What is thyroid nodules?

Thyroid nodules are growths or lumps in the thyroid gland. This gland controls how your body uses energy. Most thyroid nodules are not cancer and don't cause problems. Many don't even need treatment. A thyroid nodule may cause problems, such as making too much thyroid hormone. When this happens, you may need treatment.

There are three kinds of thyroid nodules: solid nodules, nodules that are filled with fluid (cystic nodules), and nodules that are partly 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. This can cause them to grow all of a sudden and become painful.

Most thyroid nodules do not cause symptoms and are so small that you cannot feel them. If your thyroid nodule is large, your neck may be swollen or you may be able to feel the nodule. In rare cases, you may also:

• Feel pain in your throat or feel like your throat is full.
• Have a hard time swallowing.
• Have a hard time breathing.
• Feel nervous, have a fast heartbeat, sweat a lot, lose weight, or have other symptoms of hyperthyroidism (too much thyroid hormone).
• Feel tired or depressed, have memory problems, be constipated, have dry skin, feel cold, or have other symptoms of hypothyroidism (too little thyroid hormone).

If your doctor thinks you have a nodule, he or she will do a physical exam and will ask you if you have symptoms or about any changes in how you've been feeling.

You may have tests to see how well your thyroid is working. Possible tests include:

• A blood test to check the level of thyroid hormone in your body.
• A thyroid scan to get information about your thyroid gland and nodules. Another test called an uptake scan can be done at the same time to see how well your thyroid gland is working.
• A thyroid ultrasound to see the number and size of nodules.

You may have a fine-needle aspiration to remove a small amount of material from the nodule to check for cancer.

If your nodule is not cancerous, your doctor will see you regularly to monitor the size of your nodule.

If a thyroid nodule is not cancer (is benign) and is not causing problems, your doctor will watch it closely for changes. But if the nodule is large or causing problems with swallowing or breathing, you'll need surgery to remove it.

If the nodule is causing hyperthyroidism, your doctor may recommend a dose of radioactive iodine. This most often 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. This is done to remove the nodule and some or all of the thyroid. You may also need treatment with radioactive iodine to destroy any cancer cells that remain. After surgery, you may need to take thyroid medicine for the rest of your life.

Many thyroid nodules don't need medical treatment, and most thyroid nodules aren't cancerous. If you have a thyroid nodule that is being watched, schedule regular checkups to see if there are any changes.

If you had surgery to remove your thyroid gland, make sure to:

• Take your medicine at the same time each day. Don't miss a dose.
• Follow your doctor's directions if you do miss a dose.
• Call your doctor if you have symptoms of hyperthyroidism. These include feeling nervous, having a fast heartbeat, sweating more than usual, and losing weight.
• Ask your doctor or pharmacist if your thyroid medicine can be safely mixed with other prescription or nonprescription medicines you take.