What is the best way to handle a thyroud nodule?

FNA: First get thyroid function tests to see if you have a type of hyperthyroidism, then have a fine needle aspiration (fna) if the nodule is more than 1 cm or has features that would raise the issue of cancer.

Close monitoring: You need to get a TSH to make sure it's not low. If normal, we look at the size of the nodules to determine what to do. Since 95% of thyroid nodules are benign, the best course is to follow them with ultrasound (yearly). If they grow on the next ultrasound, you will need a biopsy or if they are large now (> 1cm) you can also have an ultrasound guided biopsy now.

Depends: Thyroid nodules are evaluated with ultrasound. Depending on the nodules characteristics we may want to biopsy one or more of them. Then they are followed with serial ultrasounds to assess for stability. A change in the nodule size may lead to a repeat biopsy. If the nodules remain stable then the ultrasounds become less and less frequent.