Do you have thyroid nodules in your neck? Let's learn about this without fear!

Have you ever felt a lump or a bump on the front of your neck? Or maybe a doctor examined you and said, “You have a nodule on your thyroid.” It’s normal to feel a little scared when you hear this. But don’t worry! Most of the time, thyroid nodules are not dangerous. However, it’s important to be aware of them. Today, let’s talk about thyroid nodules in simple terms.

What are Thyroid Nodules?

Simply put, a thyroid nodule is an abnormal growth of cells in your thyroid gland, like a small lump.

Imagine, in the front of our neck, just below the collarbone, there is a small butterfly-shaped gland. That's what we call the thyroid gland . This is actually an endocrine gland in our body. It produces two very important hormones for our body , thyroxine (T4) and triiodothyronine (T3) . These hormones control many things in our body. For example:

• Keep our body's metabolism running properly.
• Control body temperature.
• Control our mood and excitability.
• Control your pulse and heart rate .
• Digest food properly.

So, those lumps can form in the thyroid gland, which does so many important things. These lumps can also be classified into:

• There may be only a single lump (solitary nodule) .
• There may also be multiple nodules .
• Some lumps may be filled with fluid, which we call cystic nodules .
• Some of them may be solid, they are called solid nodules .

The important thing is that more than 90% of these lumps found in adults are noncancerous or benign . That means they are not a big problem. However, between 4 and 6.5 percent (4.0% to 6.5%) can be thyroid cancer . Therefore, if you have a lump, it is important to make sure that it is not cancer. Sometimes these lumps can be a symptom of another thyroid disease.

Who is more likely to develop these thyroid nodules?

Actually, anyone can develop a thyroid nodule. It can affect children, adults, and anyone. However, women are four times more likely to develop it than men.These bumps are more likely to form.

Also, people in countries where iodine is not added to their food are more likely to develop these conditions, as iodine is essential for the thyroid gland to make hormones.

There are some other factors that increase the risk of developing thyroid nodules:

• If you have previously received thyroid radiation treatment .
• If someone in your family has had thyroid nodules or thyroid cancer (family history).
• The risk increases with age .
• For people with iron -deficiency anemia .
• For those who smoke (Smoking) .
• For those with obesity .
• For those with metabolic syndrome .
• For those who drink alcohol (Alcohol consumption) .
• For people who have elevated levels of Insulin-like growth factor-1 (a hormone) in the body.
• Women with uterine fibroids .

How common are thyroid nodules?

These are actually very common. A doctor will find these lumps in 5% to 7% of adults during a routine physical exam. However, an ultrasound can find that between 20% and 76% of adults have these lumps. This means that many people may have them without even knowing it.

But these are not so common among young children.

Should we be afraid of a thyroid nodule?

Most of the time, thyroid nodules are nothing to worry about. As we mentioned earlier, the majority are benign . However, a very small percentage can be thyroid cancer , so if you find out you have a nodule, you should definitely see a doctor to get it checked out. If it is cancer, the sooner it is found and treated, the better .

Remember, don't panic if you see a lump and think it's cancer. But, you should definitely get it checked out by a doctor.

What are the symptoms of thyroid nodules?

Most thyroid nodules don't cause any symptoms, which means you may not notice anything. However, if you have several nodules, or if the nodule is large, you may be able to feel it in your neck.

Very rarely, if the lumps become very large, you may experience the following symptoms:

• Trouble with swallowing food or liquids , trouble with breathing. Imagine, if you feel like something is stuck in your throat when you eat, or if you feel like it's hard to even drink a little water...
• Hoarseness or a change in voice.
• Feeling pain in the front of the neck.
• Swelling of the thyroid gland is also called a goiter .

Some nodules, especially hyperfunctioning thyroid nodules , start to produce too much thyroid hormone, a condition called hyperthyroidism . Symptoms include:

Symptoms of increased thyroid hormones (Hyperthyroidism)

• Rapid heartbeat or palpitations .
• Feeling shaky and/or nervous all the time.
• Weight loss , even though appetite increases.
• Increased appetite .
• Diarrhea and more frequent bowel movements .
• Difficulty sleeping .
• Enlarged thyroid gland or goiter .
• Light or missed menstrual periods in women.

Also, some people with thyroid nodules may have low thyroid hormone levels. This is called hypothyroidism . Here are the symptoms:

Symptoms of low thyroid hormones (Hypothyroidism)

• Feeling tired all the time (Fatigue) .
• Numbness and tingling in your hands.
• Weight gain .
• Dry , coarse skin and hair .
• Constipation .
• Depression, or mental depression .
• Frequent, heavy menstrual periods in women.

Why do these thyroid nodules form? What are the causes?

