What causes thyroid cysts?

Written by Zhang Li
Endocrinology
Updated on September 15, 2024
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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 Chen Xie
Endocrinology
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How should thyroid cysts be treated?

Thyroid cysts refer to fluid-containing sac-like formations found in the thyroid gland. For their treatment, thyroid cysts are a type of benign tumor of the thyroid. In imaging studies, if the nodule's diameter is less than one centimeter, it usually presents no clinical symptoms or signs. Regular follow-ups with thyroid ultrasonography and thyroid function tests are advised. If there is no trend of enlargement, continued observation without surgical intervention can be appropriate. However, if the nodule's diameter is greater than one centimeter, or if it is located on the surface of the thyroid, the local skin may show a protrusion or bulge, and the cyst may continue to grow, pressing on the trachea or even the esophagus, causing symptoms such as chest tightness, difficulty breathing, a feeling of swallowing, and obstruction. It is important to seek medical attention in a timely manner, undergo a fine needle aspiration biopsy if necessary, and surgical treatment may be required if needed.

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Written by Chen Xie
Endocrinology
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What should be paid attention to regarding thyroid cysts?

Thyroid cysts generally do not show obvious symptoms. When a cyst significantly enlarges or internal bleeding occurs, compressive symptoms or pain may appear. Thyroid cysts can lead to hyperthyroidism, and if persistent, may eventually cause hypothyroidism. Therefore, it is necessary to regularly monitor thyroid function to understand the status of thyroid activity. The treatment of thyroid cysts primarily involves distinguishing whether they are malignant. For thyroid cysts suspected to be malignant, surgical treatment is required. Generally, thyroid cysts are benign and only require regular observation and follow-up.

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Written by Zhao Xin Lan
Endocrinology
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Can you get pregnant with a thyroid cyst?

Thyroid cysts refer to sac-like formations within the thyroid gland that contain fluid, typically benign with rare cases of malignancy. The fluid inside these cysts, also known as blisters, has no secretory function and does not affect thyroid function, making it possible to become pregnant with a thyroid cyst. However, it is important to note that during pregnancy, if the cyst rapidly enlarges or if there is localized pain, it could be due to bleeding inside the cyst which requires urgent treatment. Aspiration of the cyst fluid can be done through fine needle aspiration to relieve pressure, and ethanol ablation can be used to close the cyst cavity. This minor surgery is generally tolerable and does not affect pregnancy.

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Written by Chen Xie
Endocrinology
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Foods to avoid with thyroid cysts

For patients with thyroid cysts, it is necessary to first understand the patient's thyroid function, whether it is normal, overactive, or underactive. For patients with thyroid cysts who also have hyperthyroidism, a diet avoiding iodine is still necessary, as excessive iodine intake can significantly affect their hyperthyroid condition, therefore they need to consume iodine-free food. However, for patients with normal thyroid function or those with hypothyroidism, a normal diet is appropriate, and there is no need to avoid iodine. It is also recommended that they avoid smoking and alcohol in their daily life.

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Written by Zhang Li
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Do thyroid cysts require surgery?

Thyroid cysts are relatively common in clinical practice. Whether surgery is necessary depends on two factors. On one hand, it depends on whether the cyst is malignant. If the ultrasound reveals small calcifications within the cyst, or other signs of malignancy, then a fine needle aspiration of the thyroid should be carried out for a pathological examination. If the cyst is confirmed to be malignant, surgery is generally recommended. However, if the examination indicates that the thyroid cyst is benign with a low malignancy level, surgery is usually not required. However, if the thyroid cyst is large, affects appearance, causes significant swallowing difficulties or hinders neck movement, surgery can also be considered.