Ruchi Mathur, MD, FRCP(C) is an Attending Physician with the Division of Endocrinology, Diabetes and Metabolism and Associate Director of Clinical Research, Recruitment and Phenotyping with the Center for Androgen Related Disorders, Department of Obstetrics and Gynecology at Cedars-Sinai Medical Center.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
Featured thyroid nodules patient discussions on established diagnosis
"My doctor just recently discovered the nodules in a routine examination. I first thought something was up when I had this rash for more than a month, then the swelling on the right hand side with some discomfort leading into the shoulder. I find these comments very helpful and calming as I am quite young and having trouble registering this all in. I had an ultrasound a month ago and I have an uptake and scan scheduled in another two weeks. It is nice to read that this is not all in my head and these are actual symptoms. Your site has helped me tremendously. "
"One day, I suddenly felt as though a lump was in my throat. I could feel it when I swallowed. After a couple of doctor visits, I went for an ultrasound that showed "several nodules" even though my thyroid levels were normal, according to blood tests. I cannot feel the nodules, but occasionally I have ear pain and seem to be quite tired."
Patient Discussions are not a substitute
for professional medical advice, or treatment.
See the disclaimer at the
bottom of the comments page.
Introduction to thyroid nodules
The term "thyroid nodule" refers to any abnormal growth that forms a lump in
the thyroid gland.
The thyroid gland is located low in the front of the neck, below the Adam's
apple. The gland is shaped like a butterfly and wraps around the windpipe or
trachea. The two wings or lobes on either side of the windpipe are joined
together by a bridge, called the isthmus, which crosses over the front of
the windpipe.
A thyroid nodule can occur in any part of the gland. Some nodules can be
felt quite easily, while others can be hidden deep in the thyroid tissue or
located very low in the gland where they are difficult to feel.
What is the prevalence of thyroid nodules and cancer?
These days, with modern imaging studies such as
ultrasound (US),
computerized tomography (CT), and magnetic resonance imaging (MRI), more and
more thyroid nodules are being found incidentally. This means the nodules
are found during studies that are being done for reasons other than
examination of the thyroid gland. It is estimated that 4-8%
of adult women and 1-2% of adult men have thyroid nodules that can be felt
on physical examination, but closer to 30% of women have nodules detectable
by ultrasound. In fact, the diagnosis of a thyroid nodule is the most common
endocrine problem in the United States.
Although the majority of thyroid
nodules are benign (not cancerous), about 10% of nodules do contain cancer
.
Therefore, the primary purpose for
evaluating a thyroid nodule is to determine whether cancer is present.
Hypothyroidism is any state in which thyroid hormone production is below normal. Normally, the
rate of thyroid hormone production is controlled by the brain at the pituitary.
Hypothyroidism is a very common condition and the symptoms of hypothyroidism are
often subtle.
Hyperthyroidism is an excess of thyroid hormone resulting from an overactive thyroid gland. Symptoms can include increased heart rate, weight
loss, depression, and cognitive slowing. Treatment is by medication, the use of
radioactive iodine, thyroid surgery, or reducing the dose of thyroid hormone.
There are four major types of thyroid cancer: papillary, follicular, medullary, and anaplastic thyroid cancer. Tumors on the thyroid are referred to as thyroid nodules. Symptoms of thyroid cancer include swollen lymph nodes, pain in the throat, difficulty swallowing, hoarseness, and a lump near the Adam's apple. Treatment usually involves chemotherapy, surgery, radioactive iodine, hormone treatment or external radiation and depends upon the type of thyroid cancer, the patient's age, the tumor size, and whether the cancer has metastasized.
Hashimoto's thyroiditis is the most common cause of hypothyroidism in the US. This conditions is caused by inflammation of the thyroid gland. Symptoms may include: fatigue, weight gain, cold intolerance, excessive sleepiness, dry or coarse hair, difficulty swallowing, a lump in the front of the throat, and many more. Treatment is usually hypothyroid medication.
There are many types of thyroid disease. Some occur due to the function of the thyroid itself such as hypothyroidism, hyperthyroidism, Hashimoto's thyroiditis, etc. Some causes of thyroid disease occur due to problems with the structure of the thyroid gland such as goiters, thyroid nodules, and thyroid cancer. Treatment of thyroid disease depends on the cause of the disease.
Thyroiditis is the inflammation of the thyroid gland. The inflamed thyroid gland can release an excess of thyroid hormones into the blood stream, resulting in a temporary hyperthyroid state. Some forms of thyroiditis can be diagnosed based on tenderness and enlargement of the thyroid gland. A thyroid scan sometimes is used in making the diagnosis. Thyroiditis can also be diagnosed with a biopsy of the thyroid gland.
Hyperthyroidism is a condition in which an overactive thyroid gland is producing an excessive amount of
thyroid hormones
that circulate in the
blood. ("Hyper" means "over" in Greek). Thyrotoxicosis is a toxic condition that is caused by
an excess of thyroid hormones from any cause. Thyrotoxicosis can be caused by
an excessive intake of thyroid hormone or by overproduction of thyroid hormones by the thyroid gland. Because both physicians and patients
often use these words interchangeably, we will take some liberty by using the
term "hyperthyroidism" throughout this article.
What are thyroid hormones?
Thyroid hormones stimulate the metabolism of cells. They are produced by the
thyroid gland. The thyroid gland is located in the lower part of the neck, below the Adam's apple. The gland wraps around the
windpipe (trachea) and has a shape that is similar to a butterfly formed by two
wings (lobe...
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