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Disease and Disorders

8 Important Key Points About Thyroid Nodules

Thyroid nodules are frequently discovered in the thyroid gland, either during physical examination or incidentally during various procedures.

They are clinically very thin needle-like and are very important in the research because of their malignant nature. For this reason, only the initial evaluation should include a physical history of features suggestive of malignancy.

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rumruay on Shutterstock

What are Thyroid Nodules?

  1. Thyroid nodules are most commonly found in women and older people, it is a kind of popular disease
  2. The purpose of thyroid nodules is benign noncancerous nodules, the study of thyroid nodules determines whether the surgery is required or not.
  3. Thyroid nodules can be defined by the American Thyroid Association, as discrete lesions within the thyroid gland.
  4. It is different from the surrounding thyroid parenchyma in terms of radiology. These nodules may be multiple nodules, they may be cystic or solid nodules. 
  5. Such nodules are very common in adults. 
  6. These thyroid nodules are spreading faster due to imaging tests like neck ultrasound, positron emission tomography (PET), magnetic resonance imaging (MRI), and computed tomography (CT).
  7. Whereas out of the detected thyroid nodule, more than 90% are thyroid benign nodules. These can be dangerous as they can produce thyroid cancer cells which ultimately lead to thyroid cancer as well as other endocrine cancers. This person has to go for a routine physical exam so that they have the proper information related to the thyroid gland of their body.

1. Thyroid Gland

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It is a gland that is located on the front of the neck below the Adam’s apple, it is in front of the windpipe. The entire thyroid gland looks like a butterfly that contains two side lobes.

There are two main types: thyroid hormones Thyroxine (T4) and Triiodothyronine (T3)

2. Thyroid Hormone

The thyroid hormone is used to control the metabolism of the body. The two hormones secreted by the thyroid gland are T4 and T3.

There are various disorders related to thyroid nodules, it may be cancerous thyroid nodules. Around 23% of the solitary nodule will represent the dominant nodule within the multinodular goitre.

The enlarged thyroid gland causes the disease of goitre. People suffering from goitre have an iodine deficiency, which will cause problems with swallowing or breathing.

Thyroid Stimulating Hormone (TSH)

It is a hormone that stimulates the function of two main hormones (T4, and T3) of the thyroid gland. This hormone is known as Thyrotrophin, secreted by the pituitary gland.

The high amount of TSH can cause depression, constipation, and infertility.

3. Thyroid Cells

There are two main types of thyroid cells i.e. Follicular cells and Parafollicular cells. These cells secrete the iodine-containing thyroid hormone.

4. Thyroid Cysts

A cyst is the abnormal growth of non-cancerous cells which are filled with semisolid and liquid. They are known as fluid-filled cysts, also, they will cause pain sometimes. So this type of growth in the thyroid gland is known as thyroid cysts.

5. Disease-Related to Thyroid Hormone

There are two main diseases of thyroid hormone: Underactive thyroid (Hypothyroidism) and the other one is Overreactive thyroid (Hyperthyroidism).

Underactive Thyroid:

It is a condition where the thyroid gland is not able to produce hormones. Its effects are body temperature and irregular heartbeat.

Overactive Thyroid:

It is a condition where the thyroid gland will produce more amount of thyroid hormones, its symptoms are sweating, weight loss, and irritability.

6. Disorders Related to Thyroid Nodules

Several disorders are related to the thyroid gland such as overgrowth of normal thyroid tissue, chronic inflammation of the thyroid gland, thyroid cancer, thyroid cyst, and iodine deficiency.

7. Factors Which Increase the Risk of Thyroid Nodules

Ionizing radiation is the major risk factor for both thyroid nodules (benign and malignant). The incidence of malignancy has been reported 20% to 50% in palpable nodules.

Some other factors that also increase the risk of nodules of the thyroid are metabolic syndrome, uterine fibroids, smoking, alcohol consumption, obesity, and an increased level of insulin.

