The thyroid is one of many essential glands we normally don’t worry about unless there’s a problem. But, considering women are more likely than men to develop thyroid diseases (groan), we should understand how the thyroid works — and how to be vigilant about potential issues.
For those unfamiliar with the thyroid and its purpose, here’s a quick primer: It’s a butterfly-shaped gland found at the base of the neck, serving as part of the body’s endocrine system. This gland makes and releases the hormones that control your metabolism, or, how the body uses energy.
Sometimes, people can develop something called thyroid nodules — solid or fluid-filled lumps that form within your thyroid. According to the Mayo Clinic, most thyroid nodules aren’t serious and don’t cause any symptoms, with only a small percentage showing signs of cancer.
While various symptoms might signal thyroid dysfunction, nodules fall into a gray area that usually warrants further investigation by your healthcare provider, if only for peace of mind. To learn more about nodules, and what they could mean for your thyroid health, Rescripted spoke with Betul Hatipoglu, M.D., an endocrinologist and professor of medicine at Case Western Reserve University School of Medicine.
Understanding thyroid nodules
Thyroid nodules are increasingly common, with women developing nodules more than men (yay). “As we do more imaging studies such as ultrasounds, we find thyroid nodules in up to 33% of the population,” says Dr. Hatipoglu. “Larger size nodules are probably around 11%, and we see more people affected as they age.”
What’s tricky about thyroid nodules is that most people don’t have any symptoms, explains Dr. Hatipoglu. But when symptoms are present, patients “might feel or see a lump in their neck.” She also highlights how “some nodules may increase thyroid hormones,” which in turn can cause thyroid problem warning signs like “feeling worried and tired, losing weight, or having a fast heartbeat.”
If and when thyroid nodules are discovered, they are classified as either benign, malignant, or suspicious for malignancy. “The majority of the nodules are [benign/noncancerous],” assures Dr. Hatipoglu. Malignant, or cancerous nodules, she says, are “less common,” but they will require immediate attention, while nodules suspicious for malignancy require further testing.
“Discovering a nodule is about deciding what the next step is,” says Dr. Hatipoglu. “It is important to classify the nodule accurately and plan an appropriate treatment.”
When to be concerned about thyroid nodules
Even though most thyroid nodules are benign, Dr. Hatipoglu advises seeing your healthcare provider as soon as possible if the nodule is rapidly growing and/or feels hard to touch. Other critical signs to look out for are voice changes or other lumps in the neck area.
Your physician will likely run a series of tests to evaluate the thyroid nodules. “Tests usually include blood tests and an ultrasound,” says Dr. Hatipoglu. In some cases, the healthcare provider will do a fine-needle aspiration. The physician uses a needle “to remove a small sample of cells from the thyroid nodule to look at them under a microscope," explains Dr. Hatipoglu. “This is to help doctors decide which nodules should be removed by surgery and which can be watched." Sometimes, the physician will perform a thyroid scan in addition to an ultrasound.
Potential thyroid nodule treatment
Here are some of the recommended courses of treatment according to Dr. Hatipoglu. Remember that treatment depends on the type of thyroid nodule, and your healthcare provider will determine the best course of action for you.
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Watching and waiting: Your physician will monitor the nodule and may perform another thyroid ultrasound and possibly another fine-needle aspiration in the future.
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Surgery to remove one or both sides of the thyroid
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Medicine: Thyroid hormone medicines may be used to try to shrink nodules.
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Radioiodine: Used only to treat nodules that produce too much thyroid hormone.
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Draining fluid from the thyroid nodule: This procedure is an option if the nodule is a fluid-filled cyst.
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Radiofrequency ablation: This procedure uses heat to make the nodule smaller.
Am I at risk for developing thyroid nodules?
Most thyroid nodule risk factors are the same for numerous other health issues, with smoking, obesity, and alcohol being at the top of the list. Dr. Hatipoglu also cites a study that suggests women with uterine fibroids “had a two-fold increased risk of thyroid nodules.” If you have a history of uterine fibroids, speak to your doctor about any potential thyroid nodule risks.
The same goes for anyone with Hashimoto’s Disease: This autoimmune condition is “a chronic inflammation of the thyroid that can result in enlarged thyroid and nodules,” says Dr. Hatipoglu. This chronic inflammation is often associated with hypothyroidism, or underactive thyroid.
Keep in mind that most thyroid nodules aren’t cause for worry. If a nodule turns out to be cancerous, however, remember that thyroid cancer is one of the most treatable kinds of cancer, according to John Hopkins Medicine. Surgery to remove part or all of the thyroid gland is typically advised, with recurrences or spread of the cancer cells uncommon.
Sarene Leeds holds an M.S. in Professional Writing from NYU, and is a seasoned journalist, having written and reported on subjects ranging from TV and pop culture to health, wellness, and parenting over the course of her career. Her work has appeared in Rolling Stone, The Wall Street Journal, Vulture, SheKnows, and numerous other outlets. A staunch mental health advocate, Sarene also hosts the podcast “Emotional Abuse Is Real.” Visit her website here, or follow her on Instagram or Twitter.