Treatment for Thyroid Nodules
According to the American Thyroid Association, thyroid nodules are the most common endocrine concern in the United States, affecting ten percent of the population. The term "thyroid nodules" encompasses any abnormal growth of the thyroid cells-- nodules may consist of solid unilateral or bilateral masses on the thyroid or painful, fluid-filled cysts. In rare cases, nodules may be cancerous, in which case treatment is more aggressive. But most of the time, thyroid nodules don't cause any symptoms until they're discovered by a doctor during a physical examination.
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Diagnosing Thyroid Nodules
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You might not notice that you have a thyroid nodule until a doctor palpates the area of the thyroid and detects abnormalities. Sometimes nodules are noted when patients receive imaging tests such as computerized tomography (CT) or magnetic resonance imaging (MRI) scan of the area of the head or neck for an unrelated condition. Once the presence of thyroid nodules is confirmed, more extensive testing is conducted. A fine needle biopsy can be used to ascertain if the nodules are cancerous.
"Wait and See"
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When benign thyroid nodules don't cause any significant signs or symptoms (such as hyperthyroidism, pain or difficulty swallowing), your doctor may take a "wait and see" approach to make sure that there is no change in your condition. Regular thyroid function tests and physical examinations may be necessary, and a repeat biopsy may be used if the nodules show a change in size.
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Thyroid Hormone Suppression
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Sometimes patients will take an oral called synthetic thyroid hormone called levothyroxine to get the pituitary gland to stop producing the thyroid-stimulating hormone (TSH) that causes thyroid tissue growth. However, according to the Mayo Clinic, there's no evidence that use of levothyroxine therapy causes thyroid nodules to shrink; therefore, this method of treatment may be debatable.
Radioactive Iodine Treatment
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Radioactive iodine treatment, commonly used in patients with certain types of hyperthyroidism such as that caused by Graves' disease, may be used to treat thyroid nodules when they case excessive amounts of thyroid hormone to be produced. This is a one-time treatment. A patient is given a capsule or liquid form of radioactive iodine, which is absorbed by the thyroid gland. The radioactive iodine ablates (destroys) the gland; hyperthyroidism subsides in two or three months. Because hypothyroidism is a result of this treatment, patients must take oral replacement thyroid hormone for the rest of their lives.
Surgical Intervention
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Malignant thyroid nodules are always removed surgically, along with a large portion of thyroid tissue. But sometimes nodules cause patients to have difficulty swallowing and breathing, an these too may require surgical removal. When a total thyroidectomy is performed, as in the case of radioactive iodine treatment, patients require lifelong thyroid hormone replacement therapy.
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