A thyroid nodule is one or more abnormally growing clumps of cells that appear in the thyroid gland, which can be solid, cystic, or a mixture of cysts. Nodules can vary in size from a few millimeters to several centimeters, and they may be single or multiple. Thyroid nodules can be both benign and malignant:
Benign thyroid nodules include:
Nodular goiter: A nodule formed by the proliferation of thyroid tissue due to an imbalance in iodine intake or other reasons. Thyroid adenoma: A tumor formed by the proliferation of thyroid follicular epithelial cells, usually with an intact capsule, that grows more slowly. Thyroid cyst: A sac-like structure that contains fluid. Malignant (cancerous) thyroid nodules mainly include:
Papillary thyroid carcinoma: the most common type of thyroid malignancy, although relatively malignant, but it needs to be prompted**. Follicular carcinoma of the thyroid gland and medullary carcinoma: less common types of thyroid malignancy. Thyroid nodules can be simple cysts, solid or mixed nodules, or multiple nodules that form due to the enlargement of the thyroid gland itself, called a goiter. Most nodules are benign, but about 5% can be cancerous.
What causes thyroid nodules.
1.Inadequate or excessive iodine intake: Iodine is an important element in thyroid hormone synthesis, and an imbalance in iodine intake may lead to abnormal thyroid function, which may lead to the formation of nodules.
2.Autoimmune diseases, such as Hashimoto's thyroiditis and g**es disease, can lead to damage to thyroid tissue and the formation of nodules.
3.Genetic factors: Thyroid nodules or cancers in other family members may increase an individual's risk of developing thyroid nodules.
4.Radiation exposure: Past exposure** or exposure to radiation exposure, especially as a child, may increase the risk of thyroid nodules.
5.Chronic thyroiditis: Long-term inflammation of the thyroid gland can lead to changes in the tissues within the thyroid gland, forming nodules.
6.Cysts: Fluid-containing cysts may form inside the thyroid gland that are benign in many cases but are also a type of nodule.
7.Thyroid adenoma: Benign tumors can also form within the thyroid gland, they are usually present alone, and may secrete excess thyroid hormones.
8.Thyroid cancer: While most thyroid nodules are benign, sometimes they can be malignant, i.e., thyroid cancer.
9.Age factor: As people age, they are more likely to develop thyroid nodules.
10.Gender effects: Women are more likely to develop thyroid nodules than men.
11.Malnutrition: For example, selenium deficiency may be associated with the development of thyroid disease.
12.Hormonal changes: Hormonal changes during pregnancy and menopause are also thought to be associated with the development of thyroid nodules.
Many thyroid nodules have no obvious symptoms or cause, and they are often discovered incidentally during other tests, such as neck ultrasound.
What are the symptoms of thyroid nodules?
Thyroid nodules may not produce any symptoms, especially when they are smaller. Many people have thyroid nodules and remain unaware. However, if the nodules become large enough or increase in number, the following symptoms may occur:
1.Neck lumps: A hard lump can be seen or felt in the front of the neck and is usually the most obvious sign of a thyroid nodule.
2.Throat discomfort: Feeling a foreign body sensation in the throat, difficulty swallowing, or pain when swallowing.
3.Difficulty breathing: Nodules can cause difficulty breathing when they compress the trachea.
4.Hoarseness: The nodule's compression of surrounding tissues, such as the vocal cord nerves, may cause voice changes.
5.Neck pain: Sometimes nodules can cause pain in the neck or ear area.
6.Coughing: Rarely, nodules can irritate the throat and cause constant coughing.
7.Thyroid dysfunction: While most thyroid nodules do not affect thyroid function, some functional hot nodules (nodules that produce thyroid hormones) can cause hyperthyroidism, which manifests as symptoms such as palpitation, weight loss, anxiety, and heat intolerance.
If you experience the above symptoms or have any concerns, you should consult your doctor for further evaluation and testing.
How to screen for thyroid nodules.
1.Self-exam: Do regular neck self-exams to look for any unusual lumps or enlargements. This can be done by standing in front of a mirror, tilting your head back, and observing if there are any bulges in your neck while drinking.
2.Medical physical examination: Nodules can be found through a neck physical examination done by a doctor. Your doctor will gently press your finger on the thyroid area to detect a lump or swelling.
3.Blood tests: Blood tests can measure thyroid function and measure levels of thyroid hormone (T4) and thyroid-stimulating hormone (TSH) to determine if the thyroid gland is working properly.
