Thyroid Nodules Overview

What are the Symptoms, Causes, Diagnoses, and Treatments for Thyroid Nodules?

Found commonly in people as a single nodule or several in number, thyroid nodules are not usually considered dangerous. In fact over the age of 60, a big majority of people have a minimum of one nodule.

So, let us see about what these nodules are, what triggers them, how are they diagnosed and treated.

What are thyroid nodules?

Thyroid nodules are unusual lumps or growths found inside thyroid gland. Formed due to excessive growth of the cells in thyroid gland, the nodules are generally benign in nature.

But in a small percentage of people they can turn cancerous. And the nodules may appear as single or multiple nodules. They can be filled with fluid including blood or present as a solid mass.

Thyroid gland consists of two lobes namely right and left lobe present in the anterior part of neck under larynx or Adam’s apple. The lobes secrete thyroid hormones which are responsible for various functions such as heart function, digestion and regulation of body temperature.

What symptoms are seen if thyroid nodules are present?

Symptoms are not frequently found in case of thyroid nodules. But if the nodule starts producing more of thyroid hormones T3 and T4, this may trigger symptoms that are similar to those found in hyperthyroidism such as irritability, anxiety, hyperactivity, nervousness, sweating, fast heart rate, trembling of hands, loss of hair, diarrhea, lighter or missing menstrual periods and weight loss.

Breathlessness, reduced appetite, vision problems, flushing of skin and muscle weakness is also present.

The enlarged nodules may also obstruct the larynx and cause difficulty in breathing, swallowing and hoarseness. Neck pain is also present.

The presence of nodules may also be related to hypothyroidism. In such a case the levels of thyroid hormone secreted in the gland are low.

This triggers symptoms such as heavy and frequent menstrual periods, fatigue, weight gain, and hoarse voice, dryness of skin, forgetfulness and irritability.

How are the nodules formed?                

The exact reason behind the formation of thyroid nodules has not been found yet. Some of the causes cited include

• In some cases the nodules are found to be genetic.
• People who have iodine deficiency also develop the nodules
• The nodule may be cancerous in a few cases

The incidence of the nodules in more in women, when compared to men and further incidence also increases as one ages. Patients with Hashimoto’s thyroiditis and those who are exposed to radiation as form of medical treatment have higher risk of the nodules.

The different categories of thyroid nodules

Thyroid nodules appear in different forms:

Cysts: Cysts are cellular growths filled partly or fully with solid or fluid material.

Colloid form: Colloids are single or multiple thyroid tissue growths which are benign in nature. They may enlarge, but do not extend to other parts of the body.

Inflammatory form:  The nodules in this type are formed due to long term or chronic inflammation of thyroid gland. Pain may be present in some cases.

Multinodular form:  Goiter or enlarged thyroid gland can have multiple nodules, which remain benign.

Hyperactive nodule: The nodules secrete thyroid hormone leading to hyperthyroidism. This leads to heart conditions such as increase in blood pressure, cardiac arrest, and abnormalities in heart rhythm. The hyperthyroidism also triggers osteoporosis and several other health problems.

Cancer of thyroid: The nodules turn cancerous in very few patients. A study conducted on patients with nodules found that less than2 percent of the total number of nodules studied was malignant.

Diagnosis of thyroid nodules

There are various tests performed to confirm the diagnosis of thyroid nodule. Here are the tests in brief

• Examination of neck and palpation of the gland can help detect the presence of nodules.
• An ultrasound helps to know the shape, contents and size of the nodule
• Biopsy and FNA (Fine Needle Aspiration) is done to examine the nodules and determine their nature. FNA is required to confirm malignancy and also to reduce the false negative
• Levels of thyroid hormones are measured to rule out presence of other thyroid problems.
• Thyroid scan is done by administering radioactive iodine orally. This helps to confirm malignancy of the nodule. This is necessary as although most of the nodules are harmless, the few percent that are malignant need to be found and excised.

Treatment of thyroid nodules

Since a majority of nodules found are benign, they just need monitoring at regular intervals of a year or so. An ultrasound done once a year to check the changes in the nodule size is sufficient. A study done on Italian patients with the nodule found that the nodules remain benign mostly and hence do not need expensive treatment methods.

If the nodule continues growing causing obstruction of swallowing or breathing or turns malignant, it is necessary to remove the nodules surgically.

For benign nodules that cause an increase in the hormone levels, the treatment of choice is using alcohol ablation or radioactive iodine.

Conclusion

If you have thyroid nodules, you need not be worried over its presence as only a minor percentage can become malignant. But to be on the safer side, it helps to get the nodules examined and tested at regular intervals. This will help alleviate fears of the nodules turning into cancerous tissue.

Further early detection helps in restricting the growth and treating the malignancy, if found, is easier too.

What do you think?