Thyroid nodule
Thyroid adenoma - nodule; Thyroid carcinoma - nodule; Thyroid cancer - nodule; Thyroid incidentaloma; Hot nodule; Cold nodule; Thyrotoxicosis - nodule; Hyperthyroidism - noduleA thyroid nodule is a growth (lump) in the thyroid gland. The thyroid gland is located at the front of the neck, just above where your collarbones meet in the middle.
Causes
Thyroid nodules are caused by an overgrowth of cells in the thyroid gland. These growths can be:
- Not cancer (benign), thyroid cancer (malignant), or very rarely, other cancers or infections
Benign
Benign refers to a condition, tumor, or growth that is not cancerous. This means that it does not spread to other parts of the body. It does not in...
Read Article Now Book Mark Article - Fluid-filled (cysts)
- One nodule or a group of small nodules
- Producing thyroid hormones (hot nodule) or not making thyroid hormones (cold nodule)
Thyroid nodules are very common. They occur more often in women than in men. A person's chance of getting a thyroid nodule increases with age.
Only a few thyroid nodules are due to thyroid cancer. A thyroid nodule is more likely to be cancer if you:
Thyroid cancer
Thyroid cancer is a cancer that starts in the thyroid gland. The thyroid gland is located in the front of your lower neck.
Read Article Now Book Mark Article- Have a hard nodule
- Have a nodule that is stuck to nearby structures
- Have a family history of thyroid cancer
- Have noticed a change in your voice
- Are younger than 20 or older than 70
- Have a history of radiation exposure to the head or neck
- Are male
Causes of thyroid nodules are not always found, but can include:
- Hashimoto disease (a reaction of the immune system against the thyroid gland)
Hashimoto disease
Chronic thyroiditis is caused by a reaction of the immune system against the thyroid gland. It often results in reduced thyroid function (hypothyroi...
Read Article Now Book Mark Article - Lack of iodine in the diet
Symptoms
Most thyroid nodules do not cause symptoms.
Large nodules can press against other structures in the neck. This can cause symptoms such as:
-
A visible goiter (enlarged thyroid gland)
Goiter
A simple goiter is an enlargement of the thyroid gland. It is usually not a tumor or cancer.
Read Article Now Book Mark Article - Hoarseness or changing voice
- Pain in the neck
- Problems breathing, especially when lying down flat
- Problems swallowing food
Problems swallowing
Difficulty with swallowing is the feeling that food or liquid is stuck in the throat or at any point before the food enters the stomach. This proble...
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Nodules that produce thyroid hormones will likely cause symptoms of an overactive thyroid gland, including:
Overactive thyroid gland
Hyperthyroidism is a condition in which the thyroid gland makes too much thyroid hormone. The condition is often called overactive thyroid.
Read Article Now Book Mark Article- Warm, sweaty skin
- Fast pulse and palpitations
- Increased appetite
- Nervousness or anxiety
- Restlessness or poor sleep
- Skin blushing or flushing
- More frequent bowel movements
- Tremor
Tremor
A tremor is a type of shaking movement. A tremor is most often noticed in the hands and arms. It may affect any body part, including the head, tong...
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Weight loss
Unexplained weight loss is a decrease in body weight, when you did not try to lose the weight on your own. Many people gain and lose weight. Uninten...
Read Article Now Book Mark Article - Irregular or lighter menstrual periods
Older people with a nodule that produces too much thyroid hormone may have only vague symptoms, including:
- Fatigue
- Palpitations
- Chest pain
- Memory loss
Thyroid nodules are sometimes found in people who have Hashimoto disease. Hashimoto disease may cause symptoms of an underactive thyroid gland, such as:
- Constipation
- Dry skin
- Face swelling
Face swelling
Facial swelling is the buildup of fluid in the tissues of the face. Swelling may also affect the neck and upper arms.
Read Article Now Book Mark Article - Fatigue
Fatigue
Fatigue is a feeling of weariness, tiredness, or lack of energy.
Read Article Now Book Mark Article - Hair loss
- Feeling cold when other people do not
- Weight gain
Weight gain
Unintentional weight gain is when you gain weight without trying to do so and you are not eating or drinking more.
Read Article Now Book Mark Article - Irregular menstrual periods
Very often, thyroid nodules produce no symptoms. Health care providers often find thyroid nodules during a routine physical exam or imaging tests that are done for another reason. A few people have thyroid nodules that are big enough that they notice the nodule on their own and ask their provider to examine their neck.
