Thyroid Nodules – Symptoms & Causes

Swell your confidence, not your sadness. This modern proverb tries to say that one needs to maximise their confidence during times of struggle in life rather than feel sad about it. Many swellings cause pain in the human body. One such swelling is the thyroid nodule. Let’s have a look at the thyroid nodules.

Thyroid Nodules

A thyroid nodule is simply a swollen tissue, which is an overgrowth of normal thyroid tissue or a collection of liquid known as a cyst. So, thyroid nodules are fluid-filled lumps that are formed within your thyroid gland. 

Though not all thyroid nodules are serious and don’t cause symptoms, only some thyroid nodules are cancerous. A few thyroid nodules might become large and visible or make it difficult for a person to swallow or breathe. 

Thyroid nodules may bulge the thyroid or expand the gland above its size and result in a noticeable droop (bulges) in the neck. A single or multiple nodules (lumps) in the thyroid or an autoimmune process will result in this thyroid condition. 

Your doctor could only find a thyroid nodule using a medical test, which might not be known to you in some cases. In a few cases, the doctor will find it during a scan. Treatment for thyroid nodules varies based on their type.

Thyroid Nodules Symptoms

Mostly, the thyroid nodules will not show any signs or symptoms. However, the thyroid nodules, in a few cases, generate extra thyroxine, which is a hormone produced by your thyroid gland. This extra thyroxine can result in the symptoms of overproduction of thyroid hormones (hyperthyroidism). So, the symptoms of thyroid nodules include :

• Increased sweating
• Unexplained weight loss
• Tremor
• Nervousness
• Rapid or irregular heartbeat

A few of the thyroid nodules become so large that they could be:

• Felt
• Visible as a swelling at your neck’s base.
• Press your windpipe or oesophagus, resulting in difficulty swallowing or shortness of breath.

But, the evaluation of all these thyroid nodules alone is enough to find out if they are cancerous. Because many cancerous thyroid nodules are very slow-growing and might be very small.

Thyroid cancers are very rare with nodules, and they might be large, fixed, and rapid-growing.

Doctor visit for thyroid nodules

As many thyroid nodules are non-cancerous, they don’t cause issues. But consult your doctor if you see any unusual swelling in your neck or are having breathing trouble or trouble swallowing. So, the doctor will help you find out the cause and check if there is any risk of cancer. You can seek the help of your doctor if you have either hyperthyroidism or hypothyroidism.

You can get a medical checkup if you see the symptoms of hyperthyroidism, like:

• A pounding heart
• Trouble in sleeping
• Unexpected weight loss, though your appetite is normal or has increased
• Nervousness
• Muscle weakness

You can consult your doctor if you see the symptoms of hypothyroidism, like:

• Cold sensation
• Feeling tired often
• Constipation
• Memory issues
• Dry skin
• Depression

Causes

There are many factors that cause thyroid nodules. The causes of thyroid nodules are:

1) Extra growth in the normal thyroid tissue

The cause of this condition is unknown, but it isn’t seen as serious until it results in considerable symptoms from its size. This, also called an adenoma, is a non-cancerous condition.

2) Colloid nodules

Colloid nodule growths are not cancerous in nature (benign), and these are the most common types of thyroid nodules. But they are overgrowths of normal thyroid tissue.

3) Thyroid cysts

The thyroid growths filled with fluid or filled partly solid and partly fluid are called thyroid cysts. These fluid-filled cavities (cysts) often occur due to degenerating thyroid adenomas. Though the thyroid cysts are noncancerous normally, sometimes they also contain cancerous solid components. Though they show only a low risk for cancer (malignancy), they are either monitored or biopsied once they become larger than 2 centimetres. 

4) Multinodular goitre

In this condition, many nodules (which are usually benign) constitute an enlarged thyroid (goitre). The enlargement of the thyroid gland, caused by iodine deficiency or a thyroid disorder, is called goitre. More nodules are seen during the multinodular goitre, though its cause is less clear. 

5) Hyperfunctioning thyroid nodules

Hyperthyroidism develops when these nodules generate an additional thyroid hormone. Immediate treatment is needed for hyperthyroidism.

6) Thyroid cancer

Only some thyroid nodules will result in thyroid cancer. However, cancer is the greatest risk once thyroid nodules occur. A large and hard nodule causes pain or discomfort. Meanwhile, there are fewer chances for a nodule to be cancerous. Some factors, like a family history of thyroid cancer, other endocrine cancers, and a history of radiation exposure in medical therapy, etc., will increase the risk of thyroid cancer.

7) Inflammatory nodules

Inflammatory nodules may or may not cause pain. In general, the long-term (chronic) swelling (inflammation) of your thyroid gland results in inflammatory nodules. 

8) Chronic inflammation of the thyroid

A thyroid disorder called Hashimoto’s disease can cause thyroid inflammation and thus lead to enlarged nodules. This condition is often related to hypothyroidism.

9) Iodine deficiency

Inadequate iodine content in your diet can sometimes result in the development of thyroid nodules in your thyroid gland. 

Thyroid gland

Thyroid gland is a small gland present just above your breastbone, at your neck base. This gland located below the larynx (Adam’s apple), has two lobes that lie on either side of the windpipe. The function of the thyroid gland is to secrete hormones for regulating some metabolic processes, like growth.

Thyroid Nodules Risks

The thyroid nodules show many risks; they include:

1) Hyperthyroidism: Problems can occur when a nodule or goitre produces thyroid hormone, leading to an excess of the hormone in the body due to the production of thyroid hormone by the nodule or goitre. This condition can cause many issues, like muscle weakness, heat intolerance, weight loss, and anxiety or irritability.

