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What Can A Nodule On Your Thyroid Mean

How Can My Doctor Tell If I Have A Thyroid Nodule That Is Cancerous

Thyroid Nodules – When to Worry? (Signs your nodule could be something more)

Your doctor can do several different tests. One test is called fine-needle aspiration. Your doctor will take a tissue sample from your thyroid gland and examine it under a microscope to see if its cancerous. The tissue sample is taken with a very small needle.

Another test your doctor may do is an ultrasound. This test uses sound waves to make a picture of the thyroids shape and the size of the nodules. It can help your doctor determine whether the nodule is a solid tumor or a cyst filled with fluid.

A third test is a thyroid scan. Your doctor will inject harmless radioactive iodine into a vein in your arm. The iodine is absorbed by your thyroid gland and makes it glow as your doctor takes a special picture. Your doctor can learn about the nodule depending on how much or how little of the iodine shows in the picture.

Imaging And Evaluating Your Thyroid

One of the best ways to look at your thyroid gland is by imaging it or looking at it via ultrasound .

Ultrasound is a nearly painless procedure which allows radiologists to look at the size, shape, texture and other characteristics of your thyroid gland.

Because the thyroid gland is near to the surface of your skin it can easily be assessed with this type of imaging.

The good news about ultrasound testing is that it is NOT associated with radiation exposure and is therefore considered to be very safe .

Doctors are often taught that the only way to hurt someone with an ultrasound is by throwing the machine at them.

Ultrasound is very important if you have an enlarged thyroid because it can further help to diagnose what exactly you are dealing with.

For instance:

If you have a single large thyroid nodule, ultrasound can pick up that nodule and give information regarding the size, shape, and consistency of the nodule.

This information can help to determine if the nodule is benign ) or potentially cancerous and also help determine if you need a biopsy.

Other conditions which cause thyroid enlargement may be consistent and make your thyroid look “irregularly inconsistent” throughout the entire gland.

Conditions which cause this type of pattern tend to result in inflammation of the entire gland or may be caused by nutrient deficiencies such as iodine deficiency.

In addition to ultrasound testing, there are other ways to check your thyroid gland such as uptake tests or CT scans .

Key Issues In Goiter & Thyroid Nodule

Whenever a person has a goiter or thyroid nodule, three questions must be answered.

  • Is the gland, or a portion of it, so large that it is stretching, compressing, or invading nearby structures? Thyroid swelling can cause a sensation of tightness or, less commonly, pain in the front of the neck. A goiter or nodule can compress the windpipe causing cough or shortness of breath, while pressure on the swallowing tube can cause discomfort with swallowing or even the inability to get things down. When a goiter extends down into the chest, blood returning from the neck and head can be partially obstructed, causing neck veins to bulge. When a goiter or nodule is due to cancer, the tumor may actually grow into nearby structures, causing pain, hoarseness when nerves to the voice box are invaded, or coughing up blood when the trachea is penetrated.
  • Third, is the goiter or thyroid nodule due to malignancy? Fortunately, most patients with a goiter or thyroid nodule do not have thyroid cancer. Often other findings in a patient with a goiter, such as the features of hyperthyroid Graves disease, make it unnecessary to do additional tests to rule out cancer. On the other hand, almost everyone with a thyroid nodule larger than 1.0 to 1.5 cm in diameter must be investigated for the possibility of thyroid cancer. The approach to these diagnostic evaluations is discussed below.
  • Table 2. Key Issues to Evaluate in a Person with a Goiter or Thyroid Nodule

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    Living With Thyroid Nodules

    Most people who have thyroid nodules lead a normal life. You might need to check in with your doctor more often, but there usually are no complications.

    If you do have complications, they can include problems swallowing or breathing. You may also sustain significant weight gain or weight loss. Work with your doctor to treat these symptoms.

    If your thyroid nodules are a symptom of thyroid cancer, you may need surgery. During the surgery, the doctor will remove most, if not all, of your thyroid. Following the surgery, youll take daily thyroid replacement hormones for the rest of your life.

    Symptoms Of Thyroid Nodules

    Thyroid Nodules: What Are Thyroid Nodules?

    Thyroid nodules usually do not cause symptoms. For this reason, theyre often found by a healthcare provider during a routine neck examination or an imaging test done for another reason .

    When thyroid nodules do produce symptoms, the most common are a lump in the neck and a sense of mass while swallowing . In addition, larger nodules may cause difficulty breathing, hoarseness, and neck pain.

    Rarely, the tissue in a thyroid nodule makes too much of the thyroid hormones triiodothyronine and thyroxine , which can lead to symptoms of hyperthyroidism . These include:

    • Anxiety
    • Food getting stuck in your throat
    • Difficulty breathing

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    Thyroid Nodule Symptom # : A Feeling Like Things Get Stuck In Your Throat Sometimes When Eating

    • What to do about it?
    • A thyroid nodule that causes any symptom of swallowing will need to be removed with surgery. The vast majority of these are simply large, benign goiters and only very few are cancerous. But like almost all thyroid nodules that cause symptoms, surgery will be necessary for this group. Many of these goiters won’t need a biopsy because it can be hard to get all the way to the back of the neck with a needle. Almost all of these will need a CAT scan to give the surgeon a better understanding of how big the goiter is and where it goes.

