Live with Thyroid Nodules (updated March, 2023)

A thyroid nodule is a lump that can develop in your thyroid gland. Thyroid nodules are very common, occurring in up to 50% of the population over 60 years old. Many of these nodules are small.

According to the Hormone Health Network, more than 90 percent of all thyroid nodules are benign (noncancerous). Most thyroid nodules aren’t serious and cause few symptoms and it’s possible for you to have a thyroid nodule without even knowing it. Unless it becomes large enough to press against your windpipe, you may never develop noticeable symptoms.

What to do to when thyroid nodules are suspected?

1. Confirm your diagnosis from diagnostic testing (i.e., thyroid ultrasound or scan) and learn from your doctor about the nature of your nodule  - thyroid nodules are classified as cold, warm, or hot, depending on whether they produce thyroid hormones or not. Cold nodules don’t produce thyroid hormones. Warm nodules act as normal thyroid cells. Hot nodules overproduce thyroid hormones.

2. Know if your thyroid function is normal from lab testing (i.e., T3, T4, TSH) and your doctor’s evaluation.  Your doctor may take a blood sample to measure levels of T3 and T4—the thyroid hormones (sometimes the tissue in a nodule makes too much of the thyroid hormones), and thyroid-stimulating hormone (TSH). TSH is a hormone made by the pituitary gland to regulate the thyroid's production of T3 and T4. These blood tests cannot detect if a thyroid nodule is cancerous, but will help rule out other thyroid conditions.

3. Thyroid nodules are commonly associate with goiter. A goiter is an abnormally large thyroid gland. A goiter develops either because the whole gland is swollen or the gland has multiple growths or nodules on it. Some people with a goiter have no symptoms; others may have symptoms of an overactive or underactive thyroid.

4. Follow up is important – thyroid ultrasound repeat at regular intervals will provide meaningful clinical picture.  Your doctor will notice the changes from comparison with previous results and advice for medical interventions when necessary.

5. A note on iodine intake – you may have read about iodine deficiency is associated with thyroid disorders. Iodine may be tricky, as too little and too much may both cause problems.  People with thyroid disease may be particularly susceptible to ill effects of iodine. Iodine regulation should be under medical guidance; do not take iodine supplement or reduce iodine intake on your own.

When a sampling a nodules' cells for testing, the procedure is called a biopsy or fine-needle aspiration (FNA). The biopsy involves using a very small needle to capture the cells. The cells are microscopically examined by a pathologist, to determine if it is cancerous.

Treatment options will depend on the size and type of thyroid nodule. If your nodule isn’t cancerous and isn’t causing problems, your doctor may decide no need for treatment at all, just watch with regular office visits, lab work, and repeat ultrasounds.

To learn about symptoms of thyroid nodules, TIRADS scoring system, biopsy criteria, and treatment options, go to https://qualitylifeforum.weebly.com/2023-march-live-with-thyroid-nodules.html

Few facts about thyroid cancer –

• A solitary nodule is more likely to be cancerous than multiple nodules.
• A nodule arising in a thyroid with normal function is more likely to be cancerous than those arising in a hyperfunctioning gland.
• Majority of thyroid nodules are benign (not cancerous); about 10% of nodules contain cancer.
• Most thyroid cancers are found between ages 20 to 50 and more common in males.
• The risk of thyroid cancer increases when a thyroid nodule is larger than 2cm.

The good news is many people can live a normal life with asymptomatic thyroid nodules without treatment, even the nodules may not go away or being “cured”.  For patients who have papillary or follicular type of thyroid cancer may expect a normal life expectancy with treatment.

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