Are thyroid nodules serious?

Written by Hu Jian Zhuo
Nephrology and Endocrinology
Updated on September 29, 2024
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The severity of thyroid nodules needs to be assessed based on their nature, size, function, and location. Generally, they can be classified into benign and malignant, with malignant nodules being thyroid cancer, which requires timely treatment. Surgical treatment is the main method for treating thyroid cancer, whereas most benign nodules do not require special handling. Regarding the size of the thyroid nodules, if the nodules are too large and compress surrounding tissues such as the trachea, esophagus, and nerves, surgical treatment is recommended. For common benign nodules, regular observation is sufficient. Functionally, some thyroid nodules may affect thyroid function, such as in Hashimoto's thyroiditis, which can present with diffuse multiple nodules, leading to either hyperthyroidism or hypothyroidism. In such cases, appropriate medication treatment is needed. From a positional perspective, ectopic growth of thyroid nodules, if located at areas like the base of the ear, pharynx, neck, esophagus, or thoracic cavity, is a rare congenital developmental anomaly. If such a nodule significantly enlarges and compresses surrounding tissues, surgical treatment is advised.

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Written by Hu Jian Zhuo
Nephrology and Endocrinology
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Thyroid nodule examination checks what

Generally, when thyroid nodules are detected, one should visit the hospital's breast and thyroid surgery department or the endocrinology department. If you find a thyroid nodule, you can consult a doctor and undergo some relevant tests based on your specific situation. Typically, the following tests are conducted: 1. Thyroid ultrasound: This can determine the size, number, location, texture, shape, and edges of the nodules, including whether there is calcification. It also examines the blood supply within the thyroid nodule, the relationship with surrounding tissues, and assesses whether there are lymph nodes in the neck and the nature of these lymph nodes. 2. Blood tests are needed to measure thyroid function, particularly the level of Thyroid Stimulating Hormone (TSH). Higher levels of TSH indicate that the thyroid nodule is more likely to be proliferative, and thus, the risk of thyroid cancer increases. In addition, Thyroglobulin (Tg) can be measured. Another measure is Serum Calcitonin (Ct). If serum calcitonin is > 100 pg/mL, medullary thyroid cancer should be highly considered, as these cancer cells can secrete large amounts of serum calcitonin, causing this marker to significantly increase. Nuclear isotope imaging is also performed. If the nodule is large and TSH levels are low, a thyroid radionuclide scan is conducted to see if the nodule is a hyperfunctioning adenoma. When necessary, a Fine Needle Aspiration Biopsy (FNAB) is also performed. Fine needle aspiration is an invasive test, but it is currently an important and most efficient method to assess the benign or malignant nature of the nodule. It is generally performed under ultrasound guidance.

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Written by Hu Jian Zhuo
Nephrology and Endocrinology
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Does thyroid nodule puncture hurt?

Fine needle aspiration is an invasive examination, but it is currently an important and most efficient method for assessing benign and malignant conditions, generally conducted under ultrasound guidance. Thyroid nodule aspiration does not cause much pain, similar to that of an injection. Anesthetics are used during the procedure, so the pain is not very noticeable. However, as the effect of the anesthetic wears off, there may still be some pain at the puncture site, but the patients do not need to carry a heavy psychological burden.

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General Surgery
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How long does thyroid nodule surgery take?

This depends on individual circumstances. Generally, when performing thyroid surgery, there are two methods: open and minimally invasive, though the treatment procedures are largely similar. For nodules, we first need to determine their nature. If they are benign, then removal within a certain range during surgery may suffice. However, if intraoperative freezing suggests malignancy, then we face the issue of lymph node dissection, which could significantly prolong the duration of the surgery.

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Nephrology and Endocrinology
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Symptoms of thyroid nodules

Thyroid nodules in the early stages often show no clear symptoms, with only small nodules appearing within the body. The size of these nodules can range from several millimeters to several centimeters, and their texture is generally slightly harder compared to the surrounding glandular tissue. When the enlargement is more noticeable, the nodule can move up and down with the thyroid gland during swallowing. In addition to the presence of nodules, when the thyroid nodule is prominent, it can compress the trachea, leading to difficulty breathing and irritative dry cough. If it compresses the recurrent laryngeal nerve, it may cause hoarseness, varying degrees of hoarseness, and even an inability to speak loudly. In patients with malignant nodules, the invasive malignant cells can cause symptoms such as hoarseness, difficulty breathing, dysphagia (difficulty swallowing), diarrhea, palpitations, facial flushing, and decreased blood calcium levels. If these symptoms occur, it is crucial to seek medical attention promptly.

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Written by Hu Jian Zhuo
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What should I eat for thyroid nodules to dissipate?

Traditional Chinese Medicine (TCM) believes that thyroid nodules are mainly caused by emotional distress, dietary imbalances, and environmental maladjustment. Long-term emotions such as anger and depression can lead to stagnation of qi (vital energy), resulting in liver qi dysfunction and the formation of phlegm. Qi stagnation and phlegm accumulation in the front of the neck lead to the formation of this goiter. Therefore, the treatment for this condition often involves the use of foods or medications that soften hardness, disperse nodules, reduce swelling, and resolve stasis. For example, purslane, loofah, plums, and dried figs are some of the foods that can clear heat, facilitate diuresis, reduce swelling, and disperse nodules. Appropriate consumption of these foods can be beneficial in slowing the progression of the disease. However, it is generally difficult to dissolve nodules through diet alone, and active treatment is still necessary.