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Thyroid Disease & Nodules

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Introduction

Thyroid nodules are growths that develop within the thyroid gland.  Your thyroid gland is located in the lower front part of your neck, in front of your windpipe.  The vast majority of thyroid nodules are not cancerous, and in fact, they may even go away without treatment.

Anatomy

Thyroid nodules can be fluid-filled cysts or composed of thyroid gland cells.  A single nodule or a cluster of several small nodules may be felt as a lump.

Causes

Thyroid nodules develop for a variety of reasons, including impaired functioning of the thyroid gland.  In some cases, the cause of thyroid nodules is unknown.  The majority of thyroid nodules are benign (not cancer).

Symptoms

Thyroid nodules may or may not cause symptoms.  Large nodules that put pressure on neck structures can cause breathing problems, voice changes, pain, swallowing difficulties, or goiter.  Thyroid nodules can also cause symptoms of hypothyroidism or hyperthyroidism.

Diagnosis

You should contact your doctor if you notice a lump in your neck.  Otherwise, a thyroid examination should be part of your yearly physical examination.  If your doctor suspects that you have a nodule, specific tests will be used to collect more information.
 
Common blood tests include the thyroid-stimulating hormone (TSH) assay and the thyroxine (T4) measurement.  The thyroid-stimulating hormone (TSH) assay is used to determine if the thyroid gland is functioning properly.  It can help identify what is contributing to an underactive thyroid gland.  The thyroxine (T4) measurement assesses thyroid functioning by testing how much T4 is in the blood.  If the thyroid-stimulating hormone (TSH) assay and the thyroxine (T4) measurement are not normal, an antithyroid antibody test is used to determine the presence of Hashimoto’s Disease.
 
A thyroid ultrasound or a thyroid scan and radioactive iodine uptake (RAIU) test are used to detect problems, identify how the thyroid gland is functioning, and specify areas that are overactive or underactive.  Further, it can determine if thyroid nodules or possible cancer are present.  If cancer is suspected, a needle biopsy of the nodule will be performed to examine the cells.

Treatment

Some thyroid nodules do not require treatment and are simply monitored.  Some nodules go away without treatment.  In other cases, supplemental hormone medication may be needed to correct thyroid function.  Nodules that cause symptoms may be reduced with laser therapy, injections, and radioactive iodine treatments.  Cancerous nodules are surgically removed.

Am I at Risk

Thyroid nodules occur more frequently in women than in men.  The risk of developing a thyroid nodule increases with age.  Other risk factors include:

•  A family history of thyroid cancer
•  Prior radiation treatment or radiation exposure to the head and neck
•  Iodine deficiency.  This is more common in  parts of the world where diets are low in salt.
•  Thyroid hormone suppression
•  Hashimoto’s disease, a type of thyroid disease

Complications

Thyroid nodules can affect the way the thyroid gland functions and lead to hypothyroidism or hyperthyroidism. 

 

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    This service should be used for second opinions, additional medical reviews and consultations; not for primary diagnosis or treatment. Please always consult your primary doctor for final diagnosis and treatment.