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Thyroid nodules are growths or lumps in the thyroid gland in the front of your neck. This gland controls how your body uses energy. Most thyroid nodules are not cancer and do not cause problems.footnote 1 Many don't even need treatment.
Sometimes a thyroid nodule can cause problems. Sometimes a nodule can make too much thyroid hormone. When a nodule makes too much hormone, the rest of the gland is suppressed and doesn't work as hard as usual.
Most thyroid nodules are not cancerous. But if tests show cancer, surgery will be done to remove the nodule.
It is not clear what causes thyroid nodules. But people who have been exposed to radiation have a greater chance of getting them. Thyroid nodules are more common as you age. Also, the nodules tend to run in families. So if your parents had thyroid nodules, you are more likely to have one.
Most thyroid nodules are so small that you don't even know you have one.
If you have a big nodule, you may be able to feel it, or you may notice swelling in your neck. It's possible that you may also:
Most people don't find thyroid nodules on their own, because the nodules aren't easy to feel and don't usually cause symptoms. Your doctor may have found a nodule on your thyroid when you were having a CT scan or ultrasound for another reason. Your doctor will do a physical exam and will ask you if you have symptoms or any changes in how you've been feeling.
You may have tests to see how well your thyroid is working and to make sure the nodule is not cancer. Possible tests include:
If your nodule is not cancer (benign) and is not causing problems, your doctor will watch your nodule closely for any changes. But if the nodule is large or causing problems with swallowing or breathing, you'll need surgery to remove the nodule.
If your thyroid nodule is causing hyperthyroidism, your doctor may recommend a dose of radioactive iodine, which usually comes in a liquid that you swallow. Or your doctor may have you take medicine (antithyroid pills) to slow down the hormone production. In some cases, surgery may be done to remove an overactive thyroid nodule.
If your nodule is cancer (malignant), you'll need surgery to remove the nodule. You may also need treatment with radioactive iodine to destroy any leftover cancer cells. After surgery, you may need to take thyroid medicine for the rest of your life.
Experts don't know the exact cause of thyroid nodules. But they do know that people who have been exposed to radiation have a greater chance of developing thyroid nodules. Exposure to environmental radiation or past radiation treatment to the head, neck, and chest (especially during childhood) raises your risk for thyroid nodules. Thyroid nodules are more common as you age.
Experts know that thyroid nodules run in families. This means you are more likely to have a thyroid nodule if one of your parents has had a thyroid nodule.
Also, if you have another thyroid condition (such as goiter), you may have a greater chance of developing thyroid nodules.
Most thyroid nodules do not cause symptoms and are so small that you cannot feel them. They often are found during a physical exam or when another test, such as a CT scan or ultrasound, is done for a different reason.
If your thyroid nodule is big, you may be able to feel it or you may notice that your neck is swollen. In rare cases, you may also:
Most thyroid nodules do not cause problems and are not cancerous.footnote 1 They are often hard to notice because they are so small. Lots of people have thyroid nodules that are never found or treated.
There are three kinds of thyroid nodules: solid nodules, nodules that are filled with fluid (cystic nodules), and nodules that are partially cystic. You can have one thyroid nodule or several thyroid nodules (multinodular goiter). You can also have some nodules that are solid and some that are cystic. Solid nodules may grow slowly over time. In rare cases, cystic nodules bleed, which can cause them to grow suddenly and become painful.
Thyroid nodules usually do not prevent the thyroid gland from doing its job. But sometimes a noncancerous thyroid nodule can cause:
If thyroid cancer is found, it's usually diagnosed and treated early. For more information, see the topic Thyroid Cancer.
You are more likely to develop a thyroid nodule if:
Call your doctor if you have any of these signs of thyroid nodules:
If you have had part of your thyroid gland removed because of thyroid nodules, you will need regular medical checkups to make sure your thyroid gland is working well.
Different types of health professionals can help treat a thyroid problem.
Your doctor may also refer you to an endocrinologist for further tests and treatment.
If you need a special exam or treatment, you may see one of these types of doctors:
The first step in diagnosing thyroid nodules is a medical history and physical exam. Thyroid nodules often are found during a physical exam or during a CT scan or ultrasound of the neck, chest, or head done for another problem. Most people do not find thyroid nodules on their own, because they are difficult to feel and usually do not cause symptoms.
If your doctor finds a thyroid nodule, he or she may refer you to an endocrinologist for more tests and treatment.
Common tests for people with thyroid nodules are:
Other tests you may have include:
If your nodule is not cancerous, your doctor will see you regularly to monitor the size of your nodule. He or she may do other tests, such as checking your thyroid-stimulating hormone (TSH) levels or doing a thyroid ultrasound. If your nodule grows, other tests or surgery may be needed.