    What Is A Stable Nodule On Thyroid

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    Causes Of Thyroid Nodules

    Itâs not always clear why a person gets thyroid nodules. Several medical conditions can cause them to form. They include:

    • Thyroiditis: This is chronic inflammation of the thyroid. One type of thyroiditis is called Hashimotoâs disease. Itâs associated with low thyroid activity .

    • Iodine deficiency: A diet that lacks iodine can result in thyroid nodules. This is uncommon in the U.S., since iodine is added to many foods.

    • Thyroid adenoma: This is an unexplained overgrowth of thyroid tissue. Most adenomas are harmless, but some produce thyroid hormone. This leads to an overactive thyroid .

    • Thyroid cancer: Most thyroid nodules arenât cancer, but some can be.

    Thyroid Nodules And Thyroid Cancer

    Thyroid Nodules: Causes, Symptoms & Treatments | Dr. Kannan

    The biggest concern on most people’s mind is probably whether or not their thyroid nodule is actually cancer in disguise.

    As I mentioned previously, most thyroid nodules are benign.

    But that leaves another 5-10% which can be cancerous and should be evaluated.

    There are some factors which have been evaluated which can help you understand your risk of thyroid cancer.

    The risk of thyroid cancers increases with these risk factors:

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    Are Thyroid Nodules Serious

    Most often the answer is no. You usually canât feel thyroid nodules. Even though they happen from an overgrowth of cells, most thyroid nodules arenât cancer.

    About 1 in 10 thyroid nodules turn out to be cancer. Benign thyroid nodules are common. Lots of people get them as they get older. If a thyroid nodule isnât cancerous, it may not need any treatment. Doctors might just watch to make sure it doesnât keep growing or begin to cause other problems.

    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 likelihood 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 hoarseness 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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    Optimize Iodine Levels To Improve Thyroid Nodules

    Thyroid hormone is made up in large part by iodine, which has led some clinicians to recommend iodine supplementation to support thyroid health. However, we need to get just the right amount of iodine. The American Thyroid Association states, Iodine deficiency, which is very uncommon in the United States, isknown to cause thyroid nodules. However, too much dietary iodine can increase the risk of goiter, multinodular goiter, nodules, and thyroid autoimmunity, especially in Hashimotos thyroiditis. [20

    Thyroid Nodules And High Calcium

    Thyroid Nodule: Causes, Signs, Symptoms, Diagnosis &  Treatment

    Ask U.S. doctors your own question and get educational, text answers â it’s anonymous and free!

    Ask U.S. doctors your own question and get educational, text answers â it’s anonymous and free!

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    What The Thyroid Gland Does

    To understand why some types of goiter develop, it is first important to know what the normal function of the thyroid gland is and how it is regulated. The thyroid gland makes and releases into blood two small chemicals, called thyroid hormones: thyroxine and triiodothyronine . Each of them is comprised of a pair of connected tyrosine amino acids to which four or three iodine molecules, respectively, are attached.

    The iodine needed for thyroid hormone production comes from our diet in seafood, dairy products, store bought bread, and iodized salt. Once absorbed, iodine in blood is trapped by a special pump in thyroid cells, called the sodium-iodide symporter. The thyroid also has several specialized biochemical ‘fastening machines,’ called enzymes, that then carry out the steps needed to attach iodine to particular parts of a very big protein called thyroglobulin, which is made only by thyroid cells.

    Some of this thyroglobulin with iodine molecules attached is stored in the gland in the form of a gooey paste called colloid, which is normally located in the center of follicles, which are balls of thyroid cells with a hollow center.

    Thyroid Nodules Are Usually Benign And Not Cancerous

    The good news is that most people with thyroid nodules do not and will not get thyroid cancer.

    The bad news is that a thyroid nodule is not normal and may be associated with other conditions of your thyroid gland.

    So, even if you don’t have thyroid cancer, you should still have your thyroid nodule evaluated and tested for other conditions which are associated with thyroid nodules.

    Conditions in this category include:

    It’s important to realize that many thyroid nodules are just run-of-the-mill nodules which are not associated with thyroid disease of any kind.

    But, in order to be on the safe side, it’s ideal that every patient who has a thyroid nodule undergoes certain tests to ensure that this is the case.

    Tests such as a comprehensive history and physical, palpation of the thyroid gland, tests of your thyroid function through blood work, and even an ultrasound may all be warranted.

    Your doctor should be walking you through these steps but you can also ask for them if you are worried.

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    How Are Thyroid Nodules Diagnosed

    Your doctor can detect a thyroid nodule by examining your neck to feel your thyroid gland. If a nodule is discovered during the physical exam, your doctor will need to answer these four questions to determine what to do about it:

    • Is the nodule cancerous?
    • Is the nodule causing trouble by pressing on other structures in the neck?
    • Is the nodule making too much thyroid hormone?
    • Does anything need to be done about the nodule?

