What Are Thyroid Nodules?
Thyroid nodules are solid or fluid-filled lumps or bumps. They're found on your thyroid, a small gland in your neck. This gland makes thyroid hormone, which affects your metabolism (the internal process that turns your food into energy), heart rate, and many other systems in your body. Sometimes, cells in your thyroid can grow out of control and form a lump, called a thyroid nodule.
Are Thyroid Nodules Serious?
Most often the answer is no. You usually can't feel thyroid nodules. Even though they happen from an overgrowth of cells, only about 1 in 10 thyroid nodules turn out to be cancer. Benign (noncancerous) thyroid nodules are common. Lots of people get them as they get older. If a thyroid nodule isn't cancerous, it may not need any treatment. Your doctor might just watch it to make sure it doesn't keep growing or start causing other problems.
Types of Thyroid Nodules
There are several types of thyroid nodules. Most are not cancerous (benign) and are easily treatable. Some nodules are so small that you may not even notice them, while others can grow large enough to cause discomfort when swallowing, sleeping, or even wearing certain clothing.
Thyroid adenoma
These are noncancerous growths of normal thyroid tissue. You do not need treatment for these growths unless they lead to symptoms. Your doctor will monitor them with regular ultrasounds of your neck.
Toxic adenoma
These growths cause your thyroid to make extra hormones, a condition called hyperthyroidism. They are very rarely cancerous. Only 1%-8% of people with hyperthyroidism develop cancer from these growths.
Thyroid cysts
These growths are filled with fluid. They are almost never cancerous.
Goiter
Any swelling or rise in the size of your thyroid is called a goiter. They can be caused by problems with your autoimmune system or by too little iodine in your body. You won't need treatment unless you are having certain symptoms.
Multinodular goiter
Your doctor might use this term when your thyroid is swollen and has multiple growths. Most often, these growths are benign. You will only need treatment if you have certain symptoms or if any of the growths test positive for cancer.
Thyroid cancer
Cancer can form when the cells in your thyroid don't grow normally. Some types of thyroid cancer — papillary and follicular — grow more slowly than other types of the disease. Other kinds of thyroid cancer include:
- Hurthle thyroid cancer
- Medullary thyroid cancer
- Poorly differentiated and anaplastic thyroid cancer
The type of cancer you have will determine your treatment.
Thyroid Nodule Symptoms
Thyroid nodules usually don't have symptoms. But in certain situations, you might experience symptoms.
Large thyroid nodule symptoms
These large nodules can cause:
- Trouble breathing
- Trouble swallowing
- A throat "tickle"
- Hoarseness or voice change
Hot thyroid nodule symptoms
When a nodule causes the thyroid to make too much hormone, this is sometimes called a "hot nodule." It may cause:
- Weight loss
- Muscle weakness
- Heat intolerance
- Anxiousness
- Irritability
- Irregular heartbeat
- Weak bones
Hypothyroidism symptoms
Sometimes, people with thyroid nodules make too little thyroid hormone. This can cause symptoms of hypothyroidism:
- Fatigue
- Cold sensitivity
- Constipation
- Dry skin
- Weight gain
- Puffy face
- Hoarseness
- Muscle weakness
- High cholesterol
- Muscle aches or stiffness
- Joint pain, swelling, or stiffness
- Thinning hair
- Depression
- Memory loss
Thyroid Nodule Causes
It's not always clear why you get thyroid nodules. Several medical conditions can cause them to form. They include:
Thyroiditis
This is chronic inflammation of the thyroid. One type of thyroiditis is called Hashimoto's disease. It's associated with low thyroid activity (hypothyroidism).
Iodine deficiency
Iodine is an essential mineral. A diet low in iodine can cause thyroid nodules. This is uncommon in the U.S. because iodine is added to many foods.
Thyroid adenoma
This is an unexplained overgrowth of thyroid tissue. Most adenomas are harmless, but some produce thyroid hormone. This leads to an overactive thyroid (hyperthyroidism).
Hashimoto's disease
This is an autoimmune disease that causes damage to your thyroid gland.
Thyroid cancer
In some cases, nodules can be caused by thyroid cancer.