4.Ultrasound: Ultrasonography is a non-radioactive imaging modality that provides detailed images of the size, morphology, and nodules of the thyroid gland. It is particularly helpful in distinguishing cystic nodules from solid nodules and can guide fine-needle aspiration biopsy.
5.Fine-needle aspiration biopsy (FNA): If ultrasonography reveals certain suspicious nodules, your doctor may recommend a fine-needle aspiration biopsy to obtain a sample of thyroid tissue and then perform cytology to rule out cancer.
6.Other imaging techniques: Further evaluation may also be made using more advanced imaging techniques such as CT scans, MRIs, or thyroid nuclide scans as needed.
7.Genetic testing: Genetic or molecular testing may be needed if there is a known family history of hereditary thyroid disorders or if the nodule has cytologic features that are suspiciously malignant.
Regular screening for thyroid nodules, especially in high-risk groups (e.g., people with a family history of thyroid disease who have had radiation to the neck**). Early detection and diagnosis of thyroid nodules can help to take appropriate management measures to prevent possible complications.
How to ** thyroid nodules.
1.Watchful waiting : If the nodules are small, asymptomatic, and there are no signs that they are malignant, the doctor may recommend regular monitoring without immediate treatment.
Regular ultrasounds and/or blood tests are done to monitor for changes in the nodules.
2.Thyroid hormone suppression**: In some cases, doctors may prescribe thyroid hormone medications, such as levothyroxine, to try to reduce the nodule and lower TSH levels, as high TSH levels may stimulate further nodule growth.
3.Radioactive iodine**: commonly used for hyperfunctional toxic nodules or multiple nodular goiters.
Radioactive iodine is given orally and concentrates in thyroid tissue, where it destroys cells and shrinks nodules.
4.Alcohol ablation: mainly used for cystic nodules.
Under ultrasound guidance, alcohol is injected inside the nodule, which can help reduce the volume of the sac.
5.Surgery: Suitable for large nodules, significant compression symptoms, suspected malignancy, or confirmed thyroid cancer. Depending on the situation, a total thyroidectomy or partial resection may be an option.
If thyroid cancer is diagnosed after surgery, radioactive iodine** may also be needed to destroy the remaining thyroid tissue.
6.Non-invasive thermal ablation**: e.g. radiofrequency ablation (RFA) or laser thermal**.
These ** destroy the nodular tissue by means of heat energy and are usually performed under local anesthesia.
7.Fine-needle aspiration biopsy (FNA): Although FNA is mainly used for diagnosis, it is also used in some cases for cystic nodules, where cystic fluid can be aspirated.
Before deciding on a ** approach, it is important to perform a thorough evaluation, including determining the benign or malignant risk of the nodule. Doctors usually base their medical history, physical examination, lab test results, and imaging results to determine the best course of action. Consultation with an endocrinologist or surgeon may also be recommended if necessary.
How to prevent it. Adequate iodine intake: Iodine is essential for thyroid function. Make sure that you have a moderate amount of iodine in your diet. Iodine intake that is too low or too high may increase the risk of thyroid nodules. The recommended daily intake can be achieved by eating iodine-rich foods such as seafood and iodized salt. Healthy lifestyle: Smoking has been linked to thyroid disease, and quitting smoking may help reduce the risk of nodules. Maintaining a healthy weight and exercising regularly can also help maintain the health of the overall endocrine system. Avoid radiation exposure: Overexposure to radiation, especially during childhood and adolescence, may increase the risk of thyroid nodules and cancer. For example, be careful when using radiation when performing a CT scan of the neck or chest. Regular check-ups: Regular check-ups, especially if you have a family history or other risk factors for thyroid disease, can detect abnormalities in the thyroid gland early. Maintain a balanced diet: A balanced diet can help maintain overall health and may help prevent thyroid problems. Make sure your diet contains enough trace elements and vitamins such as selenium, zinc, and iron, which are necessary for thyroid health. Managing stress: Long-term stress can affect the health of the endocrine system, including thyroid function. Adopt strategies to reduce stress, such as meditation, yoga, and other relaxation techniques. Avoid the potential effects of certain medications: If you need to take medications that may affect thyroid function, talk to your doctor about possible alternatives. Monitor thyroid function: If you have signs of thyroid dysfunction, such as chills, fatigue, weight changes or mood swings, see your doctor and have thyroid function tests done.
Even with all the precautions, thyroid nodules can still occur. If you have concerns about thyroid health, it's best to consult your doctor for personalized advice.