Understanding Thyroid Nodules
Thyroid nodules are a common endocrine condition in Singapore. They refer to growths that form in the thyroid gland (a gland that plays a crucial role in regulating your body’s metabolism), located at the base of your neck. The nodules can vary greatly in size, may be solid or filled with fluid, and can be malignant (cancerous) or benign (non-cancerous).
Signs and Symptoms of Thyroid Nodules
While most thyroid nodules do not cause symptoms and are detected during routine examinations or imaging tests, some certain signs and symptoms may indicate the presence of larger or problematic nodules:
- Neck Swelling: One of the most visible signs of a thyroid nodule is a swelling at the base of your neck. This swelling might be localised to a specific part of the thyroid gland where the nodule is located. It may be visible when you swallow or when you look at your reflection in the mirror.
- Changes in Voice: A nodule may press on the recurrent laryngeal nerve, which controls your vocal cords, leading to hoarseness or voice changes. This symptom typically suggests significant growth that may need further evaluation from an Endocrinologist.
- Difficulty Swallowing or Breathing: Larger nodules can exert pressure on your oesophagus or trachea, leading to discomfort or difficulty when swallowing or a sensation of being choked, especially when lying down. Similarly, if a nodule compresses the windpipe, it might cause shortness of breath.
- Thyroid Hormone Imbalance: In some cases, nodules might produce thyroid hormones independently of thyroid-stimulating hormone (TSH), which can lead to signs of hyperthyroidism, such as unexplained weight loss, increased appetite, anxiety, tremors, and palpitations.
- Pain in the neck, jaw, or ear: Although rare, some nodules can sometimes induce pain. The pain associated with thyroid nodules can vary in intensity and is often dependent on the underlying cause of the nodule.
For painful nodules, especially those with sudden onset or worsening symptoms, evaluation from an Endocrinologist is essential to rule out serious conditions like thyroiditis or malignancy.
If you have one or more of the aforementioned symptoms, it is important for you to consult an Endocrinologist who can provide a specialised diagnosis.
Diagnosing Thyroid Nodules
Seriousness of Thyroid Nodules
Diagnosing Thyroid Nodules
Endocrinologists may employ various methods to determine whether your thyroid nodules are serious or not, including:
- Detailed medical history taking: Your Endocrinologist will understand your current health condition and past medical history, which will guide further assessments and decisions.
- Physical examination: This includes inspecting the neck from the front and side to determine the lump’s location. The neck will also be examined for abnormal enlargement, contour, asymmetry, and masses, especially during repeated swallowing, by physically touching and feeling the lumps.
- Imaging tests: Imaging tools like ultrasound, CT scans, and MRI also provide invaluable diagnostic information about the nature of the neck lumps.
- Biopsy: Fine Needle Aspiration (FNA) involves using a thin needle to take a tiny tissue sample from the lump. The sample will be scrutinised under a microscope.
The seriousness of hyperthyroidism underscores the need for prompt diagnosis and effective management to mitigate these health risks and maintain quality of life.
Seriousness of Thyroid Nodules
While the presence of thyroid nodules can be concerning, it is important to understand that the majority of these nodules are benign. That is, the nodules are non-cancerous, so they do not pose a serious health threat. Despite the benign nature of the majority of these nodules, it’s crucial for individuals to undergo appropriate diagnostic procedures to confirm their nature. This is because, in the event that the nodules are malignant, they require immediate thyroid nodules treatment in Singapore to prevent the cancer from spreading.
Benign thyroid nodules
Benign thyroid nodules typically do not require treatment. Nonetheless, monitoring their growth and potential impact on thyroid function is crucial for timely intervention if needed.
Malignant thyroid nodules
Malignant thyroid nodules signify the presence of thyroid cancer, which, while generally having a good prognosis when detected early, can pose significant health risks if not appropriately managed. The significance of these nodules stems from their risk of disrupting the normal function of the thyroid gland, which regulates metabolism, temperature, and other critical bodily functions.
Managing and Treating Thyroid Nodules
The management and treatment of thyroid nodules varies significantly based on their nature—whether they are benign or malignant—and their impact on the patient’s health. Here are some options that an Endocrinologist may recommend:
- Monitoring and Surveillance: For benign nodules that are small and asymptomatic, the primary approach is regular monitoring. This includes periodic ultrasound examinations to track any changes in the size or characteristics of the nodules. Fine needle aspiration may be repeated if a nodule grows or develops suspicious features.
- Radioactive Iodine Therapy: This treatment is used primarily for overactive nodules that produce excess thyroid hormones, as well as for certain types of thyroid cancers that absorb iodine. Radioactive iodine treatment helps to shrink the nodules and can effectively treat the hyperfunctioning glandular tissue.
- Thyroid Hormone Suppression Therapy: In some cases, especially when surgery is not an option, doctors may use thyroid hormone suppression therapy to try to reduce the size of the nodules. This involves administering synthetic thyroid hormone (levothyroxine), which aims to lower the level of thyroid-stimulating hormone (TSH) and thus reduce nodule growth.
- Minimally Invasive Procedures: Thyroidectomy to if nodule is cancerous.
If you notice any lumps in your neck or discover that you have thyroid nodules (incidentally seen during CT scan or Ultrasound imaging), or multinodular goitre, you can schedule a consultation with our experienced Senior Consultant Endocrinologist, Dr Vikram Sonawane. Dr Vikram, the Medical Director of Harmony Thyroid, Endocrinology and Diabetes Centre, will come up with a personalised thyroid nodules treatment plan for your condition.
References:
- Thyroid nodules – Diagnosis and treatment – Mayo Clinic. Mayoclinic.org. Published 2017. https://www.mayoclinic.org/diseases-conditions/thyroid-nodules/diagnosis-treatment/drc-20355266
- Uludag M, Unlu MT, Kostek M, et al. Management of Thyroid Nodules. Sisli Etfal Hastanesi Tip Bulteni. 2023;57(3):287-304. doi: https://doi.org/10.14744/SEMB.2023.06992
