Condition Basics

What are thyroid nodules?

Thyroid nodules are growths or lumps in the thyroid gland. This gland controls how your body uses energy. Most thyroid nodules are not cancer and do not cause problems. Many don't even need treatment. A thyroid nodule may cause problems, such as making too much thyroid hormone. When this happens, you may need treatment.

What increases your risk for thyroid nodules?

You are more likely to develop a thyroid nodule if:

• You are older.
  • Thyroid nodules are more common in older people.
• You are female.
  • Women are more likely than men to develop thyroid nodules.
• You have been exposed to radiation.
  • Exposure to environmental radiation or past radiation treatment to your head, neck, and chest (especially during childhood) increases your risk for thyroid nodules.
• You do not get enough iodine.
  • Iodine deficiency is rare in Canada, but it is common in areas where iodine is not added to salt, food, and water. An iodine deficiency may result in an enlarged thyroid gland (goiter), with or without nodules.
• You have Hashimoto's thyroiditis.
  • Hashimoto's thyroiditis can cause an underactive thyroid gland (hypothyroidism).
• One or both of your parents have had thyroid nodules.

What are the symptoms?

Most thyroid nodules do not cause symptoms and are so small that you cannot feel them. If your thyroid nodule is large, your neck may be swollen or you may be able to feel the nodule. In rare cases, you may also:

• Feel pain in your throat or feel like your throat is full.
• Have a hard time swallowing.
• Have a hard time breathing.
• Feel nervous, have a fast heartbeat, sweat a lot, lose weight, or have other symptoms of hyperthyroidism (too much thyroid hormone).
• Feel tired or depressed, have memory problems, be constipated, have dry skin, feel cold, or have other symptoms of hypothyroidism (too little thyroid hormone).

How are they diagnosed?

If your doctor thinks you have a nodule, he or she will do a physical exam and will ask you if you have symptoms or about any changes in how you've been feeling.

You may have tests to see how well your thyroid is working. Possible tests include:

• A blood test to check the level of thyroid hormone in your body.
• A thyroid scan to get information about your thyroid gland and nodules. Another test called an uptake scan can be done at the same time to see how well your thyroid gland is working.
• A thyroid ultrasound to see the number and size of nodules.

You may have a fine-needle aspiration to remove a small amount of material from the nodule to check for cancer.

If your nodule is not cancerous, your doctor will see you regularly to monitor the size of your nodule.

How are thyroid nodules treated?

If a thyroid nodule is not cancer (is benign) and is not causing problems, your doctor will watch it closely for changes. But if the nodule is large or causing problems with swallowing or breathing, you'll need surgery to remove it.

If the nodule is causing hyperthyroidism, your doctor may recommend a dose of radioactive iodine. This most often comes in a liquid that you swallow. Or your doctor may have you take medicine (antithyroid pills) to slow down the hormone production. In some cases, surgery may be done to remove an overactive thyroid nodule.

If your nodule is cancer (malignant), you'll need surgery. This is done to remove the nodule and some or all of the thyroid. You may also need treatment with radioactive iodine to destroy any cancer cells that remain. After surgery, you may need to take thyroid medicine for the rest of your life.