Thyroid nodules: Symptoms, Causes and Complications

Thyroid nodules are solid or fluid-filled lumps which are formed within or on your thyroid gland that is at the base of your neck, below the voicebox (larynx) and above the collarbones.

Updated: September 29, 2019

Thyroid nodules are solid or fluid-filled lumps which are formed within or on your thyroid gland that is at the base of your neck, below the voicebox (larynx) and above the collarbones.
There is always a possibility of malignancy or cancer when a thyroid nodule is found. However, most of thyroid nodules are benign or noncancerous, but tests are needed to determine if a nodule is cancerous.
Benign nodules include multinodular goiter, benign follicular adenomas and thyroid cysts. When the thyroid gland has grown too large, it is called as a goiter which are nontoxic in nature. A multinodular goiter is formed as a result of excessive secretion of thyroid stimulating hormone by pituitary gland. It can be treated with thyroid hormone pills if the size of goiter is small. But if the goiter is large or does not stop growing after taking thyroid hormones, surgery is needed. A large thyroid gland can press against the trachea or esophagus causing difficult breathing or eating.
If a group of small circles or the follicular cells are contained within the nodule, the condition is called benign. Cancer is diagnosed when these cells have invaded the surrounding tissue.
When nodules are filled with fluid, it is called as thyroid cysts. It is called a complex nodule, if a nodule has both fluid and solid parts . They need to be surgically removed if they cause neck pain or difficultly swallowing.

Symptoms of Thyroid nodules:

Most thyroid nodules do not cause any signs or symptoms when it is small in size. However, when the nodules become large they can:

  • be felt
  • be seen, often as a swelling at the base of your neck
  • press on your trachea or esophagus, causing shortness of breath or difficulty swallowing

In some cases, thyroid nodules produce additional thyroxine hormone causing symptoms of hyperthyroidism such as:

  • Unexplained weight loss
  • Rapid or irregular heartbeat
  • Increased perspiration
  • Tremor
  • Nervousness

Determining the type of nodules whether it is malignant can not be done by symptoms alone. Most cancerous thyroid nodules are slow growing and may be small when they are discovered. Aggressive thyroid cancers are rare, but these nodules may be large, firm, fixed and rapid growing.
Although most thyroid nodules are noncancerous and do not cause problems, it is important to evaluate the possibility of cancer especially if you have trouble breathing or swallowing.
If you develop signs and symptoms of hyperthyroidism, such as sudden weight loss even though your appetite is normal or has increased, a pounding heart, trouble sleeping, muscle weakness, nervousness or irritability immediately evaluate the possibility of cancer.

Causes of Thyroid nodules:

Nodules can be caused by several reasons, such as overgrowth of normal thyroid tissue, fluid-filled cysts, inflammation of thyroid gland or thyroiditis or a tumor, either cancerous or noncancerous.
Overgrowth of normal thyroid tissue is sometimes referred to as a thyroid adenoma which is noncancerous. A thyroid adenoma is not considered serious unless it grows big enough to cause any bothersome symptoms. Some thyroid adenomas produces excessive thyroid hormones leading to hyperthyroidism. 
Degenerating thyroid adenomas often results in fluid-filled cavities called cysts in the thyroid. Mostly solid components are also found with fluid in thyroid cysts. Usually thyroid cysts are benign, but occasionally they contain malignant solid components.
Hashimoto's disease is a thyroid disorder that can cause chronic thyroid inflammation which is also called as thyroiditis. The inflammation of the thyroid gland develops slowly resulting in nodular enlargement. This often is associated with reduced thyroid gland activity or hypothyroidism.
Iodine deficiency in your diet can sometimes cause your thyroid gland to develop thyroid nodules. Any enlargement of the thyroid gland, which can be caused by iodine deficiency or a thyroid disorder is known as goiter. Multiple distinct nodules within the goiter results in a multinodular goiter.
Although a nodule has less chance of being malignant, certain factors increase your risk of thyroid cancer, such as a family history of thyroid or other endocrine cancers. Other risk factors include your age, being younger than 30 or older than 60, being a female, or having a history of radiation exposure, particularly to the head and neck. Unless a nodule causes pain or discomfort there is less chance of being it meligant.

Complications of Thyroid nodules:

Complications associated with thyroid nodules include:

Difficulty swallowing or breathing:

Large nodules or a multinodular goiter can press your trachea or esophagus, causing shortness of breath or difficulty swallowing.

Problems associated with thyroid cancer:

Usually most or all of your thyroid gland will be removed surgically if a thyroid nodule is cancerous. As a result of which you will need to take thyroid hormone replacement therapy for the rest of your life to compensate for the required hormone for your daily activities.

Hyperthyroidism:

Sometimes thyroid nodules produces additional thyroxine hormone causing symptoms of hyperthyroidism. Hyperthyroidism can result in weight loss, heat intolerance, muscle weakness and anxiousness or irritability. An irregular heartbeat, osteoporosis leading to weakening bones and thyrotoxic crisis are potential complications of hyperthyroidism. Thyrotoxic crisis is a life-threatening which requires immediate medical care.


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