Doctor insights on:
Do Thyroid Nodules Come And Go
Luck of the draw: Some thyroid nodules are the result of radiation exposure (like chernobyl}. Many people form colloid cysts which are incidental and of no significance. Some may have a family history for a tendency of thyroid tumors. Whatever the cause, they need to be properly evaluated. ...Read more
Part of the gland: They will move upward with the rest of the gland when you swallow, and you can move them just as you can move your larynx and trachea once you know your way around your neck. Your physician can help you make the distinction from a lymph node or other mass. ...Read more
Variable: Thyroid nodules are variable in their growth patterns. Some can grow quickly in size, particularly if there is a cystic component to the nodule. Your doctor will usually suggest an ultrasound to follow the growth of the nodule every 6 months to one year, depending on the level of suspicion. ...Read more
In certain cases: Many thyroid nodules need to be surgically removed, while others will never require surgery. Each case is individualized and there are many gray areas. It is really difficult to give a meaningful response to that question in the absence of a history and physical examination. ...Read more
Usually not: In the distant past, thyroid hormone was used to 'shrink' nodules. More recent studies with ultrasound monitoring has shown that most nodules do not shrink with thyroid hormone treatment. Because thyroid cancer is the fastest increasing cancer in women, it is important to follow most thyroid nodules with ultrasound. With hashimoto's thyroiditis, there can be false or pseudonodules. ...Read more
Most: Thyroid nodules are benign some however can be cancerous. If you have a lump in your thyroid it should be followed closely by your doctor. Most benign thyroid nodules occur spontaneously without any known cause. As often happens with organs that have a secretory function (ie ovaries)fluid filled inclusions can form and grow. Follow-up with your treating physician. ...Read more
May need biopsy: The management of thyroid nodules depends on a number of factors. How big are they? What do they look like on ultrasound? Are they "hot" (take up radioiodine) or cold? Are they part of a multinodular goiter or hashimotos thyroiditis? The risk of a nodule being cancer is usually low, but big, solitary nodules are more worrisome. A biopsy is an easy procedure by someone trained in this. ...Read more
Images: "hot" or "cold" is a term related to the appearance on nuclear medicine imaging. A "hot" nodule is one that is too active, and secretes hormone, but benign. A cold nodule takes up less tracer. About 20% of these are malignant, and so they are biopsied. Cysts will also show up cold as they are fluid rather than tissue, so this study should be interpreted along side an ultrasound. ...Read more
Several steps: 1) history and physical exam by doctor, 2) blood test to assess thyroid function. If hyperthyroid: needs treatment and usually a nuclear scan. 3) if thyroid function is normal or depressed usually a thyroid ultrasound is done 4) if nodule is solid or suspicious then fine needle aspiration. 5) if benign: follow-up - if malignant (or suggestive) refer to qualified surgeon. ...Read more
Generally not: Look for other causes. One uncommon cause is vocal cord dysfunction, which can feel just like an asthma attack, but is not relieved with inhalers. Esophageal spasm is another cause. Getting stuck on a preconceived diagnosis prevents the proper one from being made. See your doc, and describe your symptoms in detail to him, in order for the proper diagnosis to be made. ...Read more
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