Do thyroid cysts need treatment?

Written by Zhang Li
Endocrinology
Updated on September 16, 2024
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Thyroid cysts generally do not require special treatment, as most thyroid cysts are quite small, and even larger ones usually do not cause significant clinical symptoms. However, treatment may be necessary in some cases, such as when a thyroid cyst becomes large enough to cause compressive symptoms, leading to difficulty breathing or swallowing, in which case puncture or surgery might be considered. On the other hand, if a thyroid cyst is accompanied by abnormalities in thyroid function, it is important to assess whether there is hyperthyroidism or hypothyroidism and treat according to the specific functional state. Additionally, in a small number of cases where a thyroid cyst may have a tendency to worsen, a puncture biopsy is needed to make a diagnosis, and if confirmed, surgery and appropriate treatment should be carried out.

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Written by Zhang Li
Endocrinology
1min 1sec home-news-image

What causes thyroid cysts?

Thyroid cysts currently have no definitive cause identified. Previously, most believed they were possibly related to iodine deficiency, as such deficiency leads to thyroid hyperplasia and an increase in thyroid cysts. However, it was later discovered that in some high-iodine coastal areas, the incidence of thyroid cysts remains high. This suggests that variations in iodine levels, such as switches from low to high iodine or from high to low iodine, can also lead to the occurrence of thyroid cysts. Additionally, it is currently believed that there might be some connection with radiation and the use of mobile phones and computers, but there is no definitive conclusion. Regardless, once thyroid cysts occur, it is important on one hand to eliminate the possibility of malignant features, ruling out thyroid cancer, and on the other hand to ensure thorough thyroid function tests to understand if there are any abnormalities in function and whether treatment is needed.

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Written by Zhang Li
Endocrinology
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What are the symptoms of thyroid cysts?

Thyroid cysts generally refer to a cystic mass found in the thyroid, typically containing a mixture of fluid or semi-solid fluid. The mass usually has clear boundaries and is painless. It can move up and down with swallowing, which distinguishes it from some subcutaneous nodules. Thyroid cysts generally do not show obvious symptoms or clinical signs and are mostly discovered when looking in the mirror or during a physical examination. However, larger thyroid cysts may cause compression symptoms, such as pressing backward against the trachea or esophagus, leading to symptoms like breathlessness and discomfort swallowing. A small portion may also exhibit signs of thyroid dysfunction, such as hyperthyroidism or hypothyroidism, although this is relatively rare in clinical settings.

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Written by Luo Juan
Endocrinology
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Symptoms of thyroid cysts

Regarding the symptoms of thyroid cysts, typically, patients with thyroid cysts do not experience any discomfort in the early stages. Often, a neck mass is incidentally discovered during a physical examination, and usually, there are no systemic clinical symptoms. Some patients may experience slight pain. Of course, if the cyst is large or there is bleeding within the cyst, it may lead to symptoms of compression, such as pain, difficulty swallowing, difficulty breathing, or hoarseness. Additionally, some thyroid cysts can affect thyroid function. For instance, if there is hyperthyroidism, symptoms may include heat intolerance, excessive sweating, and weight loss. Conversely, in long-term cases, patients may experience symptoms of hypothyroidism, such as cold intolerance, fatigue, constipation, and poor appetite.

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Written by Zhao Xin Lan
Endocrinology
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Can people with thyroid cysts eat seaweed?

Thyroid cysts generally do not show any symptoms clinically and are mostly benign. They are usually solitary, but occasionally multiple cysts could be present. Currently, the exact cause of thyroid cysts is not completely understood. Some scholars believe that the formation of thyroid cysts is related to iodine deficiency. Others suggest that in areas with a high incidence of thyroid cysts, the iodine content is also relatively high, indicating that both exceptionally low or high levels of iodine could potentially be a cause of thyroid cysts. Seaweed is a food high in iodine. Eating seaweed occasionally should not have a significant impact, but consuming seaweed daily could lead to excessive iodine levels in the body, which is not advisable during periods of thyroid cyst affliction.

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Written by Zhang Jun Jun
Endocrinology
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Do thyroid cysts require surgery?

Thyroid cysts are generally benign lesions and are typically classified as below 3B level in thyroid ultrasound grading, which means they are categorized as class 1, 2, or even 3. The decision to perform surgery depends primarily on the size of the thyroid cyst. If the cyst is large enough to cause compressive symptoms, then surgical treatment is necessary at that time. Secondly, if the development of the thyroid cyst is rapid, and fine needle aspiration of the thyroid reveals malignant changes, then surgery is also required. For routine thyroid examinations, if the thyroid cyst is relatively small, classified at a lower level, and there are no associated thyroid functional abnormalities, regular follow-up is generally sufficient without the need for surgical intervention.