How To Shrink Thyroid Nodules
Medically reviewed and written by Izabella Wentz, PharmD, FASCP
I recently had the pleasure of connecting with a lovely lady who was very concerned about her thyroid nodules. She was a new mom who had just given birth and found that the nodules she had on her thyroid had grown. She was planning on getting them biopsied and potentially removing her thyroid, and wanted to know what her options were for addressing this concern.
I frequently receive these types of questions about thyroid nodules why they happen, and what to do about them. While I personally did not present with thyroid nodules, I have had a few clients and readers with Hashimotos and nodules, and was pleasantly surprised when they shrunk their nodules using my recommendations for Hashimotos. Dont you just love these kinds of surprises?
Up to 50 percent of our population has thyroid nodules. Nodules are also more common in those with Hashimotos so chances are, if youre reading this article, you may have a nodule .
This article will cover:
- Mildly, moderately, or highly suspicious
5. Another method of diagnosis is to get a thyroid scan done. An isotope of radioactive iodine is injected into a vein in the arm to find nodules that produce an excess of thyroid hormone. You may find cold or hot nodules. Cold nodules are non functioning and appear as defects or holes in the scan. Hot nodules are almost always non-cancerous, while only some cold nodules are cancerous.
What Do You Hope To See In The Future Of Endocrine Surgery
We strive for a precise balance between giving the patient the right amount of treatment. For example, removing the entire thyroid can cause uncomfortable side effects. A treatment strategy of less is more has shown to be a positive approach for most patients with smaller nodules. In addition, clinical research is ongoing. Our goal is to measure outcomes ahead of time in order to better address patients needs.
Are Thyroid Nodules Cancer
The vast majority more than 95% of thyroid nodules are benign . If concern arises about the possibility of cancer, the doctor may simply recommend monitoring the nodule over time to see if it grows.
Ultrasound can help evaluate a thyroid nodule and determine the need for biopsy. A thyroid fine needle aspiration biopsy can collect samples of cells from the nodule, which, under a microscope, can provide your doctor with more information about the behavior of the nodule.
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But What If Its Thyroid Cancer
A cancer diagnosis is always worrisome, but even if a nodule turns out to be thyroid cancer, you still have plenty of reasons to be hopeful.
Thyroid cancer is one of the most treatable kinds of cancer. Surgery to remove the gland typically addresses the problem, and recurrences or spread of the cancer cells are both uncommon. People who undergo thyroid gland surgery may need to take thyroid hormone afterward to keep their body chemistry in balance.
Whether its benign or not, a bothersome thyroid nodule can often be successfully managed. Choosing an experienced specialist can mean more options to help personalize your treatment and achieve better results.
Drawing Blood For Thyroid Function Tests
Before you get a blood draw to check your thyroid levels, talk with your doctor about any medications youre taking. Also let them know if youre pregnant. Certain medications and being pregnant may influence your test results.
A blood draw, also known as venipuncture, is a procedure performed at a lab or a doctors office. When you arrive for the test, youll be asked to sit in a comfortable chair or lie down on a cot or gurney. If youre wearing long sleeves, youll be asked to roll up one sleeve or to remove your arm from the sleeve.
A healthcare professional, like a technician or nurse, will tie a band of rubber tightly around your upper arm to make the veins swell with blood. Once the healthcare professional has found an appropriate vein, theyll insert a needle under the skin and into the vein.
You may feel a sharp prick when the needle punctures your skin. The healthcare professional will collect your blood in test tubes and send it to a laboratory for analysis.
When the healthcare professional has gathered the amount of blood needed for the tests, theyll withdraw the needle and place pressure on the puncture wound until the bleeding stops. They will then place a small bandage over the wound.
You should be able to return to your typical daily activities immediately.
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What Are Thyroid Nodules And How Common Are They
The thyroid gland is part of your endocrine system, which produces hormones that coordinate many of your bodys functions. Nodules are lumps of tissue in the thyroid gland, or clusters of normal cells in the thyroid that are multiplying. While nodules are common, the vast majority are benign. In fact, 50% of people over age 60 have at least one thyroid nodule and may not know it.
Why It Is Done
Thyroid hormone tests are done to:
- Find out what is causing an abnormal thyroid-stimulating hormone test. This is the most common reason for thyroid hormone tests.
- Check how well treatment of thyroid disease is working. The total thyroxine , free thyroxine , and free thyroxine index values are often used to keep track of treatment for hyperthyroidism.
- Screen newborns to find out if the thyroid gland function is normal. A condition called congenital hypothyroidism can prevent normal growth and development and cause other severe problems, such as intellectual disability, if it is not treated soon after birth.
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Getting Your Thyroid Checked Can Be A New Beginning
If you have some of the symptoms listed, and you just dont feel right, you might want to talk to your physician about it and have your thyroid checked. If your thyroid is the issue, there are a variety of treatments out there that can potentially improve your health and quality of life. It does get better.