8. Factors which Decrease the Risk of Thyroid Nodules

The use of statins and oral contraceptives will decrease the risk factors for thyroid nodules.

It is classified into two parts:

  • Neoplastic thyroid nodule

  • Non-neoplastic thyroid nodule

Neoplastic Thyroid Nodules

It is a neoplasm or in other words, it is a tumour of the thyroid, these thyroid nodules are benign or malignant. If it is benign nodules then it may be thyroid adenoma or if it is malignant then it may be follicular, anaplastic, papillary, or medullary thyroid.

Adenomatous benign neoplasms are represented by colloid nodules and these are the most common thyroid nodules, they do not have a high risk of malignancy.

The follicular adenoma is benign and they show similarities with follicular carcinoma.

Non-neoplastic Thyroid Nodules

These nodules are the results of the spontaneous raising of glandular hyperplasia or partial thyroidectomy, they are also inflammatory nodules.

The risk of thyroid nodules increases with increasing age, and iron deficiency, it is seen more in females and the person having a family history of the thyroid.

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Photo by Online Marketing on Unsplash

Hot Nodules:

Hot nodules are the nodule that causes hyperthyroidism (too much thyroid hormone), it is the nodule that produces a high amount of thyroid hormones.

Cold Nodules:

A thyroid scan is not able to differentiate between cold nodules which are cancerous and non-cancerous

Diagnosis of Thyroid Nodules

If a lump or nodule in the neck is observed then your doctor might ask you for a checkup of thyroid nodules. The test includes: 

  1. Physical exam: The doctor will ask you to swallow something while he or she examines your thyroid because a nodule present in your thyroid gland will usually move down and up during swallowing. 
  2. Thyroid function test: This is the test that measures blood levels of Thyroid-stimulating hormones and hormones produced by the thyroid gland. 
  3. Ultrasound: The imaging technique uses high-frequency sound waves which produce images of the thyroid gland. 
  4. Fine-Needle Aspiration Biopsy: The nodules are often biopsied to make sure that it is cancer or not. During the procedure, the doctor inserts a very thin needle into the nodules and smoothly removes a sample from the cells. 
  5. Thyroid Scan: The doctor will recommend a thyroid scan to help evaluate the thyroid gland nodules. During this test or scan, an isotope of radioactive iodine is injected directly into the vein in your arm. then the special camera will produce an image of your thyroid on a computer screen.

Symptoms of Thyroid Nodules:

Most thyroid nodules do not show any signs or symptoms. But some nodules are large and filled with fluid so they can show the following symptoms:

  • Swelling in the neck area

  • Pressure is felt on the food pipe and windpipe

  • Excessive weight loss

  • Fatigue

  • Irregular and rapid heartbeat

  • Sweating is increased

  • Tremor

Most thyroid nodules are benign, the cancerous nodules are slow-growing and they are detected by doctors after certain tests.

When to Consult a Doctor?

In most cases, the thyroid hormones are noncancerous and they do not cause any difficulties. But if you have any swelling near your neck and the person feels neck pain then it is time to consult a doctor. Especially in the case of breathing and swallowing.

There are some more symptoms when you have to consult a doctor:

  • Your appetite has increased but your weight is reducing rapidly.

  • The person is feeling trouble sleeping

  • Weakness in muscles

  • Irritability

These all symptoms show that the body has developed thyroid nodules. Which need immediate medication or consultation from the doctor. so that it can be treated at the early stage of the disorder, and the patient can be saved.

Treatment of Thyroid nodule

If the thyroid nodules are diagnosed then they should be treated, treatment options are different for benign and cancerous nodules.

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Photo by Vitalii Pavlyshynets on Unsplash

Treating Benign Nodules:

It is the case where the thyroid nodule is not cancerous. Its treatments are listed below:

Watchful Waiting:

When the fine needle biopsy is done and it shows that it is noncancerous (it is not thyroid cancer).

