What Causes Thyroid Nodules?
Have you noticed a lump in your neck or been told you might have a thyroid nodule? You’re not alone. Nodules on thyroid are very common, especially as people get older. In fact, by age 60, nearly half of adults will have at least one thyroid nodule, even if they don’t know it. That’s why understanding what causes thyroid nodules, when to worry, and what diagnosis options are available is important.
What Are Thyroid Nodules?
A thyroid nodule is a lump or growth that develops within the thyroid gland, a butterfly-shaped gland at the base of the neck that plays a vital role in regulating metabolism, energy, and hormone balance. Nodules can form as solid tissue, fluid-filled cysts, or a combination of both. Because nodules can vary in size, appearance, and cause, doctors often recommend a proper evaluation to understand their nature.
Are Thyroid Cysts the Same as Thyroid Nodules?
Not exactly. A thyroid nodule is any lump that forms in the thyroid gland, and they can be solid, fluid-filled, or partly both. A thyroid cyst is a specific type of nodule that is mainly or completely fluid-filled. Which means that all thyroid cysts are nodules, but not all nodules are cysts.
Can You Have Multiple Thyroid Nodules?
Yes. Many people develop more than one nodule, a common thyroid condition known as a multinodular goiter. This is especially common in adults over 50. While most multinodular goiters are benign, they should still be evaluated.
What Are Thyroid Nodule Symptoms?
Many thyroid nodules are small and cause no symptoms, which is why they are often found during routine exams or imaging tests. However, larger nodules or those that affect thyroid function may cause noticeable changes. Some structural symptoms are caused by the size or location of the nodule, these include:
- A lump or swelling in the front of the neck that you can see or feel
- Difficulty swallowing or a sensation of something stuck in the throat
- Shortness of breath or trouble breathing, especially when lying down
- Hoarseness or voice changes due to pressure on the vocal cords
- Neck pain or pressure that may radiate to the jaw or ear
- A goiter (an enlarged thyroid gland)
- Hyperthyroidism (overactive thyroid): anxiety, weight loss, rapid heartbeat, tremors, feeling hot
- Hypothyroidism (underactive thyroid): fatigue, weight gain, feeling cold, dry skin, hair loss, depressed mood
- A hard thyroid nodule that feels firm to the touch
- A persistent change in your voice or unexplained hoarseness
- Swollen lymph nodes in the neck
- A thyroid nodule that continues to grow over time
What Causes Thyroid Nodules?
There isn’t one single cause of nodules in the thyroid. Instead, they may develop for different reasons, including:
- Overgrowth of normal thyroid tissue (adenoma): A noncancerous tumor that can sometimes enlarge.
- Fluid-filled cysts: Often formed from degenerating nodules or thyroid tissue changes.
- Chronic inflammation: Conditions like Hashimoto’s thyroiditis can lead to nodules as the thyroid becomes inflamed.
- Iodine deficiency: Rare in the U.S., but still a cause worldwide.
- Radiation exposure: Past radiation treatments to the head or neck can increase risk.
- Family history: Genetics play a role; having relatives with thyroid disease raises your risk.
When to Worry About Thyroid Nodules
Not all thyroid nodules are dangerous, and the majority are harmless. However, it’s important to understand when to worry about thyroid nodules and when to see a specialist for further evaluation. Knowing what’s normal and what could be a warning sign helps you take action with confidence rather than unnecessary anxiety. Our ENT specialists in Metro Atlanta, GA, may recommend additional thyroid nodule testing if:
- The nodule is larger than 0.4 inches (about the size of a pea)
- Thyroid ultrasound imaging shows suspicious features, such as irregular shape, calcifications, or unusual blood flow
- You have a family history of thyroid cancer or certain genetic conditions that increase risk
- You notice changes in your neck, such as swallowing difficulty, hoarseness, or a visible lump
What Happens During Thyroid Nodule Evaluation?
If your thyroid doctor thinks your nodule needs a closer look, the evaluation process is usually straightforward and painless:
- Ultrasound imaging provides a clear picture of the thyroid gland, showing whether the nodule is solid, fluid-filled, or has features that need further review.
- Blood tests measure thyroid hormone levels to check if the gland is underactive (hypothyroidism) or overactive (hyperthyroidism).
- Fine needle aspiration (FNA) biopsy may be recommended if the nodule appears suspicious or continues to grow. This minimally invasive test uses a thin needle to collect cells for analysis and usually takes only a few minutes.
What Percentage of Thyroid Nodules Are Cancerous?
Studies show that over 90% are benign, and only about 5–10% of thyroid nodules turn out to be thyroid cancer. Because symptoms alone can’t confirm whether a nodule is cancerous, evaluation with ultrasound and, if needed, a fine needle aspiration (FNA) biopsy is the best way to know for sure.
How to Shrink Thyroid Nodules Without Surgery
Not every nodule needs to be removed. Many can be managed with nonsurgical thyroid nodule treatments or simple monitoring:
- Observation & Monitoring: Small, benign nodules often only need periodic ultrasounds to ensure they don’t grow.
- Thyroid Medication: If a nodule affects thyroid function, medication may be prescribed to restore balance.
- Ethanol Ablation (for thyroid cysts): A quick outpatient procedure where alcohol is injected into a fluid-filled nodule to shrink it.
- Radiofrequency Ablation (RFA): A minimally invasive treatment that uses heat to reduce nodule size, performed under local anesthesia.
These nonsurgical options allow many patients to avoid traditional thyroid surgery while still finding relief.
Do Thyroid Nodules Affect Hormones?
Most thyroid nodules don’t interfere with hormone production. However, some “hot nodules” or overactive nodules produce excess thyroid hormone, leading to hyperthyroidism. Symptoms can include:
- Rapid heartbeat or palpitations
- Anxiety or nervousness
- Tremors or shakiness
- Weight loss despite normal eating habits
- Heat intolerance or excessive sweating
In contrast, most nodules are “cold” or nonfunctioning, meaning they don’t affect hormones at all.
Thyroid Nodule Biopsy & Treatment in Metro Atlanta, GA
While most nodules don’t cause symptoms or require treatment, it’s important to know when to worry about thyroid nodules and seek evaluation. With today’s advanced thyroid diagnosis and treatment options many nodules can be treated effectively with minimally invasive surgical procedures. In some cases, nodules can be treated without any surgery at all. If you’ve noticed a lump in your neck or are experiencing thyroid nodule symptoms, don’t wait. Schedule a consultation with a thyroid expert, like Northwest ENT’s Dr. Shatul L. Parikh.
Book an appointment today to get the treatment you need.