How Are Thyroid Nodules Diagnosed
- Blood tests are done to check the level of thyroid hormones in your body. A blood test may also show if you have an autoimmune disease that caused your nodules.
- An ultrasound uses sound waves to show pictures of your thyroid on a screen.
- A fine-needle biopsy is done to get a tissue sample from your thyroid gland to be tested.
Thyroid Nodule Symptom # : A Lump In The Neck That You Can See Or Other People Can See
- What to do about it?
Thyroid nodules that the patient can see, or somebody else can see should almost always be examined by an ultrasound test. Depending on the characteristics of the nodule , the nodule may need a needle biopsy. Almost all thyroid nodules that can be seen should have a FNA thyroid needle biopsy.
What Is Molecular Profiling
At UCLA, thyroid nodules with indeterminate biopsies are sent out for an additional molecular marker test.; An indeterminate biopsy result is the gray zone where the risk of cancer is intermediate but cannot be ignored.
Sometimes the biopsy result is reported as indeterminate. This means the cells are not normal, but there are not definite signs of cancer. When biopsies are indeterminate, the risk of thyroid cancer is 15-30%.
In the past, to avoid missing a cancer, we recommended thyroid lobectomy to establish a definitive diagnosis. Now, we use molecular profiling. This refers to commercial DNA or RNA tests made specifically for indeterminate thyroid nodules. If the genetic profile appears benign, patients can avoid surgery and we simply watch the nodule over time with neck ultrasound.
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Can I Have Symptoms From Thyroid Nodules
This is often the question for those who are at risk of developing thyroid nodules. Who want to know whether or not they might feel something due to the thyroid nodules being present on their thyroid. What you need to know is there are usually no symptoms.
If the nodules are very big, and because of where your thyroid sits, they can affect swallowing or speaking. If they are really big, and I mean really, they can affect the nerves that allow your tongue to move properly. This is more rare, and they are rarely ever painful.
Bottom Line: If they are really big, or in the wrong place, nodules might cause some discomfort on certain levels. What you need to know is that this is pretty unusual. Its probably not something you need to be actively concerned about.
What Do You Do When Your Child Has A Thyroid Nodule
The first step if your child has a thyroid nodule is to get an ultrasound. This will help your healthcare provider assess the quality of your childs nodule and determine if additional workup is needed. In some cases a repeat ultrasound is needed, and in some cases a biopsy. This all depends on what it looks like on the ultrasound. Some nodules require labs to look at how the thyroid is functioning.
Thyroid Molecular Markers Allow Patients To Avoid Surgery
We want to help patients find that perfect balance between under-treatment and over-treatment. The people-gram shows how molecular testing can help patients avoid unnecessary surgery.
Left Path: Before the use of molecular markers, everyone with an indeterminate biopsy went to surgery. Of those who went to surgery, cancer was found in only 25% of those cases . 75% of the surgical patients turned out not to have needed surgery at all because their nodules were benign .
Right Path: Today, if you have an indeterminate biopsy, you also undergo molecular testing.50% of patients were categorized as benign from the molecular test and safely avoided surgery. Of the surgical patients who received a suspicious molecular test result , cancer was found in 50% of those patients .
It is very rare that patients end up having cancer because of a false negative test. Still, it is UCLAs standard of care to have a safety net and follow every patient after molecular testing, regardless of their result. Those patients will get ultrasounds every 12 months to ensure that nodules do not grow or change in appearance.
But What If Its Thyroid Cancer
A cancer diagnosis is always worrisome, but even if a nodule turns out to be thyroid cancer, you still have plenty of reasons to be hopeful.