Exams and Tests
If your provider finds a nodule or you have symptoms of a nodule, the following tests may be done:
- TSH level and other thyroid blood tests
TSH level
A TSH test measures the amount of thyroid stimulating hormone (TSH) in your blood. TSH is produced by the pituitary gland. It prompts the thyroid g...
Read Article Now Book Mark Article - Thyroid ultrasound
Thyroid ultrasound
A thyroid ultrasound is an imaging method to see the thyroid, a gland in the neck that regulates metabolism (the many processes that control the rate...
Read Article Now Book Mark Article - Thyroid scan (nuclear medicine)
Thyroid scan
A thyroid scan uses a radioactive iodine tracer to examine the structure and function of the thyroid gland. This test is often done together with a ...
Read Article Now Book Mark Article - Fine needle aspiration biopsy of the nodule or of multiple nodules (sometimes with special genetic testing on the nodule tissue)
Fine needle aspiration biopsy
Fine needle aspiration of the thyroid gland is a procedure to remove thyroid cells for examination. The thyroid gland is a butterfly-shaped gland lo...
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Treatment
Your provider may recommend surgery to remove all or part of your thyroid gland if the nodule is:
Surgery to remove all or part of your t...
Thyroid gland removal is surgery to remove all or part of the thyroid gland. The thyroid gland is a butterfly-shaped gland located inside the front ...
Read Article Now Book Mark Article- Due to thyroid cancer
- Causing symptoms such as swallowing or breathing problems
- Biopsied and the biopsy is inconclusive, and your provider can't tell whether the nodule is a cancer
- Making too much thyroid hormone
People with nodules that are making too much thyroid hormone may be treated with radioiodine therapy. This reduces the size and activity of the nodule. Pregnant women or women who are still breastfeeding are not given this treatment.
Both surgery to remove thyroid gland tissue and radioactive iodine treatment can cause lifelong hypothyroidism (underactive thyroid). This condition needs to be treated with thyroid hormone replacement (a daily medicine).
Hypothyroidism
Hypothyroidism is a condition in which the thyroid gland does not make enough thyroid hormone. This condition is often called underactive thyroid....
Read Article Now Book Mark ArticleFor noncancerous nodules that do not cause symptoms and are not growing, the best treatment may be:
- Careful follow-up with a physical exam and ultrasound
Ultrasound
Ultrasound uses high-frequency sound waves to make images of organs and structures inside the body.
Read Article Now Book Mark Article - A thyroid biopsy repeated 6 to 12 months after diagnosis, especially if the nodule has grown
Outlook (Prognosis)
Noncancerous thyroid nodules are not life threatening. Many do not require treatment. Follow-up exams are enough.
The outlook for thyroid cancer depends on the type of cancer. For the most common kinds of thyroid cancer, the outlook is very good after treatment.
When to Contact a Medical Professional
Contact your provider if you feel or see a lump in your neck, or if you have any symptoms of a thyroid nodule.
If you have been exposed to radiation in the face or neck area, contact your provider. A neck ultrasound can be done to look for thyroid nodules.
References
Haugen BR, Alexander EK, Bible KC, et al. 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid. 2016;26(1):1-133. PMID: 26462967 pubmed.ncbi.nlm.nih.gov/26462967/.
Paschke R, Eszlinger M, Kopp P. Euthyroid and hyperthyroid nodules and goiter. In: Robertson RP, ed. DeGroot's Endocrinology. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 77.
Pearce EN, Hollenberg AN. Thyroid. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 207.
Thyroid gland biopsy - illustration
The thyroid is a gland located in the neck. It is a part of the endocrine (hormone) system, and plays a major role in regulating the body's metabolism. If a sample of cells is needed from the thyroid gland a fine needle biopsy can be performed. During this procedure, a skinny needle is inserted into the thyroid gland, and a sample of thyroid cells and fluid is drawn into the needle. The needle is then withdrawn and the cells are sent for examination. This test is usually performed to determine if a thyroid nodule could be malignant (cancer).
Thyroid gland biopsy
illustration
Thyroid gland biopsy - illustration
The thyroid is a gland located in the neck. It is a part of the endocrine (hormone) system, and plays a major role in regulating the body's metabolism. If a sample of cells is needed from the thyroid gland a fine needle biopsy can be performed. During this procedure, a skinny needle is inserted into the thyroid gland, and a sample of thyroid cells and fluid is drawn into the needle. The needle is then withdrawn and the cells are sent for examination. This test is usually performed to determine if a thyroid nodule could be malignant (cancer).
Thyroid gland biopsy
illustration
Review Date: 5/20/2024
Reviewed By: Sandeep K. Dhaliwal, MD, board-certified in Diabetes, Endocrinology, and Metabolism, Springfield, VA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.