Have you ever felt a lump in your neck and wondered if it might be serious? Thyroid nodules affect up to 65% of adults globally, yet most people don’t notice these changes. While nodules are generally harmless, they become a concern if you experience symptoms like swelling and weight fluctuations. Knowing the warning signs could save your life — read on to find out when to worry about thyroid nodules and the steps you should take for proper diagnosis and treatment.
What Are Thyroid Nodules?
Thyroid nodules are solid or fluid-filled lumps in your thyroid, which is a small butterfly-shaped gland located in the neck region. As part of the endocrine system, the thyroid gland releases hormones to regulate various functions in the body such as metabolism, heart function, and bone development.
Most nodules are benign and do not pose a major health risk. However, they can become malignant through various unpredictable mechanisms like genetic mutations. Common causes of thyroid nodules include:
- Thyroid adenomas: Benign tumours from excessive thyroid tissues. While the exact cause is unknown, patients are typically found to have genetic mutations and hormonal imbalances.
- Hyperthyroidism: Excess production of thyroid hormones e.g. thyroxine, leads to hypermetabolism. Patients will experience irregular heartbeat, unexplained weight loss, and tremors.
- Thyroid cysts: Fluid-filled sacs that can cause swelling and difficulty swallowing.
- Thyroiditis: Chronic inflammation of the thyroid gland, commonly from autoimmune disorders like Hashimoto’s disease (immune cells attack thyroid gland)
- Iodine deficiency: Iodine is a key molecule to produce thyroid hormones. Insufficient iodine in your diet forces the thyroid to work harder to absorb the remaining iodine, which can cause an enlarged thyroid (goiter). Iodine deficiency can be found in pregnant women as well
When to Worry About Thyroid Nodules
Most nodules do not cause visible symptoms and are only detected during routine screening. While nodules typically resolve on their own, certain signs and symptoms may signal a more serious concern. if you experience any of the following symptoms, it’s important to consult a doctor:
- Difficulty breathing (when nodules press against the windpipe)
- Unexplained weight loss
- Fatigue
- Tremors
- Irregular heartbeat
- Hoarseness
How Are Thyroid Nodules Diagnosed?
If you notice a swollen neck and have difficulty breathing or swallowing, consult a healthcare professional for a diagnostic screening. A various thyroid screening methods to detect thyroid nodules and other abnormalities:
Blood Tests
Thyroid nodules can be caused by hormonal imbalances (hyperthyroidism and hypothyroidism). Blood tests are performed to check for certain thyroid hormones and antibodies:
- Thyroid-stimulating hormone (TSH): Produced by the pituitary gland, TSH signals the thyroid to produce thyroid hormones, which in turn suppresses TSH levels. Low levels of TSH could indicate hyperthyroidism, while high levels indicate hypothyroidism.
- Thyroxine (T4) and triiodothyronine (T3): T4 is a hormone that includes 4 iodine molecules. Once it is released into the bloodstream, the hormones lose one iodine to form T3, which regulates metabolism. Higher T4/T3 levels are signs of hyperthyroidism, while low levels indicate hypothyroidism.
- Thyroid antibodies: Elevated levels could indicate autoimmune conditions like Graves’ disease and Hashimoto’s Disease.
Blood testing is straightforward and requires no special preparation. A small blood sample is drawn from your arm and analysed in a laboratory. Your physician will discuss the results and recommend any necessary next steps
Ultrasound scan
If blood tests indicate a thyroid issue, the next step is often an ultrasound. This is a non-invasive procedure that uses sound waves to obtain images of the thyroid, which helps to determine the size and appearance of any nodules. During the examination, you will lie on your back with your neck extended slightly backwards. A gel will be applied to the skin over the neck region to allow the transmission of sound waves. A transducer, which is a device that emits sound waves, will move gently over the neck region to capture images of the thyroid gland. The whole process will last from 15 to 30 minutes.
