Navigating Thyroid Nodules: What You Need to Know

Today, we're diving into a common topic that many people encounter: thyroid nodules. While the discovery of a lump in your neck can be concerning, it's important to understand what thyroid nodules are, how frequently they occur, and when it's time to seek expert medical advice.

Understanding Thyroid Nodules

Thyroid nodules are simply abnormal growths or lumps that form within the thyroid gland. The thyroid, a small butterfly-shaped gland located at the base of your neck, plays a crucial role in producing hormones that regulate metabolism, energy levels, and many other vital bodily functions. These nodules can be solid or filled with fluid (cysts).

Why Do Thyroid Nodules Form?

The exact reasons why thyroid nodules develop aren't always clear, but several factors are believed to contribute to their formation:

• Iodine Deficiency: While less common in iodine-sufficient regions like the United States due to iodized salt, a lack of iodine in the diet can sometimes lead to the development of nodules.
• Thyroiditis: Chronic inflammation of the thyroid gland, known as thyroiditis (such as Hashimoto's thyroiditis), can increase the likelihood of nodule formation.
• Multinodular Goiter: This condition involves the enlargement of the thyroid gland with multiple nodules. The exact cause is often unknown but can be related to iodine deficiency or other underlying thyroid issues.
• Thyroid Adenoma: These are benign (non-cancerous) overgrowths of thyroid tissue.
• Thyroid Cancer: In a small percentage of cases, a thyroid nodule can be cancerous. This is why proper evaluation is crucial.
• Genetics: There may be a genetic predisposition in some individuals to develop thyroid nodules.

How Common Are Thyroid Nodules?

Thyroid nodules are surprisingly common. It's estimated that they can be found in up to 50-60% of the adult population when high-resolution ultrasound is used. However, many people are unaware they have them because they are often small and don't cause any noticeable symptoms.

The likelihood of developing thyroid nodules increases with age. They are also more common in women than in men. While the vast majority of thyroid nodules are benign, the prevalence of thyroid cancer within these nodules is relatively low, estimated to be around 5-15%.

When Should You Seek Attention?

While most thyroid nodules are harmless, certain signs and symptoms warrant a visit to your doctor for evaluation. It's important to be proactive if you experience any of the following:

• A noticeable lump in your neck: This is the most common way nodules are discovered, either by self-examination or during a routine physical exam by your doctor.
• Difficulty swallowing or breathing: Large nodules can sometimes press on the esophagus or trachea, leading to these symptoms.
• Hoarseness or changes in your voice: A nodule pressing on the nerve that controls the vocal cords can cause voice changes.
• Pain in the neck or jaw: While less common, some nodules can cause localized pain.
• Symptoms of hyperthyroidism: In rare cases, a nodule can produce excess thyroid hormone, leading to symptoms like rapid heartbeat, weight loss, anxiety, and tremors.
• Symptoms of hypothyroidism: Less frequently, nodules can be associated with an underactive thyroid, causing fatigue, weight gain, and cold intolerance.
• A family history of thyroid cancer or multiple endocrine neoplasia (MEN) syndromes: These conditions can increase your risk of thyroid cancer.
• History of radiation exposure to the head or neck: This is a known risk factor for thyroid cancer.

What to Expect at Palmetto Endocrinology

If you or your primary care physician discover a thyroid nodule, Palmetto Endocrinology is here to provide comprehensive and expert care. Our experienced endocrinologists specialize in the diagnosis and management of thyroid disorders, including thyroid nodules.

When you come to Palmetto Endocrinology for a thyroid nodule evaluation, we typically follow these steps:

1. Thorough Medical History and Physical Examination: We will discuss your symptoms, medical history, family history, and perform a careful examination of your neck.
2. Thyroid Function Tests: Blood tests will be ordered to assess your thyroid hormone levels (TSH, free T4, and sometimes free T3) to determine if your thyroid gland is functioning properly.
3. Thyroid Ultrasound: This imaging technique uses sound waves to create detailed images of your thyroid gland, allowing us to visualize the size, location, and characteristics of any nodules present.
4. Fine-Needle Aspiration (FNA) Biopsy: If a nodule is of a certain size or has suspicious features on ultrasound, we may recommend an FNA biopsy. This minimally invasive procedure involves using a thin needle to collect a small sample of cells from the nodule, which is then examined under a microscope by a cytopathologist to determine if it is benign or malignant.
5. Radioactive Iodine Scan (in some cases): For certain types of hyperfunctioning nodules, a radioactive iodine scan may be used to assess their activity.
6. Genetic Testing (in specific situations): In some cases, genetic testing may be considered to evaluate the risk of certain types of thyroid cancer.

Based on the results of these tests, our endocrinologists at Palmetto Endocrinology will develop a personalized management plan tailored to your specific needs. This may include:

• Observation: Many benign, small, and asymptomatic nodules do not require immediate treatment and can be monitored with regular ultrasound exams.
• Medication: If the nodule is associated with hyperthyroidism, medication may be prescribed to regulate thyroid hormone levels.
• Radioactive Iodine Therapy: This may be used to treat hyperfunctioning nodules or certain types of thyroid cancer.
• Surgery: Surgical removal of the nodule or the entire thyroid gland (thyroidectomy) may be recommended for large nodules causing symptoms, nodules with suspicious features on biopsy, or confirmed thyroid cancer.

Your Partner in Thyroid Health

At Palmetto Endocrinology, we understand that discovering a thyroid nodule can be a source of anxiety. Our dedicated team is committed to providing you with accurate information, compassionate care, and the most up-to-date diagnostic and treatment options. If you have any concerns about a lump in your neck or have been diagnosed with a thyroid nodule, we encourage you to schedule an appointment with one of our experienced endocrinologists. We are here to guide you through every step of the process and ensure your thyroid health is in expert hands.

Contact Palmetto Endocrinology today to schedule your consultation and take proactive steps towards your well-being.

Author

Joseph Mathews, MD, FACP, FACE, ECNU, CCD Joseph W. Mathews M.D., a board certified Endocrinologist and Medical Director of Palmetto Endocrinology, was born and raised in South Carolina. He earned his Bachelor of Science in Biology from the College of Charleston, Cum Laude. He then achieved his M.D. at the Medical University of South Carolina where he also completed his residency in Internal Medicine and a Fellowship in Endocrinology, Diabetes, and Metabolism. Dr. Mathews is also a Fellow of both the American College of Endocrinology and the American College of Physicians, holds an Endocrine Certification in Neck Ultrasound (ECNU) and is a Certified Clinical Densitometrist (CCD). He has extensive experience performing ultrasound guided fine needle aspiration biopsies. His practice includes a range of specializations including prescribing and fitting patients with insulin pumps. Dr. Mathews' practice has drawn patients from out of state to benefit from his expertise in thyroid disorders, diabetes, cortisol problems and their Endocrine disorders.