What are thyroid nodules and how are they treated?

Appearing singly or in clusters, a thyroid nodule is a solid or fluid-filled lump which can be caused by several different things:

• Lack of iodine in your diet
• Abnormal growth of thyroid cells within your thyroid gland (a hyperplastic or colloid nodule)
• Thyroid adenoma (a benign tumour)
• Thyroiditis-  see my blog post  
• A multinodular goitre comprising several nodules  - see my blog post 
• Thyroid cancer (those at highest risk are extremes of age - below 20 or above 70 years -and men more than women).

More than 95% of thyroid nodules are harmless or benign, but you should nevertheless contact your GP if you detect a lump or swelling low in the front of your neck below your Adam’s apple.

Thyroid nodules are more common in women and are more likely to occur as we age. Although most nodules don’t cause symptoms they can become so large that they can be felt, seen or cause breathless or difficulty in swallowing as they press on your windpipe or oesophagus. In rare cases there may even be hoarseness or difficulty speaking because of compression of a large nodule on the larynx.

Some nodules are described as “hot” producing extra thyroid hormone which can then cause symptoms of hyperthyroidism . Patient information on hyperthyroidism is just here 

A few nodules are malignant but most are slow growing and small when found.  Aggressive thyroid cancer is uncommon but these nodules will be large, firm, fixed and fast growing.

Testing

A blood test is usually carried out to see if your thyroid is running abnormally. If it is, an ultrasound scan will be used to establish the size and number of nodules and whether a fine needle aspiration cytology (FNAC) to remove cells for microscopic examination will be required. This will help to decide whether it is benign or malignant.  Sometimes the tests are not reassuring enough to give a definitive answer so surgery or ultrasound surveillance is advised.

Treatment

If the tests reveal that the nodule/nodules are not causing any problem and are benign then no further action is required unless there is evidence of increased growth of the nodule. Benign nodules can get bigger but treatment is rarely required unless they are causing significant compression symptoms in the neck.

If there are problems you may need surgery. Occasionally anti-thyroid drug therapy or radioiodine therapy is used if there is evidence of overactivity. A cancerous nodule will be removed surgically and you may then be treated with radioactive iodine. 90% of those identified with thyroid cancer will have a positive outcome. Please see this video to see more details about thyroid cancer 

Please be aware that the occurrence of thyroid nodules does tend to run in families and also in those who have had an early childhood in areas that have been iodine deficient in the past including Europe.

I do hope this information has been helpful.

Although every effort is made to ensure that all health advice on this website is accurate and up to date it is for information purposes and should not replace a visit to your doctor or health care professional.

As the advice is general in nature rather than specific to individuals Dr Vanderpump cannot accept any liability for actions arising from its use nor can he be held responsible for the content of any pages referenced by an external link