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How The Thyroid Works
Just as the thyroid gland communicates with other organs through the hormone it produces, the pituitary gland in the brain communicates with the thyroid through a hormone it makesthyroid-stimulating hormone, or TSH. When the pituitary senses that thyroid hormone levels are too low, it releases more TSH to coax the thyroid into action. When the thyroid is nudged by TSH, it produces thyroid hormonea large proportion of which is thyroxine and a smaller proportion triiodothyronine . The T4 is eventually converted into T3, the active form that is taken up by receptors in body cells.
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Radioactive Iodine Uptake Test
A radioactive iodine uptake test, also called a thyroid uptake test, can help check thyroid function and find the cause of hyperthyroidism. The thyroid takes up iodine from the blood to make thyroid hormones, which is why this is called an uptake test. Your health care professional may ask you to avoid foods high in iodine, such as kelp, or medicines containing iodine for a week before the test.
For this test, you will swallow a small amount of radioactive iodine in liquid or capsule form. During the test, you will sit in a chair while a technician places a device called a gamma probe in front of your neck, near your thyroid gland. The probe measures how much radioactive iodine your thyroid takes up from your blood. Measurements are often taken 4 to 6 hours after you swallow the radioactive iodine and again at 24 hours. The test takes only a few minutes.
If your thyroid collects a large amount of radioactive iodine, you may have Graves disease, or one or more nodules that make too much thyroid hormone. You may have this test at the same time as a thyroid scan.
Even though the test uses a small amount of radiation and is thought to be safe, you should not have this test if you are pregnant or breastfeeding.
The Diagnosis Meaning And Treatment Of Thyroid Nodules
Thyroid nodules are most commonly found when a doctor examines a patient’s neck, feeling the thyroid gland. Sometimes thyroid nodules are found when a patient gets x-rays or scans of the neck for some other reason. Sometimes it is a screening x-ray or scan for carotid arteries or neck pain that shows nodules in the thyroid. Thyroid nodules that are large, develop in women with thin necks, or are present in the middle portion of the thyroid gland may be visible and discovered as a lump in the neck.
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Thyroid Nodules: Potential Causes
Several conditions may cause or predispose to the development of thyroid nodules including:
Iodine deficiency
Diets deficient in iodine can predispose individuals for the development of thyroid nodules. Portions of the world continue to lack iodine in their diets however in the United States, the presence of iodine in our daily diets makes this an unlikely cause for thyroid nodules.
Overgrowth of normal thyroid tissue
The reason why these thyroid nodules occur is not well understood. These thyroid nodules are commonly called follicular adenomas or thyroid adenomas. . Follicular adenomas are clearly not cancerous and are not worrisome and do not require removal except if they are symptomatic due to their size. The rare follicular adenoma or thyroid adenoma will overproduce thyroid hormone and be the cause of hyperthyroidism. For some reason these excessive thyroid hormone producing adenomas lose their ability to be regulated by the pituitary glands production of Thyroid Stimulating Hormone .
Thyroid cysts
Thyroid cysts are fluid filled cavities caused by degenerating thyroid adenomas, congenital cysts, or overproduction of a fluid produced by the thyroid called colloid.
Inflammatory diseases of the thyroid Multinodular disease of the thyroid Thyroid Cancer
Although the likelihood that a thyroid nodule is a cancer is quite low, the following are associated with an increased malignant risk:
Other Ways To Test Your Thyroid
What about the more traditional ways to assess your thyroid? Those shouldnt be ignored either which is why they are mentioned here.
First on the list is the use of thyroid function testing which can be done by checking your blood.
This gives us an idea as to how much thyroid your gland is producing in total because we can assume that most of the thyroid that is produced by your thyroid gland is being released into your blood.
We can also test how responsive your thyroid gland is to influence from your brain by looking at hormones which are secreted from the brain .
All of this information helps us understand how your thyroid is functioning at the various levels of thyroid regulation.
Each one is important and has value, contrary to popular belief, with some tests being more valuable than others.
Thyroid Function Testing
There is definitely an art to testing the thyroid with many different tests being available.
Ordering the right tests and putting them into the greater context is very important for every thyroid patient.
I recommend that you use thyroid lab testing in conjunction with the other tests I already mentioned.
As it relates to lab tests, Ive broken down the important lab tests below.
You can read more about each of these labs, what they mean, and how to interpret your results in the links provided above.
Each test gives you slightly different information and its important to understand how they all fit together.
Ultrasound testing
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Symptoms Of Thyroid Nodules
Most thyroid nodules dont cause symptoms. For people who do have symptoms, they may have trouble swallowing or breathing or have a feeling of fullness, pain, or pressure in the throat or neck. Some people might notice a lump in their neck when they look in the mirror, but this is uncommon. Some people experience rapid unintended weight loss, feelings of nervousness, or an irregular heartbeat.
