When to Worry About Thyroid Nodules

What is the thyroid? 

The thyroid is one of the glands that belongs to the endocrine system. The butterfly-shaped gland is responsible for releasing hormones into the bloodstream to control and regulate many of the body’s daily functions. It sits just below the larynx and is made up of right and left lobes that form a bridge. Without the thyroid, general regulations like digestion, sex drive and heart function would cease.

What is a thyroid nodule? 

A thyroid nodule is a lump that grows inside any of the thyroid lobes or multiple lobes. They can be solid or fluid-filled. When they contain fluid, they are referred to as cysts. Thyroid nodules can remain the same size or grow over time and may progress at a variety of rates. Thyroid nodules are either benign, meaning non-cancerous, or malignant. Benign nodules still pose a risk and if you feel any lump at all in the area below the throat, it’s crucial to schedule an appointment with your doctor. 

When should I worry about thyroid nodules? 

The American Thyroid Association says that approximately half of the U.S. population will have a thyroid nodule by the time they reach 60 years of age. Most thyroid nodules are benign, but that doesn’t mean you should take yours lightly just yet. If you first feel a bump in your neck, don’t panic. First, assess the situation and if any of these conditions are happening congruently, it may be cause for more concern. 

• Larger than average nodules. Most nodules under 1cm are benign. If you first feel a small nodule that quickly grows to exceed the 1cm measurement, it could indicate something serious. Larger nodules and fast growing nodules can indicate malignancy, or thyroid cancer. 
• Thyroid pain. Thyroid cancer can cause thyroid pain, which may feel like pain while swallowing, discomfort when turning the head, or sensitivity in the thyroid area when pressure is applied. Thyroid cancer is slow growing and difficult to catch early on, but it only exists in 5% of thyroid nodule cases so it is pretty rare. Reporting pain in the thyroid can help oncologists get a head start on treatment, greatly reducing the risk of complication or death from thyroid cancer. 
• Experiencing symptoms of hyperthyroidism or hypothyroidism in conjunction with nodules. 
  • Hyperthyroidism. Hyperthyroidism is an autoimmune disorder that occurs when the thyroid kicks into overdrive for unknown reasons, sensing excess amounts of hormones into the bloodstream. This overactive thyroid condition means that the body’s systems are thrown off, causing one to experience a host of symptoms that may include increased metabolic rate, weight loss, hot flashes, irritability, trouble concentrating, insomnia and more. 
  • Hypothyroidism. Antithetically, hypothyroidism is when the thyroid doesn’t release enough hormones to adequately run the body’s systems. Too little hormones and the metabolism will slow, leading to a drop in libido, metabolic rate, lethargy and more. Both of these conditions need treatment as soon as possible as they can drastically inhibit physical and mental well being. 
• Difficulty swallowing or breathing. The actual nodule may be benign itself but if it grows large enough to block your esophagus, you need medical attention immediately. 
• Family history of cancer. Certain cancers run in bloodlines. Establish a primary care doctor and inform them of your family’s medical history so they may be aware of any heightened risk factors. If relatives have had thyroid cancer or other cancers that often occur in conjunction with thyroid cancer, your doctor will want to take any and all nodules in the throat area seriously. 

Causes and Risk Factors of Thyroid Nodules. 

Thyroid nodules can be caused by a number of different things but doctors and researchers are still unsure as to what the root cause of nodules are. Some causes and risk factors are: 

• Iodine deficiency. The thyroid relies on iodine to make hormones. A shortage of it can increase the risk factor for hypothyroidism and nodules. While this is less of a concern in the United States, many individuals around the globe experience iodine deficiency due to a lack of diet diversity. If your diet doesn’t incorporate fresh, leafy greens, cruciferous veggies and fruit, you may have an iodine shortage. 
• Thyroiditis. Also known as inflammatory disease of the thyroid or Hasimoto’s Thyroid, this occurs when a patient’s immune system develops antibodies to fight thyroglobulin – which is a normal protein produced by the thyroid. This autoimmune disorder can cause nodules to form. 
• Inflammation. Prolonged periods of thyroid inflammation may incite the onset of one or more nodules. Many health issues and experiences can trigger inflammation, including Hasimoto’s Thyroid, radiation treatment, viral or bacterial infections or in response to medication.
• Cancer. Thyroid cancer – occurring in only 5% of causes of thyroid nodules – causes nodules to form. 
• Autoimmune disorders like hyperthyroidism or hypothyroidism. If you already know you have one of these thyroid conditions, be on the lookout for thyroid nodules. 

Treatment for Thyroid Nodules. 

Treatments for thyroid nodules vary greatly depending on the type of nodule one has and the root cause of the nodule. 

• No treatment. If the nodule is small enough, not growing at a fast rate, and isn’t blocking an airway or causing pain, your endocrinologist may decide to leave it alone for the time being. 
• Radioactive Iodine. Taking radioactive iodine may help improve the function of the thyroid, allowing it to heal itself and stopping other nodules from forming. 
• Surgery. If the thyroid bump grows large enough to pose a risk, your doctor may order its surgical removal. If the nodule is cancerous, surgery is typically one of the first steps of treatment. 
• Radiation and/or Chemotherapy. If cancer is the cause of the thyroid nodule, a host of cancer treatments may be implemented to combat both the thyroid cancer and the nodule itself. 

Thyroid Nodules are Typically Harmless. 

If you feel a lump at the base of your neck, don’t panic. The majority of thyroid nodules are benign. However, you shouldn’t diagnose your own thyroid nodule but should seek advice from an endocrinologist you know and trust. Since about half of the American population will experience a thyroid nodule at some point, it’s important to begin establishing a rapport with a primary care doctor and an endocrinologist, who can work together to foster a healthy, happy quality of life. 

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