Treating Thyroid Nodules

Treatment options depend largely on thyroid type. They may include:

Wait and monitor - If it is determined through a biopsy that you have developed a benign noncancerous thyroid nodule, your doctor may simply suggest that your condition be watched. This will usually involve physical exams and thyroid function tests regularly. If the nodule grows in size, you’ll need to most likely get another biopsy done. If the benign thyroid nodule shows no sign of change, your treatments may never go beyond careful monitoring. You can always speak with your doctor regarding further options.

Thyroid hormone suppression therapy - A benign thyroid nodule can be treated with levothyroxine. This is a synthetic form of T3 or thyroxine. It can be taken orally in pill form. The idea behind this treatment is in providing additional thyroid hormone, the pituitary gland will be signaled to produce less TSH (hormones that stimulate growth of thyroid tissues). Theoretically, this should work. However, there is no clear evidence to support that levothyroxine therapy shrinks thyroid nodules. There is even some question as to whether it is necessary to reduce the size of benign nodules.

Radioactive iodine - Radioactive iodine is used to treat multinodular goiters or hyperfunctioning adenomas. It can be taken orally as a pill or in liquid form. Radioactive iodine is the easily absorbed by the thyroid gland. This causes nodules to shrink followed by the reduction of symptoms of hyperthyroidism. Within two to three months the symptoms subside.

Since thyroid hormone is released into your blood while nodules are being destroyed, symptoms can sometimes worsen for a short period, generally a few days or weeks after radioactive iodine therapy. However, that is rare. It is possible that you may have some tenderness in the neck or a sore throat. There are cases where one can also develop hypothyroidism because this type of treatment eventually slows thyroid activity down.

Surgery - This is the usual treatment for any malignant thyroid nodules. Removal of the nodule as well as major portions of thyroid tissue may be required. This procedure is called a thyroidectomy. In some cases, even a benign nodule may require an operation especially if it is large and it interferes with swallowing or breathing. Surgery is considered to be the best treatment for patients with large multinodular goiters. Multinodular goiters can constrict airways or blood vessels. If biopsy findings on nodule cells are indeterminate or inconclusive, surgical removal will more than likely be suggested for closer and more thorough examination of the cancer.

There are some risks associated with surgical removal. These risks may include damage to the nerve that controls your vocal cords and damage to your parathyroid glands. Parathyroid glands are four tiny glands situated behind the thyroid gland that help to regulate the level of calcium in your blood. A total thyroidectomy where the entire thyroid gland is being removed can create this risk and requires a skillful surgeon with experience to conduct. After a thyroidectomy, a patient will need to have levothyroxine therapy – a means to supply the body with appropriate amounts of thyroid hormone for the rest of the patient’s life.