Updated: September 29, 2019
Treatment depends on the type of thyroid nodule you have whether it is benign or malignant.
Several treatment options are available if a thyroid nodule is not cancerous. These may include:
If the result of biopsy shows that you have a benign thyroid nodule, simply waiting and watching your condition will be suggested by your doctor. A physical examination and thyroid function tests are done at regular intervals during this period. If there is sign of growth of the nodule, another biopsy will be done . If the size of benign thyroid nodule remains unchanged, you may not need any treatment.
The hormone levothyroxine, a synthetic form of thyroxine will be given in pill form as a method of treatment in order to preventing nodule growth or reducing the size of cold nodules.
The additional thyroid hormone taken as pill form will signal the pituitary to produce less TSH, the hormone that stimulates the growth of thyroid tissue.
When the nodule is so large that it makes it hard to breathe or swallow, it requires surgery even if it is benign. Surgery is also considered for people with large multinodular goiters, particularly when the goiters press airways, the esophagus or blood vessels. Suspicious nodules from biopsy also need surgical removal, so they can be examined for signs of cancer.
If a thyroid nodule is producing excessive thyroid hormones, treating your hyperthyroidism is suggested. Different options for this condition include:
Adenomas that are hyperfunctioning or multinodular goiters are often treated with radioactive iodine. Radioactive iodine can be taken either as a capsule or in liquid form, which is absorbed by your thyroid gland. This will result in shrinkage of the nodules and reducing the effect of hyperthyroidism. Usually the process takes two to three months to be effective.
In some cases, an anti-thyroid medication such as methimazole is recommended to reduce symptoms of hyperthyroidism. But this treatment can have serious side effects on your liver and it may take more time to be effective. Therefore it is important to discuss the risks and benefits of this treatment with your doctor before opting for it.
Surgery can only be an option if treatment with radioactive iodine or anti-thyroid medications is not effective for a person. The overactive thyroid nodule can be removed in this case.
The risks associated with surgery should be thoroughly discussed with your doctor before going for it.
The most common treatment for a nodule that is cancerous usually involves surgery.
Usually surgical removal is the treatment option for malignant nodules. This can be done with a procedure called near-total thyroidectomy in which the thyroid nodule is removed along with the majority of thyroid tissue. Damage to the nerve that controls your vocal cords and damage to your parathyroid glands are the most common risks of thyroid surgery. Parathyroid glands are four tiny glands located on the back of your thyroid gland that help control the level of calcium in your blood. So in case this gland is damaged because of surgery, you will develop osteoporosis post surgery. After a thyroidectomy, you will need lifelong hormone replacement therapy with levothyroxine to supply your body with normal amounts of thyroid hormone.
For management of certain small cancerous nodules another option is alcohol ablation. A small amount of alcohol is injected in the cancerous thyroid nodule in this technique.
Cancer that occurs in areas that are not easily accessible during surgery can be treated by this technique. Multiple treatment sessions are often required.
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