Thyroid Nodules Are Typically Harmless
If you feel a lump at the base of your neck, dont panic. The majority of thyroid nodules are benign. However, you shouldnt diagnose your own thyroid nodule but should seek advice from an endocrinologist you know and trust. Since about half of the American population will experience a thyroid nodule at some point, its important to begin establishing a rapport with a primary care doctor and an endocrinologist, who can work together to foster a healthy, happy quality of life.
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What Size Thyroid Nodule Should Be Biopsied
According to the Society of Radiologists in Ultrasound, biopsy should be performed on a nodule 1 cm in diameter or larger with microcalcifications, 1.5 cm in diameter or larger that is solid or has coarse calcifications, and 2 cm in diameter or larger that has mixed solid and cystic components, and a nodule that has
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:
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Optimize Iodine Levels To Improve Thyroid Nodules
Thyroid hormone is made up in large part by iodine, which has led some clinicians to recommend iodine supplementation to support thyroid health. However, we need to get just the right amount of iodine. The American Thyroid Association states, Iodine deficiency, which is very uncommon in the United States, isknown to cause thyroid nodules. However, too much dietary iodine can increase the risk of goiter, multinodular goiter, nodules, and thyroid autoimmunity, especially in Hashimotos thyroiditis.
To learn more about how to assess your iodine levels, check out our blog.
How Is A Patient With A Toxic Thyroid Nodule Treated
There are three main treatment options:
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What Is A Normal Size For Thyroid Nodules
Thyroid nodules range in sizeyour doctor will decide what to do depending on their size.
- Tiny nodules, which are less than 1 cm in diameter. These arent usually biopsied.
- Nodules larger than 1 cm with suspicious features are biopsied. Those that are slightly larger and have fewer suspicious features may not be biopsied until they reach a size of 1.5 to 2 cm.
- Very large nodules are surgically removed. This is necessary because of an increased risk for thyroid cancer and potential to damage nearby structures in the neck.
Nodules of any size that get bigger should also be biopsied.
Dr. Rx
A common misconception is that nodules can be shrunken by medications, such as thyroid hormone replacement. This was an approach used by doctors a long time ago, but it was found to be ineffective. In fact, it can cause harm to the heart in the form of irregular and fast heartbeats and weaken bones so it is no longer a recommended treatment. Dr. Arakawa
Can Thyroid Nodules Be Prevented
Since researchers dont know what causes the majority of thyroid nodules, you cant prevent them in most cases.
You can, however, try to decrease your risk of developing them by managing certain risk factors. For example, if you have obesity, talk to your healthcare provider about attaining a healthy weight for you. If you smoke cigarettes, try to quit. Its also important to make sure you get enough iodine in your diet. If you use iodized table salt, youre likely consuming enough.
Studies have shown that people who take oral birth control and/or statins may have a reduced risk of developing thyroid nodules.
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Can A Suspicious Thyroid Nodule Be Benign
There are several types of thyroid nodules. A nodule can be benign, or noncancerous toxic, meaning it produces too much thyroxine or cancerous. Doctors at NYU Langone are experts in determining what type you have and choosing the appropriate treatment. About 90 to 95 percent of thyroid nodules are benign.
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.
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Living With Thyroid Nodules
Most people who have thyroid nodules lead a normal life. You might need to check in with your doctor more often, but there usually are no complications.
If you do have complications, they can include problems swallowing or breathing. You may also sustain significant weight gain or weight loss. Work with your doctor to treat these symptoms.
If your thyroid nodules are a symptom of thyroid cancer, you may need surgery. During the surgery, the doctor will remove most, if not all, of your thyroid. Following the surgery, youll take daily thyroid replacement hormones for the rest of your life.
What Are Goiters And Thyroid Nodules
An enlarged thyroid gland can be felt as a lump under the skin at the front of the neck. When it is large enough to see easily, it’s called a goiter.
A thyroid nodule is a lump or enlarged area in the thyroid gland. A nodule may simply be swollen tissue, an overgrowth of normal thyroid tissue, or a collection of fluid called a cyst. Most thyroid nodules in children are not caused by cancer.