Risk Factors for Thyroid Nodules
Thyroid nodules are quite common. By the age of 60, half of all people have them.
Several things can raise your risk of a thyroid nodule. They include:
- Having low iodine levels
- Having low iron levels
- Having a family history of thyroid nodules
- Being assigned female at birth
- Being older
- Having a history of radiation exposure to your head or neck
- Smoking
- Having obesity
- Consuming alcohol
Diagnosing Thyroid Nodules
You may be able to identify one just by looking in the mirror. Face the mirror with your chin raised a little. Swallow and look for a bump on either side of your windpipe near your Adam's apple. Put your fingers gently on your neck in that spot and feel for a bump. If you find one, ask your doctor about it.
If you notice one, have your doctor check it. For problems with your thyroid, you may want to see a specialist called an endocrinologist. Endocrinologists specialize in health problems related to the glands that make hormones, including the thyroid. They will do a physical exam and might order one of the following tests to find out if it's cancer or not:
Sonogram of thyroid nodules
Your doctor, or a physician who specializes in thyroid disease, may perform a sonogram of your neck. This procedure, sometimes called an ultrasound, is painless. It uses high-frequency radio waves to create a picture of your neck. This helps your doctor to better diagnose the size, shape, and number of nodules, whether they might be cysts or something more serious. A sonogram can also help your doctor perform a biopsy.
Thyroid nodule biopsy
Your doctor may test a very tiny sample of cells to see whether the growth is cancerous. They will use a sonogram to help insert a very delicate needle into a nodule, remove a small number of cells, then send them to a lab for closer examination under a microscope.
You may not need any treatment for thyroid nodules, especially if they are small and not causing any symptoms. The type of nodule, and whether or not it's cancerous, will help you and your doctor decide on the best approach.
Thyroid Nodule Treatments
You may not need any treatment for thyroid nodules, especially if they are small and not causing any symptoms. The type of nodule, and whether it's cancerous, will help you and your doctor decide on the best approach.
Common treatments include:
Draining. Fluid in cysts may be removed by your doctor or a specialist using a fine needle.
Ablation. Your doctor might use heat or an alcohol injection to break up nodules.
Surgery. Your doctor or a surgeon might remove nodules if they are large, cause symptoms, or are cancerous or if the cancer has spread. Part or all of your thyroid gland may also be removed if necessary. This is called a thyroidectomy. You may also be given radioactive iodine treatment after your operation to make sure any remaining cancer cells are destroyed. If your thyroid gland is removed, you will need to take medication for the rest of your life.
Takeaways
Thyroid nodules are common, especially if you are older than 60 years. Most nodules are noncancerous, but if you have trouble breathing or swallowing or experience other symptoms, like a hoarse voice that won't go away, it's wise to get checked by a doctor. Your doctor can conduct several tests to determine how serious the problem is and will discuss your treatment options, depending on the results. In some cases, you may need surgery, but many nodules can be treated without an operation.
Thyroid Nodules FAQs
Can thyroid nodules cause mucus in the throat?
Yes. Hoarseness that won't go away, frequent coughing, or feeling a need to to keep clearing your throat may be symptoms of a thyroid nodule.
What size thyroid nodules are worrisome?
You should get any size thyroid nodule evaluated by your doctor, who may decide to wait and see if it grows. Small nodules often don't need to be treated if they are not cancerous.
Do thyroid nodules need to be removed?
Small nodules often do not need to be removed, especially if they are not causing symptoms. Larger nodules or growths that cause you trouble swallowing, breathing, or discomfort should be evaluated for possible removal.
What should you avoid if you have thyroid nodules?
If you have thyroid problems, it's best to speak with your doctor about what foods to avoid or cut back on. Soy and soy-based products can interfere with hormone medication, for example. Other foods that may cause problems for people with thyroid issues include:
- Cassava
- Cruciferous vegetables like broccoli, cabbage, cauliflower, and radishes
- Kelp in supplemental form
- Iodine supplements
Do thyroid nodules cause weight gain?
Weight gain can be a sign of hypothyroidism. If diet, exercise, and lifestyle modifications are not addressing your weight issues, ask your doctor to check your thyroid levels.