People of any age or gender can experience growths in their thyroid gland called thyroid nodules. These nodules are fluid-filled or solid lumps that form within the butterfly-shaped gland in your neck. You may develop a single nodule or multiple nodules over time. While more than 90% of thyroid nodules are benign, they can be a sign of an underlying health problem that needs to be addressed.

Endocrinologists treat patients with thyroid nodules. These doctors perform physical exams, order blood work to check thyroid hormone levels, and perform procedures to help treat thyroid conditions.

An endocrinologist can identify the cause of your thyroid nodule and recommend treatment. Learn the most common causes of thyroid nodules, the difference between hot and cold nodules, and the different treatments required.

1. Overgrowth of Normal Thyroid Tissue

An overgrowth of normal tissue, also called thyroid adenoma, are non-cancerous growths within your thyroid that cause nodules. It’s not clear why they happen, but they are generally harmless unless they begin causing symptoms.

As benign thyroid nodules grow over time, they may compress other areas of your neck, leading to trouble swallowing, breathing, or a hoarse voice. Symptomatic nodules that result from an overgrowth of tissue need treatment.

Treatment may involve surgically removing the nodule or a less invasive procedure called radiofrequency ablation. Your treatment depends on the location and size of your thyroid nodule and must take your medical history into account.

2. Cysts in the Thyroid

Thyroid cysts are fluid-filled cavities that form as a thyroid adenoma breaks down. Solid parts of tissue growth are mixed in with fluid, forming cysts. Cysts are typically non-cancerous but can contain cancerous solid material within them.

Your doctor may want to perform a thyroid ultrasound to determine if solid tissue is present. If it’s detected, you may need additional tests to see if the tissue is cancerous or benign. Benign fluid-filled lumps like cysts do not need to be treated if they aren’t causing you any symptoms. However, your doctor may order routine imaging to monitor any growth or changes.

3. Thyroid Cancer

While most thyroid nodules are benign, some are caused by thyroid cancer. Nodules that feel hard or large or cause pain are of more concern. If a physical exam or ultrasound of your thyroid results in suspicion of cancer, you need to undergo a fine needle aspiration biopsy to confirm whether the tissue is malignant or benign.

If your nodule is cancerous, you must have thyroid surgery to remove the nodule and any other cancerous tissue such as the thyroid gland or nearby lymphatic tissue. A family history of thyroid cancer or radiation exposure from previous medical treatments can increase your risk of developing thyroid cancer.

4. Chronic Inflammation of the Thyroid

Chronic inflammation of the thyroid, also called thyroiditis, can cause nodules to develop. Types of thyroiditis include postpartum thyroiditis, subacute thyroiditis, and Hashimoto’s thyroiditis. Postpartum thyroiditis occurs after giving birth and involves the body producing too much thyroid hormone, followed by a severe drop in hormone production.

Subacute thyroiditis is an immune reaction in the thyroid that develops from a viral infection. Having an upper respiratory infection puts you at risk of developing subacute thyroiditis. It can cause tenderness and pain in and around the thyroid gland and neck. Once your immune system clears the infection, thyroiditis dissipates.

Hashimoto’s thyroiditis is the most common form of thyroiditis. It is an inflammatory-based disease of the thyroid that causes hypothyroidism, thyroid inflammation, and enlarged thyroid nodules.

Patients who suffer from Hashimoto’s need to have their thyroid hormones checked regularly to maintain their health. They may also benefit from regular thyroid nodule ultrasounds, which detect smaller nodules not felt on physical exams.

5. Iodine Deficiency

A lack of iodine in your diet can cause you to develop thyroid nodules. Iodine deficiencies can result in the enlargement of your thyroid gland, called a goiter. A multinodular goiter contains several distinct nodules within the thyroid. Since iodine is frequently added to table salt, other foods, and multivitamins in the United States, the risk of an iodine deficiency is low.

Causes of Thyroid Nodules

Hot vs. Cold Thyroid Nodules

Thyroid nodules are classified as either cold or hot nodules. A hot thyroid nodule produces thyroid hormones that can cause hyperthyroidism. Hot nodules are also referred to as toxic nodules. When your nodule produces excess thyroid hormones, you may experience symptoms such as:

  • An irregular or rapid heart rate
  • Nervousness
  • Sleeping difficulties
  • Unexplained weight loss
  • Muscle weakness

Thyroid nodules that don’t produce thyroid hormones are called cold nodules. Hot nodules are detected through thyroid scans. A thyroid scan is a test using radioactive materials to determine the location and size of the thyroid. It can also detect whether a nodule is hot or cold. A hot nodule absorbs more radioactive material than a cold nodule and other thyroid tissue, making it appear brighter on the scan.

Hot nodules are usually not cancerous but do require treatment. The American Thyroid Association (ATA) recommends treating hot nodules based on their symptoms. Some patients need antithyroid medications to control thyroid hormone production. They may also need beta blockers to help control heart rate symptoms.

Other patients may need thyroid surgery to remove the section of their thyroid that contains the hot nodule. Patients can also undergo a course of treatment with radioactive iodine. This material gets absorbed by the hot nodule and effectively shuts down its ability to produce thyroid hormones. Patients may need one or more doses of radioactive iodine to treat a hot nodule.

When to See a Doctor

Most thyroid nodules don’t cause symptoms and aren’t a serious health problem. You may develop thyroid nodules and not even know they’re present. Thyroid nodules that don’t cause symptoms may need to be monitored over time but don’t necessarily require treatment.

Nodules can become problematic as they grow. You should see a doctor if you’re experiencing symptoms of a growing nodule. This includes:

  • Having difficulties swallowing or breathing
  • Feeling a constant tickle in your throat
  • If a goiter has formed
  • Voice changes or hoarseness
  • You have pain or discomfort near the base of your neck

You should also see a doctor if you’re experiencing symptoms of hyperthyroidism or Hashimoto’s thyroiditis. Hyperthyroidism could be due to a hot nodule that needs treatment. While having Hashimoto’s could make you more likely to develop thyroid nodules and not produce enough thyroid hormones.

How Associated Endocrinologists Can Help

If you’re experiencing a thyroid nodule or other thyroid disorder symptoms, it’s important to seek treatment with a doctor qualified to treat these conditions. Consider Associated Endocrinologists in Michigan. Our board certified endocrinologists have extensive expertise in thyroid and other hormone-related disorders.

We provide thyroid ultrasounds, fine needle aspiration biopsies, radiofrequency ablation, thyroid scans, and radioactive iodine treatments. Our doctors can diagnose, manage, and treat your thyroid nodule or disorder.

Contact us today to schedule an in-person or telehealth appointment to discuss your health and treatment options.

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