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Reduce Thyroid Nodules By Improving Gut Health
One of the most common reasons for thyroid nodules is thyroid autoimmunity, especially Hashimotos thyroiditis. Research indicates thyroid health is closely connected to your gut health. In several studies, improving gut health by treating infections or supporting digestion improved thyroid lab markers and thyroid antibodies.
Here are two research-backed steps you can take to improve your thyroid health.
1. Eat an Anti-Inflammatory Diet
Research shows an anti-inflammatory diet such as the Paleo diet, gluten-free and dairy-free diets , or the Autoimmune Paleo diet may support your thyroid health.
A Paleo diet template is low-carb, dairy-free, and gluten-free, and could be a good place to start.
2. Take High-Quality Probiotics
Probiotics are an effective way to balance your gut microbiome with few side effects. One study showed probiotics decreased thyroid symptoms and the needed dose of levothyroxine. For more about how to use probiotics, see our Probiotics Starter Guide.
What Is A Toxic Thyroid Nodule
Ultrasound scan in transverse section of the thyroid gland of a 73-year-old female patient, showing a hot nodule in one thyroid lobe corresponding to a toxic adenoma.
A toxic thyroid nodule causes hyperthyroidism . This occurs when a single nodule grows on the thyroid gland causing it to become enlarged and produce excess thyroid hormones. If the increased hormone production is coming from a single nodule in the gland, this is called toxic adenoma. If there are many nodules causing the hyperthyroidism, this is referred to as multinodular goitre.
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Do They Go Away On Their Own
According to an ATA study, thyroid nodules that occur due to iodine deficiency may resolve on their own over time if people increase their iodine intake. In 618 participants with thyroid nodules, roughly one-third of single nodules were no longer present at the 11-year follow-up.
The researchers concluded that increasing iodine intake through iodized salt might be the reason for the disappearance of the nodules.
In other cases, benign thyroid nodules may grow larger over time, and people may need treatment to remove them.
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What Causes Thyroid Nodules
Researchers dont know why most thyroid nodules form. Nodules can form for various reasons, and there are different types, including:
- Colloid nodules: These are one or more overgrowths of normal thyroid tissue. These growths are not cancer . They may grow large, but they dont spread beyond your thyroid gland. These are the most common type of thyroid nodules.
- Thyroid cysts: These are growths that are filled with fluid or are partly solid and partly filled with fluid. Cystic nodules pose a low risk for cancer and are either monitored or biopsied if theyre larger than 2 centimeters.
- Inflammatory nodules: These nodules develop as a result of long-term swelling of your thyroid gland. These growths may or may not cause pain.
- Multinodular goiter: Sometimes an enlarged thyroid is made up of many nodules .
- Hyperfunctioning thyroid nodules: These nodules produce extra thyroid hormone, which may lead to the development of hyperthyroidism. Hyperthyroidism requires treatment.
- Thyroid cancer: Cancer is the biggest concern when thyroid nodules form. Fortunately, thyroid cancer is very rare its found in less than 6.5% of all thyroid nodules.
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Is It Normal To Have Nodules On Thyroid
Thyroid nodules are very common, especially in the U.S. In fact, experts estimate that about half of Americans will have one by the time theyre 60 years old. Some are solid, and some are fluid-filled cysts. Others are mixed. Because many thyroid nodules dont have symptoms, people may not even know theyre there.
When To Worry About Thyroid Nodules
Due to the risk of cancer and other health conditions, your doctor will need to evaluate you if you suspect a thyroid nodule. It is very important that patients with thyroid nodules see a physician with expertise in thyroid diseases, reminds Dr. Abikhaled. That way, an appropriate evaluation of the nodules can be undertaken.
There are many ways your healthcare provider can diagnose a thyroid nodule. If you tell your doctor that youre experiencing pain or discomfort, or that you feel a lump on your neck, they will give you a physical exam to palpate your thyroid.
Other times, your physician may suspect a thyroid issue based on weight changes or abnormal blood test results. In either case, there are a variety of tests your doctor can order to confirm your diagnosis and ascertain the cause. You may need a thyroid stimulating hormone test to measure your thyroid function, a thyroid ultrasound, or fine needle aspiration biopsy.