Thyroid cancer is one of the most treatable kinds of cancer. Surgery to remove the gland typically addresses the problem, and recurrences or spread of the cancer cells are both uncommon. People who undergo thyroid gland surgery may need to take thyroid hormone afterward to keep their body chemistry in balance.;
Whether its benign or not, a bothersome thyroid nodule can often be successfully managed. Choosing an experienced specialist can mean more options to help personalize your treatment and achieve better results.;
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Thyroid Nodules: Potential Causes
Several conditions may cause or predispose to the development of thyroid nodules including:
Diets deficient in iodine can predispose individuals for the development of thyroid nodules. Portions of the world continue to lack iodine in their diets however in the United States, the presence of iodine in our daily diets makes this an unlikely cause for thyroid nodules.
Overgrowth of normal thyroid tissue
The reason why these thyroid nodules occur is not well understood. These thyroid nodules are commonly called follicular adenomas or thyroid adenomas. . Follicular adenomas are clearly not cancerous and are not worrisome and do not require removal except if they are symptomatic due to their size. The rare follicular adenoma or thyroid adenoma will overproduce thyroid hormone and be the cause of hyperthyroidism. For some reason these excessive thyroid hormone producing adenomas lose their ability to be regulated by the pituitary glands production of Thyroid Stimulating Hormone .
Thyroid cysts are fluid filled cavities caused by degenerating thyroid adenomas, congenital cysts, or overproduction of a fluid produced by the thyroid called colloid.
Inflammatory diseases of the thyroid Multinodular disease of the thyroid Thyroid Cancer
Although the likelihood that a thyroid nodule is a cancer is quite low, the following are associated with an increased malignant risk:
Whats The Treatment For A Thyroid Nodule
Even a benign growth on your thyroid gland can cause symptoms. If a thyroid nodule is causing voice or swallowing problems, your doctor may recommend treating it with surgery to remove all or part of the thyroid gland.
If the doctor recommends removal of your thyroid , you may not even have to worry about a scar on your neck. Some patients are good candidates for a scarless thyroid procedure, where the surgeon reaches the thyroid through an incision made on the inside of your lower lip.
A newer alternative that the doctor can use to treat benign nodules in an office setting is called radiofrequency ablation . Radiofrequency ablation uses a probe to access the benign nodule under ultrasound guidance, and then treats it with electrical current and heat that shrinks the nodule. Its simple: Most people treated with RFA are back to their normal activities the next day with no problems.
The Johns Hopkins; Thyroid and Parathyroid Center
Our thyroid experts in the head and neck endocrine surgery team diagnose and treat patients with a variety of thyroid and parathyroid conditions. Learn about what we offer at our center.
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What About Radiation Exposure
Ionizing radiation has been known for a number of years to be associated with a small increased risk of developing thyroid cancer. The risk is very small and the amount of radiation exposure is higher than that produced by the routine use of x-rays. There is typically a delay of 5 years or more between radiation exposure and the development of thyroid cancer.Radiation was used occasionally between the 1920s and 1950s to treat certain head and neck conditions, such as enlarged tonsils, certain skin conditions , and sinusitis.Testing for the possibility of thyroid cancer developing from exposure to radiation has been done in the United States. These epidemiological studies determined that nuclear tests would likely increase the number of thyroid cancers seen in Americans over future decades.
However, the risks are greatest for those patients living near test sites for many years. If there is any good news from this report, it is that these cancers will typically be of the well-differentiated papillary thyroid cancer, the type that has an excellent prognosis with a very high cure rate. Despite these increased risks, thyroid cancer is still relatively uncommon and usually very curable.
Inherited types of thyroid cancer are very uncommon. The one type of thyroid cancer that may have a higher genetic link, by far, is called medullary thyroid cancer. Approximately only 3% of all thyroid cancers are medullary thyroid cancer and of these, less than one half are inherited.
The Worst Foods For The Thyroid
For thyroid health, it is most helpful to avoid certain foods.;;Among these are:
1.Sugars, including even fruit sugars, fruit juices and many others.;;The reason is that sugars often cause a sympathetic nervous system reaction in the body.;;This is not helpful for the thyroid and adrenal glands at all.