Your treatment will depend on how your thyroid nodule affects you. If your thyroid nodule is not cancerous (benign) and is not causing any problems, your doctor will watch the nodule closely before doing anything else. For information about thyroid cancer and its treatment, see the topic Thyroid Cancer.
If your thyroid nodule is causing problems, such as making too much thyroid hormone (hyperthyroidism), you may need to take medicine or have surgery. For more information on hyperthyroidism, see the topic Hyperthyroidism.
When you know you have a thyroid nodule, your treatment options include:
If you have a thyroid nodule:
If your thyroid nodule gets bigger, your doctor may recommend another fine-needle aspiration.
Thyroid nodules cannot be prevented.
Experts do not agree on whether adults who don't have symptoms should have a thyroid test. The American Thyroid Association and the American Association of Clinical Endocrinologists recommend that testing be considered for those older than age 60. footnote 2The U.S. Preventive Services Task Force makes no recommendation for or against screening for people who do not have symptoms of thyroid problems. The USPSTF states that there is not enough evidence to support screening.footnote 3
Talk to your doctor about whether testing is right for you.
Most thyroid nodules aren't cancerous.footnote 1 Many thyroid nodules don't need medical treatment. If you have a thyroid nodule that is being watched, schedule regular medical checkups to see whether there are any changes.
If you have had surgery to remove your thyroid gland, it is important to:
If you have had radioactive iodine treatment for thyroid nodules, call your doctor if:
Radioactive iodine is sometimes used to treat hyperthyroidism in people who have noncancerous thyroid nodules.
If a nodule is noncancerous but is producing too much thyroid hormone, causing hyperthyroidism, antithyroid medicines may be used before radioactive iodine treatment. For more information on treating hyperthyroidism, see the topic Hyperthyroidism.
Surgery (thyroidectomy) is the best treatment for thyroid nodules that are:
People who develop thyroid nodules after receiving radiation treatment to the head, neck, or chest are more likely to need surgery because their risk for developing thyroid cancer is greater. But most nodules in people who have had radiation therapy are not cancerous.
For information about thyroid cancer and its treatment, see the topic Thyroid Cancer.
Thyroid-stimulating hormone (TSH) suppression therapy may be given to shrink noncancerous thyroid nodules. This uses medicines such as levothyroxine (for example, Synthroid, Levoxyl, or Levothroid), liothyronine (for example, Cytomel), liotrix (Thyrolar), or desiccated thyroid (for example, Armour Thyroid).
It is not clear how well thyroid-stimulating hormone suppression therapy works to shrink noncancerous thyroid nodules. If you have a noncancerous nodule, talk to your doctor about whether TSH suppression therapy is right for you.
TSH suppression therapy can raise your risk of heart and bone problems, especially if you have heart disease or osteoporosis. If you have heart disease, this kind of medicine can make chest pain or problems with your heart rhythm worse. It can also raise your chances of heart attack. If you have osteoporosis, TSH suppression therapy can further weaken your bones.
Hypothyroidism (too little thyroid hormone) occurs in some people after being treated with radioactive iodine for thyroid nodules. For this reason, your doctor will check your thyroid hormone levels regularly after you have this treatment.
If a thyroid nodule is not cancerous but is making too much thyroid hormone, causing hyperthyroidism, antithyroid medicines may be used before radioactive iodine treatment. For more information on treating hyperthyroidism, see the topic Hyperthyroidism.
Yassa L, et al. (2007). Long-term assessment of a multidisciplinary approach to thyroid nodule diagnostic evaluation. Cancer, 111(6): 508-516. DOI: 10.1002/cncr.23116. Accessed August 25, 2016.
Garber JR, et al; American Association of Clinical Endocrinologists and American Thyroid Association Taskforce on Hypothyroidism in Adults (2012). Clinical practice guidelines for hypothyroidism in adults: Cosponsored by the American Association of Clinical Endocrinologists and the American Thyroid Association. Endocrinology Practice, 18(6): 988–1028.
LeFevre ML (2015). Screening for thyroid dysfunction: U.S. Preventive Services Task Force recommendation statement. Annals of Internal Medicine, published online Mar 24, 2015. DOI: 10.7326/M15-0483. Accessed April 10, 2015.
Current as of: November 6, 2018
Author: Healthwise StaffMedical Review: E. Gregory Thompson, MD - Internal MedicineKathleen Romito, MD - Family MedicineAdam Husney, MD - Family Medicine
Current as of:
November 6, 2018
Medical Review:E. Gregory Thompson, MD - Internal Medicine & Kathleen Romito, MD - Family Medicine & Adam Husney, MD - Family Medicine
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