Thyroid nodules: Should I be worried?

Thyroid nodules are lumps that form within the thyroid gland, located at the base of the neck. They can be solid or filled with fluid, and they are relatively common, especially as people age. Understanding what thyroid nodules are and whether they should cause concern is important for anyone who discovers they have one.

Leading ENT specialist in Birmingham and West Midlands Mr Ijaz Ahmad addresses this important topic in expert detail.   

What are thyroid nodules?

Thyroid nodules are abnormal growths of thyroid tissue. They can vary in size and number, ranging from a single nodule to multiple nodules. Most are benign (non-cancerous). However, a small percentage can be malignant (cancerous).

What causes thyroid nodules?

Several factors can contribute to the formation of thyroid nodules. They include:

• Iodine deficiency: A lack of iodine in the diet can lead to the development of nodules.
• Thyroiditis: Inflammation of the thyroid gland, often due to autoimmune conditions such as Hashimoto's thyroiditis, can cause nodules.
• Overgrowth of normal thyroid tissue: Sometimes, normal thyroid tissue can grow excessively, forming a benign nodule.
• Thyroid cysts: These are fluid-filled cysts and can develop within the thyroid gland.
• Thyroid adenomas: Benign tumours can form in the thyroid gland.
• Thyroid cancer: Although rare, malignant tumours can develop in the thyroid gland.

What are the symptoms of thyroid nodules?

Many thyroid nodules do not cause any symptoms and are often discovered during a routine physical examination or imaging tests for another condition. However, some can cause symptoms, including:

• A visible lump: A noticeable swelling or lump in the neck.
• Difficulty swallowing or breathing: Larger nodules can press on the oesophagus or trachea, causing discomfort.
• Hoarseness or voice changes: If a nodule affects the nerves connected to the vocal cords, it can cause hoarseness or changes in the voice.
• Thyroid dysfunction: Some nodules can produce thyroid hormones, leading to hyperthyroidism (overactive thyroid), while others may be associated with hypothyroidism (underactive thyroid).

How are thyroid nodules diagnosed?

Diagnosis typically involves several steps:

• Medical history and physical examination: A thorough review of the patient's medical history and a physical examination of the neck.
• Blood tests: To assess thyroid function and measure levels of thyroid-stimulating hormone (TSH).
• Ultrasound: An imaging test which utilises sound waves in order to create a detailed picture of the thyroid gland and its nodules.
• Fine-needle aspiration (FNA) biopsy: A minimally invasive procedure where a small sample of the nodule is taken using a thin needle and examined for signs of cancer.
• Radionuclide scan: A test that uses a small amount of radioactive material to determine whether the nodule is "hot" (producing excess thyroid hormone) or "cold" (not producing thyroid hormone).

What are the treatment options for thyroid nodules?

Treatment depends on the type, size, and symptoms of the nodule, as well as the patient's overall health. Options include:

• Watchful waiting: Benign nodules that do not cause symptoms may simply be monitored with regular check-ups and ultrasounds.
• Medications: Thyroid hormone replacement therapy may be used to suppress the growth of benign nodules or manage hypothyroidism.
• Radioactive iodine: Used to shrink benign, overactive thyroid nodules.
• Surgery: Indicated for nodules that are large, symptomatic, or suspicious for cancer. Surgical options include lobectomy (removal of part of the thyroid) or total thyroidectomy (removal of the entire thyroid).

When should I be worried about thyroid nodules?

While most thyroid nodules are benign and not a cause for concern, certain factors may warrant closer attention and further evaluation:

• Rapid growth: A nodule that grows quickly over a short period.
• Symptoms: Persistent difficulty swallowing, breathing, or hoarseness.
• Family history: If members of your family have had thyroid cancer or other endocrine cancers.
• Radiation exposure: Previous exposure to radiation, particularly to the head and neck region, increases the risk of thyroid cancer.

Thyroid nodules are common and often benign, but it's important to seek medical assistance if you discover a lump in your neck or experience related symptoms. Early diagnosis and appropriate management can ensure that any potential issues, including thyroid cancer, are addressed promptly. Consult with your healthcare provider for a thorough evaluation and possible treatment plan.

If you’re concerned about thyroid nodules, arrange a consultation with Mr Ahmad via his Top Doctors profile.