2. Most Soy products.;;These contain thyroid inhibitors in many cases.;;Especially avoid all unfermented Soy such as Soy protein powders, Hamburger Helper, and many others.;;Tofu and;tempeh;are not quite as bad, but not highly recommended foods, either.;;They are lower quality protein foods that are fine once in a while, but not as staples.
3. Tap water.;Drinking tap water, even carbon filtered tap water, will increase your intake of toxic fluorides and chlorine compounds as well.;;;This is why I recommend spring water only. Do not drink reverse osmosis water;in your effort to obtain clean water.;;Reverse osmosis water does not seem to hydrate the body well in most cases, and makes the body more yin.;;It is also seriously deficient in trace minerals.;;For a much more complete discussion on water, read;Water For Drinking.
4. Foods made with tap water.;;These tend to contain chlorides and usually fluorides in America that are direct thyroid antagonists.;;They include hundreds of prepared items such as breads, beverages like teas and coffees in restaurants, soda pop and many other prepared foods.
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What Causes A Thyroid Nodule To Form
Sometimes the thyroid begins to grow , causing one or more nodules to form. Why this happens is not known. Cancer is the biggest concern when nodules form. Fortunately, cancer is very rare it is found in less than 5 percent of all nodules. Nodules develop more often in people who have a family history of nodules, and in people who dont get enough iodine. Iodine is needed to make thyroid hormone.
There are different types of thyroid nodules:
- Colloid nodules: These are one or more overgrowths of normal thyroid tissue. These growths are benign . They may grow large, but they do not spread beyond the thyroid gland.
- Thyroid cysts: These are growths that are filled with fluid or partly solid and partly filled with fluid.
- Inflammatory nodules: These nodules develop as a result of chronic inflammation of the thyroid gland. These growths may or may not cause pain.
- Multinodular goiter: Sometimes an enlarged thyroid is made up of many nodules .
- Hyperfunctioning thyroid nodules: These nodules autonomously produce thyroid hormone without regard for normal feedback control mechanisms, which may lead to the development of hyperthyroidism. Hyperthyroidism can affect the heart and cause such problems as sudden cardiac arrest, high blood pressure, arrhythmias , osteoporosis and other health problems.
- Thyroid cancer: Less than 5 percent of thyroid nodules are cancerous.
How Do I Know If I Have Thyroid Nodules
Most thyroid nodules do not produce any symptoms. However, if you have several nodules, or large nodules, you may be able to see them. Although rare, nodules can press against other structures in the neck and cause symptoms, including:
Hyperfunctioning thyroid nodules can lead to overproduction of thyroid hormones, also known as hyperthyroidism. Symptoms of hyperthyroidism include:
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Why Is Thyroid Disease So Common Today
Thyroid problems are epidemic around the world, especially;;in the Western world, for the following reasons:
1. Stress.;;Stress can cause many cases of thyroid imbalance.;;The stress can be physical, emotional, financial, structural or other.;;Any of these weakens the thyroid gland.
2. Iodine antagonists in the environment.;;This is a very serious problem that few talk about.;;However, the water and food supply is loaded with halogens, which are elements that can replace iodine in the thyroid gland.;;They mainly include fluorides, chlorides, and bromides.;;These elements compete with iodine for absorption and utilization in our bodies.;;When they replace iodine, the thyroid gland simply stops working properly.;;To read more about this, read;Iodine And Iodine Antagonists.
3. Copper and mercury toxicity in almost everyone.;According to the research of Dr. Paul Eck and many others, copper and mercury can easily interfere with the functioning of the thyroid gland.;;They may do this by antagonizing or opposing the action of zinc, manganese and selenium, or perhaps by other mechanisms.;;Unfortunately, copper and mercury toxicity are almost universal today.;Mercury gets into our bodies due to mercury in dental fillings, mercury in all fish except perhaps very small fish like sardines, and in some cases other sources of mercury.;;To read more about this, read;Mercury Toxicity.
