Thyroid Nodules

What is a thyroid nodule?

  • A thyroid nodule is a growth (lump) in your thyroid gland. The thyroid gland is a small, butterfly-shaped organ in the front part of your neck. It makes hormones (special chemicals) that act as messengers to help control how your body works. Thyroid hormones help control your body temperature, heart rate, and growth. Thyroid hormones also control your body changes and uses food for your energy needs.

  • You may have one or more thyroid nodules. The nodule may grow, and you may be able to feel it with your fingers. The nodule may also be painless and you may not know it is there. There is a chance that your thyroid nodule may lead to cancer. Having your thyroid nodule seen by a caregiver will help him learn more about your condition. It can help your caregiver decide what treatment is best for you. It can also help your caregiver learn what conditions are causing your nodule. Having your thyroid nodule treated may decrease its size, make your symptoms go away, and prevent further problems.

What causes a thyroid nodule?

Your thyroid nodule may be caused by any of the following conditions:

  • Cancer: This is a tumor (abnormal growth) found in your thyroid gland. Tumors from other parts of your body that have spread to your thyroid gland may also cause nodules.

  • Colloid nodule: This is a growth of thyroid tissue that is not cancer.

  • Thyroid disorders:

    • Hashimoto's thyroiditis: This is an autoimmune thyroid disorder. The disorder occurs when your immune system attacks your thyroid gland. The immune system is your body's defense against infection and diseases. Problems with your immune system may make your body attack its own cells, including your thyroid gland. An attack on your thyroid gland may cause the gland cells to increase in number. The attack may also cause your thyroid gland not to function properly.

    • Simple or hemorrhagic cyst: This is a sac in or on your thyroid gland filled with fluid or blood.

    • Thyroid goiter: A thyroid goiter is a condition where your thyroid gland grows larger than normal. A nodular goiter is a thyroid goiter with one or more lumps on or in the goiter.

    • Other diseases: These include other thyroid disorders such as follicular adenoma and subacute thyroiditis. Ask your caregiver for more information about these diseases.

What increases my risk of having a thyroid nodule?

  • Age: Your risk of having a thyroid nodule increases as you get older.

  • Family history: Having relatives or family members with thyroid cancer may increase your risk.

  • Gender: Women are at higher risk of having thyroid nodules than men.

  • Iodine deficiency: Having too little or no iodine in your diet may cause a thyroid nodule.

  • Pregnancy: Pregnant women are at higher risk of having thyroid nodules.

  • Radiation: Past head or neck radiation therapy increases your risk of having a thyroid nodule.

What are the signs and symptoms of a thyroid nodule?

  • You may have no signs and symptoms at first. As your thyroid nodule gets bigger, you may be able to feel it or see it. A thyroid nodule is normally not painful. A thyroid nodule may become painful if it bleeds. If your nodule grows, it may press on your airway, or the veins in your neck. This may cause signs and symptoms including the following:

    • A hoarse voice.

    • Coughing or choking.

    • Having a flushed (red) face and swollen neck veins when you raise your arms over your head.

    • Pain or trouble swallowing food or liquids.

    • Trouble breathing when you are in certain body positions, such as lying down.

  • You may also have signs and symptoms of hyperthyroidism or hypothyroidism. Hyperthyroidism is when you have more than the normal amount of thyroid hormones. Hypothyroidism is when you have less than the normal amount of thyroid hormones. Ask your caregiver for more information about the signs and symptoms of these conditions.

How is a thyroid nodule diagnosed?

Your caregiver will ask about your signs and symptoms, and when they started. Tell your caregiver when you first felt your nodule, and how fast it has grown. Your caregiver may also ask if you have had any medical conditions, or past treatments on your neck. You may also be asked about your family's health. Tell your caregiver if you have recently been pregnant. Your caregiver will look at and feel your neck. You may also need any of the following:

  • Blood tests: You may need blood taken for tests. These tests will show the amount of thyroid hormones in your blood. Your blood can be taken from a blood vessel in your hand, arm, or the bend in your elbow. You may need to have blood drawn more than once.

  • Fine-needle aspiration: This is also called a FNA. During this test, your caregiver may use medicine to numb the front part of your neck. A small needle will be inserted into your neck. Your caregiver will use the needle to take a tissue sample from your thyroid gland or lymph nodes. The sample is then sent to a lab for tests.

  • Ultrasound: This is a test that uses sound waves to look inside your neck. Pictures of your thyroid gland will show up on a TV-like screen. This test may also be used to guide your caregiver during a FNA.

How is a thyroid nodule treated?

Small thyroid nodules may not need treatment but will need regular follow-up with your caregiver. Other thyroid nodules may need any of the following:

  • Iodine supplement: Your caregiver may ask you to increase the amount of iodine in your diet. Iodine is found in milk, fish, clams, and other seafood. In areas where iodine deficiency is common, you may be given iodine supplements. This treatment may also help shrink your thyroid nodule.

  • Medicines:

    • Radioactive iodine: This medicine damages cells in your thyroid gland, decreasing the amount of thyroid hormone in your blood. This may help your body work better. After taking radioactive iodine, your thyroid gland may still make too much or not enough hormone. If this happens, you may still need to take thyroid medicine.

    • Thyroid hormone: You are given this medicine to bring your thyroid hormone level back to normal.

  • Procedures:

    • Ethanol injection: Ethanol (alcohol) is given as a shot into your nodules to make them smaller. An ultrasound is used to guide your caregiver as he injects the ethanol into your thyroid gland. Ask your caregiver for more information about ethanol injection treatment.

    • Laser ablation: This treatment uses a laser (high-energy light that does not produce heat) to make your nodule smaller. Ask your caregiver for more information about this laser ablation.

    • Surgery: You may need to have all or a part of your thyroid gland removed. Surgery is done if your nodule is found to be cancerous. Lymph nodes (bean-shaped tissue that can trap cancer) may also be removed. You may also need surgery if you have trouble breathing or swallowing, or pain in your neck. Ask your caregiver for more information about thyroid surgery.

When should I call my caregiver?

Call your caregiver if:

  • You cough often, or feel like you are choking.

  • Your voice becomes hoarse or you have trouble swallowing.

  • You have questions or concerns about your condition, treatment, or care.

When should I seek immediate help?

Seek care immediately or call 911 if:

  • You suddenly have trouble breathing.

  • Your symptoms suddenly get worse.

Where can I find support and more information?

Contact any of the following:

  • American Academy of Family Physicians
    11400 Tomahawk Creek Parkway
    Leawood , KS 66211-2680
    Phone: 1- 913 - 906-6000
    Phone: 1- 800 - 274-2237
    Web Address: http://www.aafp.org
  • American Cancer Society
    250 Williams Street
    Atlanta , GA 30303
    Phone: 1- 800 - 227-2345
    Web Address: http://www.cancer.org
  • American Thyroid Association
    6066 Leesburg Pike, Suite 550
    Falls Church , VA 22041
    Phone: 1- 703 - 998-8890
    Phone: 1- 800 - 849-7643
    Web Address: www.thyroid.org

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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