The doctor determines to do a physical exam and then the tests are done at regular intervals, it will be an ultrasound or another biopsy. If the benign nodule is not changing then the treatment is not needed.

Thyroid Hormone Therapy:

Thyroid hormone therapy is recommended by the doctor when your thyroid gland is not able to produce enough amount of thyroid hormone.

Surgery:

Sometimes, surgery is recommended by doctors for treating the nodules, especially in the case of large multinodular goitre, as it causes problems in swallowing and breathing. So, the large nodules are surgically removed.

Treatment of Thyroid Nodules Which Causes Hyperthyroidism

There are three main treatment that is usually done to treat thyroid nodules that causes hyperthyroidism:

Radioactive Iodine:

Radioactive iodine is used to treat hyperthyroidism. It can be in the form of a capsule or liquid form, the radioactive iodine is then absorbed by the thyroid gland. As a result, the thyroid nodule will shrink and the symptoms not be seen in the patient after two to three months.

Anti Thyroid Medication:

Some medications will reduce the symptoms of hyperthyroidism, these medications are methimazole. This treatment is long-term and has some side effects on the liver.

Surgery:

If the above two medication does not work then we go for the surgery or we can say that the doctor advised for the surgery. It has many side effects also on the patient’s body but it is the last option to save the life of the individual.

After the successful surgery, the thyroid hormones are given to the patients through diet or medication throughout the life of the individual. 

Treatment for Cancerous Nodules

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Photo by National Cancer Institute on Unsplash

The treatments for the cancerous nodules are as follows:

Observation

Small cancers have a low risk of growing. So these types of cancers are first observed, this observation includes performing blood tests and monitoring by ultrasound.

Surgery

It is usually done in the case of cancerous nodules, it will remove all the thyroid tissue. But due to the surgery nerve cells are damaged which controls the vocal cord and it will also damage the parathyroid glands.

After the surgery, the thyroid tissue is removed so the patient has to take lifelong treatment. In this treatment, levothyroxine is given to fulfill the demand for thyroid hormone in the body.

Alcohol Ablation

It is another method to treat small cancerous nodules. In this method, a small amount of alcohol is injected into the cancerous thyroid nodule to destroy it, it requires many treatment sessions.

Frequently Asked Questions

1. When should I worry about thyroid nodules?

A nodule’s chances of being cancerous are slim. A thyroid nodule that is huge and hard, or creates discomfort or pain, is more concerning. You should probably have it examined by a doctor.

2. Do thyroid nodules need treatment?

You might not need therapy if a normal thyroid nodule does not cause pain and disappears in a few weeks.

3. Can thyroid nodules be removed?

Thyroid nodule treatment surgery may involve performing a lobectomy or a complete thyroidectomy to remove a part or the entire thyroid containing the lesion.

Closing Thoughts

Thyroid nodules are lumps that are formed in the thyroid gland, it is a disability of the thyroid gland when the thyroid nodule is filled with fluid (some are semi-solid and some are liquid). There are two types of thyroid nodules benign and malignant i.e. cancerous and noncancerous.

It may be due to family history and some other reasons. The major risk factors of most thyroid nodules are a history of radiation exposure, cysts, and tumour.

Many thyroid nodules are benign and noncancerous and do not need treatment as they are not so harmful but the cancerous nodules are very harmful and they will not show any signs and symptoms so it will become difficult to detect them.

There may be single or multiple nodules in the gland. There are various methods to find thyroid nodules. As they are only detected by some thyroid tests they are blood tests, thyroid ultrasound, and thyroid ultrasonography.

After consulting with the doctor, the proper treatment should be started to overcome the disease. Stay safe and healthy!

Author

  • Priyanshi Sharma

    Priyanshi is a Biotechnologist with expertise in microbiology, food technology, and psychology. While she loves spending time in the laboratory, she wants to write about it too. Her expertise in the medical domain spans several years, and as a writer, she manages to craft words that make intrepid medical and health related content seem appealing for a general audience. Expertise: Biotechnologist, and degree in psychology.

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