How Is Thyroid Cancer Diagnosed
Most people who are eventually diagnosed with thyroid cancer first come to their doctor after noticing a lump in their neck, so the diagnostic process usually starts with an evaluation of this nodule. The first step is a medical history and physical exam from a medical professional. Blood and imaging tests for thyroid cancer may follow. A thyroid biopsy is used to confirm the diagnosis of thyroid cancer.
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Can I Take The Test At Home
At-home thyroid test kits are commercially available without a prescription and measure the same hormones as the traditional thyroid panel.
For at-home testing, you prick your finger to get the necessary blood sample. That sample is then mailed to a laboratory that conducts the thyroid panel and makes the results available to you directly.
While at-home testing can measure thyroid levels, it is generally not a substitute for a test ordered by your doctor. If an at-home test detects abnormal thyroid levels, your doctor will likely recommend a new blood sample and thyroid panel to confirm the results. At-home tests for thyroid labs may not be as accurate as tests done in a laboratory.
What Is A Thyroid Nodule
The thyroid is a small gland located at the base of your throat that regulates body functions such as heart rate, metabolism, and the rate at which your body burns calories. A thyroid nodule is a lump in the thyroid gland in your neck. More than 90% of all thyroid nodules are benign . Some are actually cysts filled with fluid.
Thyroid nodules are more common in women than in men. They also tend to run in families.
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What Is A Thyroid Biopsy
A thyroid biopsy involves collecting a small sample of cells so they can be looked at under a microscope for signs of cancers. A small, thin needle placed within a thyroid nodule can draw up the needed cells.
This is called a Fine Needle Aspiration, and can usually be done in a typical exam room with local anesthesia . An ultrasound may be used to help guide the needle into the nodule.
The FNA may give one of four results:
-
Non-diagnostic:
This means that not enough cells were removed to make a diagnosis. Even in the best of hands, this happens 5 to 10% of the time. Typically the FNA will be repeated.
-
Benign Thyroid Nodule:
This means that there is a 97% chance that the thyroid nodule is not cancer. In most cases, patients with a benign biopsy are watched with an USG and physical exam 6 months later, and then at regularly scheduled times.
-
Malignant Thyroid Nodule:
This means that there is a 97% chance that the thyroid nodule is cancer . Sometimes the results say that the thyroid nodule is “suspicious for thyroid cancer” which means that there is an 80 to 90% chance of cancer.
-
Indeterminate:
This means that the cells do not look normal, but they are not clearly cancer cells. There is a 15 to 20% chance of having thyroid cancer with an indeterminate biopsy.
How To Do A Thyroid Self
Below are easy steps for examining your thyroid:
1. Face a mirror.
âPosition yourself or the mirror to focus on the lower-front portion of your neck, and remove anything that could block the view of your neck. â
2. Tilt your head.â
Extend your neck back slightly, pointing your chin toward the ceiling, while still being able to see into the mirror without trouble.â
3. Find your thyroid.â
Put your finger on tip of your chin and slide that finger down the midline. The first structure you hit is the top of the thyroid cartilage, which despite its name, is not where the thyroid gland is situated. Keep moving your finger down your neck to the Adam’s apple. Just beyond you will feel the cricoid cartilage. Continue downward below the cricoid ring are the first two rings of the trachea on top of which lies the thyroid gland.
4. Take a sip of water.â
Keeping your neck extended backward, take a sip of water and swallow. â
5. Look for lumps.â
As you swallow, with your neck still extended back, examine your neck for any visual irregularities including enlargements, lumps, protrusions, or imbalances. â
6. Touch the area.â
Gently feel the area around your thyroid for any enlargement or lumps. Thyroid nodules usually appear round in shape and move/roll with the gland when you swallow. A goiter can be found on one or both sides of the thyroid.
7. Repeat the process.
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What Are The Symptoms Of A Thyroid Nodule
Most thyroid nodules do not cause symptoms. Often, thyroid nodules are discovered incidentally during a routine physical examination or on imaging tests like CT scans or neck ultrasound done for completely unrelated reasons. Occasionally, patients themselves find thyroid nodules by noticing a lump in their neck while looking in a mirror, buttoning their collar, or fastening a necklace. Abnormal thyroid function tests may occasionally be the reason a thyroid nodule is found. Thyroid nodules may produce excess amounts of thyroid hormone causing hyperthyroidism . However, most thyroid nodules, including those that cancerous, are actually non-functioning, meaning tests like TSH are normal. Rarely, patients with thyroid nodules may complain of pain in the neck, jaw, or ear. If a nodule is large enough to compress the windpipe or esophagus, it may cause difficulty with breathing, swallowing, or cause a tickle in the throat. Even less commonly, hoarseness can be caused if the nodule invades the nerve that controls the vocal cords but this is usually related to thyroid cancer.
The important points to remember are the following:
- Thyroid nodules generally do not cause symptoms.
- Thyroid tests are most typically normaleven when cancer is present in a nodule.
- The best way to find a thyroid nodule is to make sure your doctor checks your neck!