Ultrasound-guided biopsy
If a suspicious nodule is detected, your doctor may recommend an ultrasound-guided fine-needle aspiration (FNA) biopsy. This procedure uses ultrasound to guide a fine needle towards the thyroid to extract a small tissue sample of a suspicious thyroid nodule (larger than 1cm). FNA uses a finer needle than a normal biopsy, making it less invasive.
No fasting is required before the procedure, though you may be advised to avoid blood thinners a few days before to reduce the risk of bleeding. Local anaesthetic may be given to minimise any discomfort. Like the ultrasound scan, a transducer is placed on the skin over the thyroid gland, showing an ultrasound image on a monitor that helps the doctor guide the biopsy needle towards the thyroid. A syringe is attached to the needle to extract a small tissue from a detected nodule, which is sent for lab analysis to determine if the nodule is benign or cancerous.
Importance of Early Thyroid Screening
Early detection improves treatment outcomes. Routine thyroid screenings can catch potential issues before they become serious. This is especially important if you have the following risk factors:
- Family history of thyroid nodules or other thyroid-related disorders
- Hyperthyroidism or hypothyroidism
- Increasing age
- Iron-deficiency or iodine-deficiency
- Smoking
- Obesity
- Radiation exposure from previous medical treatments
What to Do If You Have a Thyroid Nodule?
If the nodule is benign, regular monitoring is the best option. You may need to schedule follow-up ultrasounds every 6 to 12 months to determine if the nodules have decreased in size. However, if you experience more symptoms, or notice an enlargement, further intervention may be needed:
Medication
Different types of medication are prescribed based on what causes your thyroid nodules.
For nodules caused by hormonal imbalances, medications help to regulate your thyroid hormone levels:
- Thyroid hormone replacement pills: The pills replace T4 or T3 hormones to mitigate the effects of an underactive thyroid. They are also prescribed after thyroid removal surgery as the body can no longer produce them naturally.
- Hormone blockers: For patients with overactive thyroid, anti-thyroid drugs reduce hormone production. Drugs including atenolol (Tenormin) reduce hormone production by blocking cell receptors.
Surgery
Surgery is typically reserved for localised tumours or nodules that have affected breathing. Depending on the size and type of nodules, surgery options include:
- Thyroidectomy: Complete removal of the thyroid, typically when there are multiple cancerous nodules that have spread across the entire thyroid. Patients will need a lifelong thyroid replacement therapy to maintain a normal metabolism.
- Thyroid lobectomy: Removal of a part of the thyroid where the nodule is found.
Most patients recover well, and those with benign nodules do not require further treatment. If the surgery was performed due to thyroid cancer, patients may need follow-up radioactive therapy and additional monitoring. With proper post-surgical care, patients can lead a healthy life even without a thyroid.
Lifestyle habits
For long-term thyroid health, a healthy lifestyle is vital. The good news is it’s not that complicated — here are some simple habits that you can adopt for a stronger thyroid:
- Iodine-rich diet: Iodine helps the thyroid produce hormones. Adults are recommended to take 150 micrograms of iodine per day. Good sources include seafoods like tuna, as well as dairy products e.g. eggs, milk.
- Minimise intake of processed foods or raw vegetables: They contain goitrogens that can disrupt the balanced thyroid hormone production. If you have thyroiditis, cut down on gluten-rich food like grains. Instead, focus on a mediterranean diet consisting of fruits, vegetables, beans, seafood, and nuts.
- Exercise: Aim for 150 minutes of moderate to vigorous exercise per week; that’s only about 20 to 30 minutes a day! However, consult your doctor first f you have a thyroid or other medical conditions, as certain thyroid medications may cause an extremely high heart rate during intense exercise.
Conclusion
Thyroid nodules are more common than you think. While most are harmless, proper monitoring and diagnosis is crucial to detect for early signs of cancerous growth. The best part? You can get your screening results on the same day!
Don’t let a busy schedule come before your health. If you suspect you have thyroid nodules, book your thyroid screening with us today!
Safeguard Your Health Today
At Centre for Screening and Surgery, we prioritise delivering quality and comfortable early cancer screening and treatment using minimally invasive procedures. If you are concerned about your thyroid and are looking for a thyroid screening, call us to book an appointment today!