Thyroid nodules

Your thyroid is located in your neck, underneath your Adam’s apple. Its main purpose is to produce the hormone thyroxine, which helps stabilize your metabolism, heart and muscle function, brain development and bone strength.

A thyroid nodule, also known as a thyroid adenoma, is when there is a small lump or mass found on the thyroid. There are a few different kinds of thyroid nodules including:

• Goiters. A goiter occurs when the thyroid is swollen or enlarged, and it is the most common thyroid disorder.
• Multinodular goiters. This is when there are multiple lumps found on the thyroid.
• Toxic adenomas. These types of nodules release excess thyroid hormone and cause hyperthyroidism.
• Thyroid cysts. When the nodule is full of fluid, such as blood, it is called a cyst. Cysts can be present at birth or be caused by an injury or inflammation.
• Thyroid cancer. While not as common, five to 15 percent of thyroid nodules are malignant, or cancerous.

Most often, a thyroid nodule is found during a routine physical examination. Unless it is obstructing your swallowing and breathing or is visible to the naked eye, your healthcare provider will typically notice it when examining your neck or may catch it during imaging tests ordered for other conditions.

If your healthcare provider is concerned about the possibility of a thyroid nodule, he or she may order some combination of the following tests:

• Blood tests. Your provider may order blood tests to measure your thyroid function. This will help your provider determine if your thyroid is producing too much or too little thyroid hormone. Additionally, the blood tests may also be used to study your antibody levels to determine if your immune system is overactive.
• Imaging tests. Your doctor may order imaging tests – such as an ultrasound – to get a closer look inside your body and see how large the nodule is.
• Thyroid scan. You will receive a safe, radioactive substance injected intravenously before you have a computerized tomography (CT) scan. The substance attaches itself to the nodule to help identify it in the imaging study.
• Biopsy. During a biopsy, your provider will remove a small sample of the tissue or cells from the goiter through a thin needle. The sample will then be sent to a laboratory for a pathologist to study it and determine if there is cancer present or not.

The type of treatment you receive will be dependent upon your individual case and the root cause of your thyroid nodule. In some instances, if the nodule is not severe, your provider may recommend a ‘watch-and-wait’ approach.

If treatment is necessary, your provider may recommend one of the below treatment options or a combination of treatments including:

• Medications. Some medication can help your thyroid levels return to a normal level if the nodule was caused by an overactive or underactive thyroid.
• Radioactive iodine treatment. With this treatment option, a dose of radioactive iodine is taken orally, which once in the body, targets the cells in the thyroid. Because the treatment can drastically lower the thyroid hormone production, long-term thyroid hormone replacement medication is typically needed afterwards.
• Surgery. Surgery may include a partial thyroidectomy, which removes a part of the thyroid, or a total thyroidectomy, to remove the full thyroid. Typically, a hormone replacement medication is needed after either procedure.