodules Signs and Symptoms

Most cases of thyroid nodules are harmless and cause no symptoms. However, in other cases, they can become enlarged and cause the following symptoms:

  • Visible lump.
  • Lump sensation in your neck.
  • Shortness of breath and difficulty to swallow.

Sometimes, thyroid nodules are related to the incremental production of thyroid hormones (hyperthyroidism), and cause typical symptoms like:

  • Unexplained weight loss.
  • Rapid heartbeat.

Thyroid Nodules Causes

There are many possible causes related to thyroid nodules, including:

  • Iodine deficiency. Having a poor iodine diet can cause your thyroid to develop some nodules. However, since the introduction of iodine to table salt in most countries, thyroid nodules related to a lack of iodine is not common anymore.
  • Thyroid adenoma. Which is a noncancerous nodule that usually doesn’t cause any serious problems. Sometimes, a thyroid adenoma can overproduce thyroid hormones, leading to hyperthyroidism.
  • Multinodular goiter. Here, the appearance of multiple nodules in the thyroid produces an increment in the gland size.
  • Thyroid cancer. Even though most cases of thyroid nodules are benign, there is a small possibility for them to be malignant. Sometimes, it’s difficult to differentiate a benign nodule from a malignant one, but if your nodule causes pain, is very large or has a hard consistency, the chance of having a malignant nodule is bigger.

Thyroid Nodules Diagnosis

Sometimes, a goiter can be diagnosed just by practicing a simple neck palpation exam. In any case, your doctor will request some additional tests to determine the underlying cause of your condition, including:

  • Blood test. In order to detect your thyroid hormones levels.
  • Thyroid ultrasonography. This technique provides good quality information about the shape of the nodules and helps doctors distinguishing solid from cyst nodules.
  • Fine-needle aspiration (FNA) biopsy. Usually, nodules are biopsied in order to make sure there is no cancer in your gland. During the procedure, your doctor inserts a very thin needle into the nodule and removes a sample of cells for microscopic analysis.

Thyroid Nodules Treatment

The treatment of your nodules depends on its nature, whether they are benign or malignant.

Benign Nodule

  • Follow-up. In case your nodule is benign and cause no significant symptoms, your doctor might recommend simply having regular checks of your condition.
  • Thyroid hormone suppression therapy. By using levothyroxine, a synthetic form of thyroxine, doctors make sure to suppress the growth of the gland.
  • Radioactive iodine. In case you have a benign but hyperfunctioning adenoma, your doctor will recommend using radioactive iodine, which causes the nodules to shrink.
  • Antithyroid drugs. These drugs block the excessive thyroid hormone production. Include methimazole and propylthiouracil.
  • In case your benign nodule is too large and makes it hard to breathe or swallow, you might require surgery.

Cancerous Nodules

If you have a cancerous nodule, the usual treatment recommended will be surgery. Your doctor will surgically remove your cancerous nodule along with the majority of the gland tissue – a procedure known as partial or total thyroidectomy. After thyroidectomy, you will require lifelong supplementary treatment with levothyroxine, in order to obtain normal thyroid hormone levels. Additionally, doctors will use radioactive iodine to make sure any possible cancerous tissue remaining will be destroyed.