What are Thyroid Nodules?

Thyroid nodules are solid or fluid-filled lumps or bumps. They’re found on your thyroid, a small, powerful 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 the body. Sometimes, cells in your thyroid can grow out of control and form a lump.

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, most thyroid nodules aren’t cancer.

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. Doctors might just watch to make sure it doesn’t keep growing or begin to cause other problems.

Types of Thyroid Nodules

There are different types of thyroid nodules that aren’t cancerous:

Toxic nodules make too much thyroid hormone. This can lead to hyperthyroidism, which makes the metabolism speed up.

Multinodular goiters have several nodules. They may also make too much thyroid hormone and may press on other structures.

Thyroid cysts are full of fluid, sometimes with other debris. They may happen after an injury.

Symptoms of Thyroid Nodules

Thyroid nodules usually don’t have symptoms. If they are large, they may cause:

Trouble breathing

Trouble swallowing

A throat “tickle”

Hoarseness or voice change

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

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

Causes of Thyroid Nodules

It’s not always clear why a person gets 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: A diet that lacks iodine can result in thyroid nodules. This is uncommon in the U.S., since 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).

Thyroid cancer: Most thyroid nodules aren’t cancer, but some can be.

Risk Factors for Thyroid Nodules

Thyroid nodules are actually quite common. By the age of 60, half of all people have them. They’re often very small. You might only learn you have a thyroid nodule when your doctor feels for one during an examination or if you have an ultrasound of your thyroid.

Still, several things can increase your chances of developing a thyroid nodule. They include:

Living in a part of the world where the diet doesn’t include iodine

Having a family history of thyroid nodules

Being female

Being older

Having a history of radiation exposure to head or neck

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.

About 90% of thyroid nodules are benign (noncancerous).

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:

Blood test for thyroid hormones

Ultrasound

Fine-needle biopsy

Thyroid scan

With a biopsy, your doctor will insert a very fine needle into your thyroid nodule to collect a few cells. They’ll send them to a lab for further study.

Noncancerous thyroid nodules can still be a problem if they grow too large and make it hard for you to breathe or swallow.

Treatment for Thyroid Nodules

When a nodule is not cancerous, treatment may include:

“Watchful waiting”

Thyroid hormone therapy

When nodules cause hyperthyroidism, treatment may include:

Radioactive iodine

Antithyroid medicines

Beta blockers

Surgery

Any cancerous thyroid nodules should be removed surgically. The same is true for very large ones and those that change and develop strange features over time.

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