An irregular heartbeat, weak bones, and a thyrotoxic crisis are the risks of hyperthyroidism, but rare, life-threatening symptoms need immediate medical care.

2) Swallowing or breathing issues: A multinodular goitre or the bigger nodules interfere with swallowing or breathing.

3) Issues connected to thyroid nodule surgery: If your doctor suggests surgery to operate a nodule, you might take thyroid hormone replacement therapy for your whole life.

Thyroid Nodules Diagnosis

In general, the doctor conducts a medical test to find out the functioning of the thyroid and the chances of cancer. Those tests include: 

1) Physical examination

During the physical exam, your doctor suggests you swallow. When the patient swallows, the doctor will examine your thyroid because a nodule in your thyroid gland will generally move up and down at the time of swallowing. Your doctor will check the signs and symptoms of hyperthyroidism and hypothyroidism. 

2) Thyroid function tests

Many tests measure the blood levels of thyroid-stimulating hormone (TSH) and hormones produced by your thyroid gland. They will help indicate whether you have hyperthyroidism or hypothyroidism. 

3) Ultrasound

Ultrasound provides details about the shape and structure of nodules. This method uses high-frequency sound waves for the generation of images of the thyroid gland. The doctors might determine if multiple nodules are present. They might use the details of this method as a guide to perform a fine-needle aspiration biopsy.

4) Fine-needle aspiration biopsy

In the fine-needle aspiration biopsy, your doctor inserts a thin needle in the nodule and collects a sample of cells. Then, your doctor sends the samples to a lab for further analysis under a microscope. The biopsy of nodules helps ensure that no cancer is present. 

5) Thyroid scan

A thyroid scan will help evaluate the thyroid nodules. Your doctor might suggest this test if there is any need. An isotope of radioactive iodine is injected into an arm’s vein during this test. A camera will help produce an image of your thyroid on a computer screen. 

Nodules that generate extra thyroid hormone are known as hot nodules; they take up more isotopes. These hot nodules are almost noncancerous. Nodules that consume fewer isotopes are called cold nodules; they are cancerous.

6) Needle biopsy

A needle biopsy is a method used to collect a sample of cells from your body. They help you find out if you have cancer or another condition.

7) High-frequency sound waves

High-frequency sound waves are used in this method to see inside the body. They show movement of the body’s internal organs and also the blood flowing through the blood vessels. Through this, they help determine if it is a solid tumour, a sign of cancer, or a fluid-filled cyst.

Thyroid Nodules Treatment

The type of thyroid nodule decides the treatment needed for a person’s thyroid nodule.

1) Benign nodule treatment

The non-cancerous thyroid nodule treatment includes:

i) Waiting: If you have found that you have noncancerous thyroid nodules in the biopsy, then your doctor might simply watch out for your condition. Your doctor would suggest you have another biopsy if the nodule grows more. But if the thyroid nodule does not change, then you might not need treatment. 

ii) Thyroid hormone therapy: Your thyroid hormone therapy identifies if your gland does not produce sufficient thyroid hormone, then your doctor might suggest thyroid hormone therapy. 

iii) Surgery: A noncancerous nodule may sometimes require surgery if it’s so large or makes it hard for a person to breathe or swallow. The doctors might suggest surgery for people with multinodular goitres. Nodules diagnosed as suspicious through a biopsy also require surgical removal so that they can be examined for cancer signs.

2) Treatment for hyperthyroidism induced nodules

The condition in which the thyroid nodule produces more thyroid hormones than the normal hormone production levels is called hyperthyroidism. In such a case, your doctor might suggest treating you for hyperthyroidism using the following:

i) Radioactive iodine: Doctors use radioactive iodine in the form of a capsule or a liquid to treat hyperthyroidism. When taken by the patient, this radioactive iodine gets absorbed by the thyroid gland. This will cause the nodules to shrink and the signs of hyperthyroidism to be present, usually within two to three months. 

ii) Anti-thyroid medications: Anti-thyroid medications will help lower the symptoms of hyperthyroidism. Generally, the treatment is long-term and might have some side effects. So, discuss it with your doctor.

iii) Surgery: If the radioactive iodine or anti-thyroid medications are not enough to treat a person’s condition, then the surgery might help remove the overactive thyroid nodule. You could also ask your doctor about the risks of surgery.

3) Treating cancerous nodules

The treatment for a thyroid nodule that is cancerous needs surgery.

i) Looking forward – Only a few cancers have less risk of growth, so the doctor must closely watch the cancerous nodules before providing the treatment. Observation includes the ultrasound monitor and blood tests, which could help with watching them. 

ii) Surgery – Surgery helps remove the cancerous nodules. A procedure called near-total thyroidectomy helps remove the majority of thyroid tissue. A near-total thyroidectomy might be used based on the extent of the disease.

Thyroid surgery complications include nerve damage and damage to your parathyroid glands. Post-completion of thyroid surgery will require a lifelong treatment with levothyroxine to supply thyroid hormone to your body. Your thyroid specialist will only help with post-survey follow-ups after the surgery.

iii) Alcohol ablation – Ablation of the alcohol on the small cancerous nodules helps in treating some of the small cancerous nodules. In this process, a small amount of alcohol is injected into the cancerous thyroid nodule to destroy it. Multiple But this method necessitates many treatment sessions. 

Conclusion

A thyroid nodule is a fluid-filled lump that is formed within your thyroid gland. Thyroid nodules could be caused by some causes, like colloidal nodules, multinodular goitre, etc. However, they show many symptoms like increased sweating, unexplained weight loss, tremors, etc. After finding out the risks involved in the thyroid nodule of a person, the doctor will suggest a proper solution that suits the person. Seeking medical advice from the doctor will help the patient properly treat his or her condition. 

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