    Here are tests your doctor may use to learn more about your thyroid nodule and determine what to do next.

    What Are The Symptoms Of A Thyroid Nodule

    What You Need to Know about Thyroid Nodules

    Most thyroid nodules do not cause symptoms. Often, thyroid nodules are discovered incidentally during a routine physical examination or on imaging tests like CT scans or neck ultrasound done for completely unrelated reasons. Occasionally, patients themselves find thyroid nodules by noticing a lump in their neck while looking in a mirror, buttoning their collar, or fastening a necklace. Abnormal thyroid function tests may occasionally be the reason a thyroid nodule is found. Thyroid nodules may produce excess amounts of thyroid hormone causing hyperthyroidism . However, most thyroid nodules, including those that cancerous, are actually non-functioning, meaning tests like TSH are normal. Rarely, patients with thyroid nodules may complain of pain in the neck, jaw, or ear. If a nodule is large enough to compress the windpipe or esophagus, it may cause difficulty with breathing, swallowing, or cause a tickle in the throat. Even less commonly, hoarseness can be caused if the nodule invades the nerve that controls the vocal cords but this is usually related to thyroid cancer.

    The important points to remember are the following:

    • Thyroid nodules generally do not cause symptoms.
    • Thyroid tests are most typically normaleven when cancer is present in a nodule.
    • The best way to find a thyroid nodule is to make sure your doctor checks your neck!

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    Majority Of Benign Thyroid Nodules Do Not Grow Over Time And Cancer Is Rarely Found

    JAMA

    Introduction: Detection of asymptomatic thyroid nodules has become increasingly common, largely owing to detection of small incidentally discovered nodules. Consensus is lacking regarding the optimal follow-up of cytologically benign and sonographically nonsuspicious nodules.

    Current guidelines from the American Thyroid Association recommend serial ultrasound examinations and repeat cytology examination if significant growth in the nodule is observed. However, no reliable predictors of nodule growth have been identified. In addition, it is unclear whether nodule growth increases the risk for malignancy.

    Methods: Researchers studied the frequency, magnitude, and factors associated with changes in thyroid nodule size. The study involved 992 patients with 1 to 4 asymptomatic, cytologically or sonographically benign thyroid nodules. Patients were recruited from 8 hospital-based thyroid disease referral centers in Italy between 2006 and 2008. Data collected during the first 5 years of follow-up through January 2013 were analyzed.

    Results: The majority of patients showed no significant change in nodule size. Nodules decreased in size spontaneously in 184 patients , with a mean reduction in the largest diameter of 3.7 mm and mean reduction in volume of 0.5 mL.

    Thyroid cancer was diagnosed in 5 original nodules , only 2 of which had grown in size. New nodules developed in 93 patients , and cancer was detected in 2 of these new nodules.

    Are Thyroid Nodules Ever Surgically Removed For Reasons Other Than Cancer

    Yes. Surgery might be considered if a nodule is large and causing a visible mass in your neck, or if its pressing on your windpipe or esophagus , which can cause discomfort or difficulty breathing or swallowing. In cases where a thyroid nodule is cranking out excess amounts of thyroid hormone, surgically removing the nodule can cure the hormone overproduction.

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    What Does A Thyroid Fine Needle Aspiration Or Biopsy Entail

    In some situations this is performed with local anesthesia in the clinic. Your child will be awake. In very young children the FNA is done in the operating room under general anesthesia. The pathologist will look at the tissue to determine what they thyroid nodule is composed of and if additional workup or surgery is needed. It often takes about one to two weeks to get the results.

    Lab Testing For Your Thyroid

    What Can A Lump In Your Thyroid Mean?

    Looking at your thyroid gland via imaging doesn’t usually give you any information about the FUNCTION of the thyroid gland.

    The function of your thyroid gland is very important because it relates to how well your thyroid is able to produce thyroid hormone.

    Any change to the ability of your gland to produce thyroid hormone will result in very specific symptoms that are too big to be ignored and these symptoms will often drive people into the Doctors office for evaluation.

    Fortunately, many conditions that result in thyroid gland enlargement usually do not interfere with thyroid hormone production.

    Some conditions, such as Hashimoto’s thyroiditis, cause both thyroid gland enlargement AND thyroid hormone issues.

    Because of this each and every patient with a known or suspected thyroid gland issue should undergo thyroid function testing with blood tests.

    To test your thyroid function you will need the following tests:

    • TSH – This will help you understand if your brain is talking to your thyroid gland.
    • Free T3 – This is the most important thyroid hormone in your body and is responsible for the majority of thyroid cellular activity/
    • Free T4 – This is the most abundant thyroid hormone in your body and is important because it acts as a reservoir for T3 thyroid hormone.
    • Thyroid Antibodies – The presence or absence of thyroid antibodies can help you understand if you have an autoimmune disease or if your body is attacking your own thyroid gland.

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