Thyroid Nodules

Thyroid nodules are unusual clusters of cells that grow in your thyroid. Your thyroid is a small gland in your neck that sits right below your Adam’s apple. Many physicians say that it has the general shape of a butterfly.

Your thyroid makes hormones that control your metabolism, heart rate and body temperature. Nodules might be solid or filled with fluid. You can have a single nodule or several at the same time. They are very common and most of them are not cancerous.

Signs of a Thyroid Nodule

Most of these nodules do not cause any symptoms. You will likely not know you have one until a physician finds a nodule during a routine exam. For example, your care team might spot one on a scan.

Large nodules can show these signs:

• Swollen neck
• Trouble swallowing
• Voice changes
• Hoarseness
• Shortness of breath

You may or may not be able to see the swelling in your neck. Thyroid nodules can press on your esophagus or windpipe. This pressure can make it harder to talk, swallow or breathe.

Some nodules make extra hormones. If this happens, you might feel your heartbeat speed up. You could also lose weight, feel nervous or have trouble sleeping.

Causes

Thyroid nodules do not have a single clear cause. Many form out of an overgrowth of normal tissue.

Other possible causes:

• Fluid filled cysts
• Chronic inflammation
• Enlarged thyroid
• Lack of iodine

When fluid collects in your thyroid, it can form a cyst. Ongoing inflammation can irritate thyroid tissue, which can result in swelling or lumps. When your thyroid is bigger than usual, it can create uneven growth. Iodine deficiencies make your thyroid work harder. This extra pressure can lead to nodules.

Risk Factors

There are some risk factors that make it more likely that you will develop thyroid nodules.

Risk factors:

• Gender. Women are more at risk than men.
• Age. Older adults are more at risk.
• Genetics. A family history of the condition or of cancer is a risk factor.
• Radiation. Having a history of radiation to your neck or head is a risk. This is especially true if you received radiation as a child.

Reasons a Physician Will Check a Thyroid Nodule

Most thyroid nodules are not harmful to your health. Finding one is not a reason to jump to conclusions or to panic. You should still get checked. A physician may look closer at a nodule if you have other symptoms. For example, the nodule has grown. Other reasons might be if you have trouble swallowing. A cough or change in how you speak can be a reason for further examination. Swollen lymph nodes in your neck are another reason.

A family history of thyroid cancer is often a telling sign. Let your physician know if you have had radiation to your neck or head as a child. These risk factors do not guarantee that nodules are cancerous. Most nodules turn out benign. Thyroid cancer that is found early is usually very treatable.

Diagnosis

An endocrinologist will evaluate you. They will start by asking about your history and may do a physical examination of your neck. Next, they might order a TSH blood test. This is one of the best tests to check your thyroid. A thyroid ultrasound is usually the main imaging test. The ultrasound shows the size and features of nodules. It also helps check lymph nodes. In some cases, they might use a thin needle to get a sample of cells. This is a simple, in office procedure. Your care team will look for cancer.

Treatment

If you have a nodule, your physician may want to monitor it with occasional ultrasounds and exams. Sometimes a nodule makes it hard to speak clearly or swallow. Surgery is an option. Surgery removes part or all of the thyroid. For an overactive nodule, medicine can help. Radioactive iodine is another option.

If a nodule comes back as cancerous, treatment often begins with surgery. Thyroid surgery can resolve the issue in many cases. Your specific treatment plan is personalized to you.

When to See a Physician

Here is when to reach out to a Baptist Health endocrinologist:

• You notice that your neck is swollen.
• The swelling affects your breathing.
• The swelling affects your swallowing.
• Your heart is racing.
• You lose weight suddenly.
• You feel shaky.

If you feel a lump in the lower part of the front of your neck, get it checked. Most nodules found through an exam or scan should also be checked to rule out cancer.