Before discussing how to help most thyroid conditions, here is a brief review of how the thyroid gland works.
What Causes Thyroid Goiters And Thyroid Nodules
The most common cause of goiters and soft nodules today is the hormone estrogen.
In hypothyroidism, excess estrogen accumulates in your body for two reasons:
As estrogen accumulates within your body, it tends to affect your thyroid gland in two ways:
Think of your thyroid gland like a balloon.
The effects of estrogen are such that air is being continuously added to the balloon , without any air being allowed to escape.
The balloon will just continue to get bigger and bigger.
The solution to the problem is to stop adding more air to the balloon while at the same time, letting air out, allowing the balloon to shrink and normalize in size.
Well cover this in more detail in just a second.
First, lets cover where most people go wrong
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What Is A Toxic Thyroid Nodule
Ultrasound scan in transverse section of the thyroid gland of a 73-year-old female patient, showing a hot nodule in one thyroid lobe corresponding to a toxic adenoma.
A toxic thyroid nodule causes hyperthyroidism .;This occurs when a single nodule grows on the thyroid gland causing it to become enlarged and produce excess thyroid hormones. If the increased hormone production is coming from a single nodule in the gland, this is called toxic adenoma. If there are many nodules causing the hyperthyroidism, this is referred to as multinodular goitre.
Thyroid Nodule Symptom # : A Cough That Just Won’t Go Away Frequent Coughing And A Need To Keep Clearing Your Throat
- What to do about it?
Thyroid nodules that cause the patient to cough should always be evaluated with an ultrasound scan. Occasionally a CAT scan is required because it is better at looking at big thyroid goiters than ultrasound is . Sometimes it just can’t be known for sure if the thyroid nodule is actually causing the coughing. Often these patients undergo a laryngoscopy . If the thyroid nodule is causing the coughing, or there is a high liklihood it is the cause, then surgery is indicated. Of course, it is now very important for you to chose your surgeon wisely. The nerves to the vocal cords are occasionally damaged by a surgeon removing a thyroid and this will cause severe horseness and a loss of voice for months or even forever. We have an entire page dedicated to helping you chose a surgeon wisely!
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Thyroid Nodule Symptom # : A Lump In The Neck That You Can Feel
- What to do about it?
Thyroid nodules that the patient can feel under the skin, which is confirmed by a doctor should almost always be examined by an ultrasound test. Depending on the characteristics of the nodule , the nodule may need a needle biopsy. We have an entire section of this website on thyroid needle biopsies.
Other Approaches To Thyroid Therapy
1. Iodine therapy.;;This has become very popular.;;Most holistic doctors are using;Iodoral,;Lugols;solution, or other iodine preparations.;;I think they are on the right track giving iodine to many clients.;;However, we observe that these products build up in the liver.;;In other words, they are slightly toxic.;;I have never seen this with kelp, however, which is, after all, a totally natural food eaten by human beings for thousands of years.;;This is why I much prefer kelp to provide extra iodine.
Some doctors object to kelp because it contains mercury and other toxic metals from the sea.;;This is a valid concern.;;However, I have not seen toxicity from Natures Way and;Solaray;Kelp, and few other brands.;;This may be due to their very high alginate content that binds and removes toxic metals found in the kelp.
2. Relaxation therapies such as meditation.;;This is an excellent adjunctive approach to help the thyroid.;;Part of Myers Detox Protocol;is a mental exercise taught by Mr. Roy Masters.;;It is extremely relaxing when done properly.;;For more on this, read my article;Meditation.
3. Chiropractic and perhaps other body work such as;rolfing.;;This can be very helpful to relieve tension in the neck area that can put pressure on the cervical spinal nerves leading to the thyroid gland.;;Quality chiropractic, therapeutic massage and Rolfing or structural integration, and;cranio-sacral therapies are all excellent and highly recommended.
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