If youre worried that you might have a thyroid nodule, you most likely dont need to worry. A small percentage of thyroid nodules are cancerous, explained Dr. Abikhaled. Your doctor can order a biopsy to determine whether or not your thyroid nodule is cancerous.
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How Are Goiters Treated
Depending on the test results, a goiter might not need to be treated. If it does, treating the thyroid disease causing the goiter usually will decrease or control the enlargement.
Surgery might be needed if the thyroid keeps getting bigger even with treatment and causes discomfort or a very large lump in the neck.
What Tests Will Be Done To Diagnose And Evaluate Thyroid Nodules
Your healthcare provider may order any of the following tests to help diagnose and evaluate a thyroid nodule:
- Thyroid blood test: This test checks the levels of thyroid hormone in your blood. The hormone levels are usually normal even if you have nodules, but they can be abnormal in some cases and point to thyroid disease.
- Thyroid ultrasound: This is an imaging test that uses sound waves to create pictures of your thyroid gland. It can determine if a nodule is solid or a fluid-filled cyst. This test also checks on the growth of nodules and helps find nodules that are difficult to feel. In addition, providers sometimes use ultrasound to help guide the placement of the needle during a fine-needle biopsy.
- Fine-needle biopsy: With this test, your provider uses a very thin needle to take a sample of cells from one or more thyroid nodules. They then send the samples to a laboratory for evaluation. Most nodules are noncancerous. However, if the test results are inconclusive, your provider may repeat this test. They may also suggest you have surgery to remove the nodules to make an accurate diagnosis.
- Thyroid scan: In this test, you take a small amount of radioactive iodine orally. Your provider will check to see how much of the radioactive iodine the thyroid nodules absorb and how much is absorbed by normal thyroid tissue. This will provide further information about the thyroid nodules, helping your provider determine the likelihood of cancer.
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How Common Are Thyroid Nodules
Thyroid nodules are very common, especially in the U.S. In fact, experts estimate that about half of Americans will have one by the time theyre 60 years old. Some are solid, and some are fluid-filled cysts. Others are mixed.
Because many thyroid nodules dont have symptoms, people may not even know theyre there. In other cases, the nodules can get big enough to cause problems. But even larger thyroid nodules are treatable, sometimes even without surgery.
What Is The Average Size Of A Cancerous Thyroid Nodule
When the analysis of nodule size was compared with the type and distribution of thyroid malignancy, a significant relationship was detected. The majority of cancer cases, having a nodular size of 1.0-1.9 cm, were diagnosed as papillary carcinoma, and 61.9% of cancerous nodules 4 cm were follicular carcinomas.
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How Big Does A Thyroid Nodule Have To Be To Cause Symptoms
Thyroid nodules usually move up and down with swallowing. When thyroid nodules become large they may cause symptoms by pressing on the airway or esophagus. These are also called compressive symptoms. Compressive symptoms include: discomfort with swallowing.
Can benign thyroid nodules cause problems?
Although most thyroid nodules are noncancerous and dont cause problems, ask your doctor to evaluate any unusual swelling in your neck, especially if you have trouble breathing or swallowing. Its important to evaluate the possibility of cancer.
Can a thyroid nodule make you feel sick?
Most thyroid nodules dont cause any symptoms. However, if they grow large enough, they can cause swelling in your neck and lead to breathing and swallowing difficulties, pain, and goiter.
How Are Thyroid Nodules Diagnosed
Sometimes you can feel or see a thyroid nodule yourself, or your healthcare provider may discover it during a physical exam. Your provider may also discover a nodule with an imaging test done for another reason.
Even though thyroid nodules are almost always noncancerous , the small chance that it could be cancer means that most thyroid nodules need some type of evaluation.
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How Thyroid Nodules Are Diagnosed
Thyroid nodules are diagnosed through physical examination and imaging. Doctors routinely perform physical exams of your thyroid to check for enlargement and the formation of nodules. Your thyroid nodule may be large enough for your doctor to feel by hand.
Your doctor might suspect thyroid nodules if you have abnormal blood work. Routine thyroid blood tests can detect hormone abnormalities that suggest thyroid nodules, even if your doctor cant feel any through examination. You may need additional imaging for diagnosis, such as a thyroid ultrasound.