Thyroid nodules are very common and not usually anything to worry about. The majority (95%) of them are not cancerous. If they’re not cancer, what are they? They are atypical lumps (growths) found in the thyroid gland.
If you find a nodule, there’s no need to panic. Many of them can remain untreated with no effects. However, you should point them out to your doctor to make sure they are not one of the 5% of nodules that are cancerous. Cancerous nodules will be removed by surgery.
Occasionally, the nodules may effect the functioning of the thyroid, possibly causing hyperthyroidism or the over production of thyroid hormones. With hyperthyroidism, the gland works extra hard and produces more of the hormone than it needs. This causes the thyroid stimulating hormone (TSH)to decrease in an effort to slow production. Testing would show up at the low end of the normal range (.5 – 5.0).
Thyroid nodules are more likely in people exposed to radiation and sometimes run in families, but the exact cause of the nodules is unknown. The majority of them will not make their presence known, but if your neck is swollen or if you can feel a bump you may have a nodule. Other symptoms that occasionally occur are a feeling of pain or fullness in the throat, difficulty swallowing, difficulty breathing, nervousness, accelerated heart rate, sweating, weight loss and other symptoms that may indicate hyperthyroidism (overactive thyroid). Symptoms of hypothyroidism (underactive thyroid) include fatigue, depression, memory problems, constipation, dry skin, and feeling cold
If you feel a lump or have any of the other symptoms, your doctor will examine you and ask about your medical history before making a diagnosis. Nodules are generally too small to feel and seldom cause any symptoms. Your doctor may find a nodule while you are having another kind of testing for some other reason.
You will probably have a blood workup also, including a thyroid-stimulating hormone test (TSH) which gives your doctor an idea how your gland is working. Your doctor may also do a biopsy on the nodule to make sure it is not cancerous. If you have a nodule, and you are having symptoms of hypo or hyperthyroidism s/he may also send you for a thyroid scan to evaluate how well your gland works.
Treatment for nodules generally involves just keeping an eye on them. Symptom causing nodules may prompt your doctor to recommend antithyroid pills or a dose of radioactive iodine to negate the part of your thyroid that isn’t working right.
If your lump is overly large and causing problems, or if it is cancerous, your doctor will schedule you to have it surgically removed. After surgery a radioactive iodine treatment may be used to catch any remaining cancerous cells. Often the entire thyroid is removed. If this happens, you will be on thyroid medications (usually T4) for the rest of your life, as well as frequent testing.