Researchers still don't know exactly why most thyroid nodules develop. However, they can develop for a variety of reasons. There are several types of nodules:

• Colloid nodules:These are the most common type. They are caused by an overgrowth of normal thyroid tissue. They are not cancerous (benign). They can grow large, but they do not spread beyond the thyroid gland.
• Thyroid cysts: These are lumps that are filled with fluid, or are partly fluid and partly solid. They have a low risk of becoming cancerous (malignancy). If they are larger than 2 centimeters, doctors will observe them or perform a biopsy .
• Inflammatory nodules: These are caused by chronic inflammation of the thyroid gland. They can be painful or non-painful.
• Multinodular goiter: Sometimes the thyroid gland becomes enlarged due to multiple nodules (goiter). These nodules are usually not cancerous.
• Hyperfunctioning thyroid nodules: These nodules produce extra thyroid hormones. This can cause hyperthyroidism , which requires treatment.
• Thyroid cancer: When we talk about a thyroid lump, the biggest fear we have is whether it is cancer. Fortunately, thyroid cancer is very rare. Less than 6.5% of all thyroid lumps are cancerous .

How do you accurately determine if you have thyroid nodules?

Sometimes you can feel a thyroid nodule yourself, or see it in the mirror. Or your doctor may find it during a physical exam. A nodule can also be found accidentally during an imaging test done for another reason.

Although most thyroid nodules are not cancerous (benign), many nodules require some type of testing because of the small chance that they could be cancerous.

What tests are done for this?

Your doctor may do one or more of these tests to look for a thyroid nodule:

• Thyroid blood test: This checks the level of thyroid hormones in your blood. Most of the time, even if there are nodules, the hormone levels are normal. However, sometimes they can be abnormal, which can indicate a thyroid disorder.
• Ultrasound scan: This is a test that uses sound waves to take pictures of the thyroid gland. It can help determine whether a lump is solid or a fluid-filled cyst. (Solid lumps are more likely to be cancerous.) It can also help monitor the growth of the lump and find lumps that are hard to reach. Sometimes, ultrasound can help guide the needle during a fine-needle biopsy .
• Fine-needle biopsy:In this test, a doctor uses a very thin needle to remove a sample of cells from a thyroid nodule or nodules. The sample is then sent to a lab for testing. Most nodules are not cancerous. However, if the test results are inconclusive, the doctor may do the test again. Or, they may recommend surgery to remove the nodule to make a definitive diagnosis.
• Thyroid uptake scan: In this test, you are given a small amount of radioactive iodine to drink. The doctor then looks at how much iodine the thyroid nodules absorb and how much normal thyroid tissue absorbs. This provides more information about the thyroid nodules, which can help the doctor determine the risk of cancer.

What are the treatments for thyroid nodules?

Treatment depends on the type of thyroid nodule. There are several treatment options:

• No treatment/watch and wait: If the lumps are not cancerous, you and your doctor may decide that no treatment is needed right now. However, you will need to see your doctor regularly to see if the lumps change.
• Radioactive iodine: Doctors use radioactive iodine to treat hyperfunctioning thyroid nodules and goiters with several nodules. When the thyroid gland absorbs this radioactive iodine, the nodules shrink.
• Surgery: If the lumps are cancerous, causing obstruction such as difficulty swallowing or breathing, and are “suspicious” (meaning they cannot be diagnosed without surgical removal and examination), the best treatment is to remove them surgically.

Can thyroid nodules be prevented?

Because researchers don't know what causes most thyroid nodules, they often can't be prevented.

However, you can try to reduce your risk by controlling some risk factors. For example, if you are obese , talk to your doctor about maintaining a healthy weight. If you smoke, try to quit smoking . Also, make sure you are getting enough iodine in your diet. If you use iodized table salt , you are probably getting enough iodine.

Some studies have shown that people taking oral birth control pills and/or statins may have a reduced risk of developing thyroid nodules.

What is the prognosis if you have thyroid nodules? (Prognosis)

Non-cancerous (benign) thyroid nodulesThe prognosis is very good. They often do not require treatment. Moreover, only a small percentage of these non-cancerous lumps, about 1%, cause thyroid disease , and even those can be treated.

The outlook for malignant thyroid nodules varies depending on several factors, including:

• The type of cancer .
• Your age at diagnosis .
• The size of the nodule/tumor .
• Whether it has spread to nearby tissues, such as lymph nodes .
• Whether it has spread (metastasized) to distant parts of the body.

If you have thyroid cancer, your doctor will be able to give you a more accurate prognosis.

Do young children get thyroid nodules?

Young children are much less likely to develop thyroid nodules than adults, but researchers are still not sure exactly how many.

Nodules found in children and adolescents are more likely to be thyroid cancer than in adults. However, more than 75% of nodules found in children and adolescents are not cancerous (benign) .

The symptoms, diagnosis, and treatment in children are the same as in adults (as we discussed above).

Finally, I have to tell you… (Take-Home Message)

Thyroid nodules are very common, and they usually don't cause any major problems. However, if you notice a lump in the front of your neck, be sure to see a doctor . Although most nodules are not cancerous, it's important to get them checked out because there's a small chance that they could be cancerous.

If you already know that you have a thyroid nodule, and your doctor has advised you to “watch and wait,” don't forget to see your doctor at regular intervals to check for any changes in the nodule .

If you have any questions about your risk of thyroid cancer or thyroid disease, talk to your doctor. They are here to help. Don't be afraid, be informed!