Thyroid Nodules: Symptoms and Causes

January 27, 2020
The detection of thyroid nodules in the thyroid gland may cause concern and fears. While these nodules are benign in most cases, studies are needed to confirm this. In this article, we explain what causes them and how they’re diagnosed.

Thyroid nodules are cell growths in the thyroid gland in the form of lumps or swellings. Some of them are detectable by simple palpation, although many of the nodules are small and can’t be palpated in the neck.

Thyroid nodules may be solid or cystic. For their part, cystic nodules are liquid-filled and covered by capsules that contain them. Solid nodules, however, are completely solid.

They can be located in different parts of the thyroid gland, which consists of two lobes connected by a thin band of tissue. This gland is located in the neck and, under normal conditions, you can’t feel it by palpating your neck.

As one of the functions of the thyroid gland is to produce T3 and T4 hormones, a nodule in this gland can be functional. This means that it’s capable of secreting hormones just like normal tissue does. In these cases, symptoms linked to hormone overproduction appear.

Most thyroid nodules are benign and many doctors detect them accidentally in a medical consultation regarding another problem. Anyway, due to the fact that a small percentage of nodules can de due to thyroid cancer, the patient must get complementary tests required for diagnosis.

Causes of thyroid nodules

The reasons behind thyroid nodules are varied, from a change in diet to the proliferation of malignant cells. Here are some of the most important:

Lack of iodine in the diet

When you don’t get enough iodine from the foods you eat, a thyroid nodule may form. This classic and historic cause of thyroid disease has led several countries to legislate the obligation to artificially add iodine to many foods, including table salt.

These laws were approved in times where there was a high incidence of goiter, a swelling of the neck due to a lack of iodine, in several parts of the world.

Thyroiditis

This term refers to inflammation of the thyroid gland. When the inflammation is chronic and persistent, it can cause nodules. One of the most popular varieties is Hashimoto’s thyroiditis, whose symptoms are hypothyroidism.

Thyroiditis usually responds to autoimmune processes, in which the body attacks its own gland with antibodies.

The proliferation of normal thyroid cells

In some circumstances, normal thyroid cells grow disproportionately and form a nodule. This is known as thyroid adenoma and it’s benign.

The problem is that the adenoma may be functional. In other words, it may be capable of producing hormones and adding them to the blood. This can make the person suffer from hyperthyroidism.

Fluid accumulation

Thyroid nodules can be cystic. In other words, they can be liquid-filled cavities. They’re benign and usually not functional. Thus, they’re unable to produce hormones.

A woman getting a thyroid ultrasound.

Thyroid nodules may appear due to iodine deficiency, thyroiditis, fluid accumulation, or abnormal cell growth. Although they’re often benign, it’s best to get a proper diagnosis through all the necessary tests.

The proliferation of malignant cells

The most dangerous form of thyroid nodules is thyroid cancer. Luckily, it accounts for a small percentage of cases. With early detection, treatment and surgery can prevent it from spreading.

Keep reading: Stress and Hyperthyroidism: A Relationship That You Should Be Aware of

Symptoms of thyroid nodules

Thyroid nodules don’t usually cause symptoms because they tend to be small and nonfunctional. In many cases, they’re discovered through a thyroid ultrasound that the patient gets for another reason or through a CT scan of the neck region.

When the nodule is detectable from the outside by palpating the neck, then the patient has a sufficiently large formation. These situations can be perceived by a doctor during a physical examination or by the patient themselves.

If, along with the detected nodule, the patient has other symptoms such as weight loss, episodes of profuse sweating, changes in heartbeat, or difficulty swallowing, then the nodule may be malignant. Although the definitive diagnosis can be benign, the presence of these symptoms forces the acceleration of the realization of complementary methods.

On the other hand, if you’re dealing with functional thyroid nodules capable of producing hormones and dumping them into the bloodstream, then the symptoms are those of hyperthyroidism. The patient will suffer from tachycardia, lack of strength, changes in their nails and hair, diarrhea, irritability, and no weight gain despite increased food intake.

A woman who felt a lump in her neck.

In some cases, when the nodules reach considerable sizes, the doctor or the patient may detect them with a physical examination.

Keep discovering in this article: The Difference Between Hypothyroidism and Hyperthyroidism

Diagnosis of thyroid nodules

When a thyroid nodule is palpated or discovered in a test for another cause, the doctor will request a series of diagnostic tests. These studies will include:

  • Dosage of thyroid hormones. Through blood tests that measure T4 and TSH levels.
  • Thyroid ultrasound. If it hasn’t been done previously, this test is the first step to address the thyroid nodule. First of all, it allows the medical professional to differentiate between solid and cystic nodules, in addition to measuring its size.
  • Needle biopsy. If the doctor suspects that the nodule is malignant, they’ll schedule a biopsy procedure. It involves inserting a very thin needle into the gland to extract cells from the nodule that will be analyzed in a microscope. Currently, a patient will undergo this on an outpatient basis and won’t require hospitalization. Doctors usually carry this out under local anesthesia.

Summing up…

Thyroid nodules may appear as a consequence of several diseases that can affect the thyroid gland. While they’re usually benign, a proper diagnosis is needed to rule out a more serious problem. Therefore, it’s necessary to consult your doctor if you notice any signs.

  • Román-González, Alejandro, et al. “Nódulo tiroideo, enfoque y manejo. Revisión de la literatura.” Iatreia 26.2 (2013): 197-206.
  • Ambriz, Pedro Torres, et al. “Diagnóstico y tratamiento del nódulo tiroideo.” Revista de Endocrinología y Nutrición 8.3 (2000): 87-93.
  • Uliaque, Carolina Franco, et al. “Utilidad de la ecografía en la evaluación de los nódulos tiroideos.” Radiología 58.5 (2016): 380-388.
  • Pereira Despaigne, Olga Lidia, et al. “Diagnóstico de las afecciones nodulares del tiroides.” Medisan 19.6 (2015): 788-796.