Thyroid nodules often look worse than they really are and rarely pose a threat to the person affected. They are much more common in developing countries than in rich industrialized nations and also vary greatly in the way they develop.
What is a thyroid nodule?
A thyroid nodule refers to the morphological change in the thyroid gland, which is located in the neck and is responsible for important metabolic processes, as well as the storage of iodine and the production of vital hormones. See bittranslators for About Chronic Renal Failure.
In medicine, we speak of so-called cold and hot knots, which differ from one another by various characteristics.
A hot node works independently and bypasses the thyroid gland and its so-called thyrotropic control circuit, which controls the release of hormones from the thyroid gland into the blood.
A cold thyroid nodule, on the other hand, refers to abnormal tissue that forms in the thyroid gland but does not produce hormones.
In most cases, a thyroid nodule indicates a lack of iodine, which must be obtained from food. This is why they often occur in countries with poor basic nutrition, where a regular intake of iodine, which is contained in eggs or fish, for example, cannot be guaranteed.
But also in some southern federal states of Germany there has been an iodine deficiency in parts of the population for many years. In the rarest cases, the thyroid nodule turns out to be a cancerous growth that proliferates in the thyroid gland and is initially indistinguishable from a harmless, benign thyroid nodule.
Symptoms, Ailments & Signs
Thyroid nodules do not always cause symptoms initially. If the organ is still fully functional, minor growths only cause slight difficulty in swallowing and occasionally hoarseness. However, if the permanent pressure that the nodule exerts on the thyroid gland causes it to become overactive or underactive, various health problems can occur.
Hyperfunction primarily causes diarrhea, weight problems and sweating. Affected people usually feel an intense malaise, which occurs in flares and subsides again in phases of rest. An underfunction leads to fatigue, constipation and depressive moods. Thyroid nodules are usually not visible externally.
Only large growths can be felt from the outside. Occasionally they can be seen as a bump under the skin. The swollen knots hurt when touched, which can immediately lead to cold sweats and dizziness. If the thyroid nodules are not treated, other symptoms can develop.
Further growth inevitably leads to a disruption in organ function, which in the long term also affects the hormonal processes in the body. A failure of the thyroid gland can lead to hair loss, chronic fatigue and a changed complexion. In addition, mental illnesses can occur, which are usually associated with other complaints.
Diagnosis & History
Thyroid nodules are usually late or not noticed at all by the affected person, because they often do not cause any pain or other discomfort.
Only from a certain size can they – by pressing on the nearby windpipe and esophagus – lead to swallowing and breathing difficulties, a feeling of pressure and the famous “lump in the throat”. Because of this, they are usually discovered purely by chance during routine examinations and then examined for their respective properties and classification.
Cold knots can lead to more serious problems just from overgrowth. Hot knots, on the other hand, can degenerate into an overactive thyroid gland due to their autonomous release of hormones , which can manifest itself in diarrhea, tachycardia, nervousness and weight loss. The consequence of a malignant thyroid nodule is metastasis which, if left untreated, will inevitably lead to death.
An untreated thyroid nodule can primarily cause hormonal problems. Hot knots then lead to diarrhea, tachycardia, nervousness or weight loss. Cold knots often result in a narrowing of the trachea. This can lead to shortness of breath, shortness of breath and other breathing difficulties. If the thyroid nodule occurs in the context of polycystic thyroid disease, it can lead to the development of hypothyroidism.
A lump in the thyroid gland can also cause difficulty swallowing. Depending on the size of the growth, food residue can be aspirated, causing shortness of breath and, rarely, pneumonia. Another possible complication is chronic hoarseness, which mainly occurs if the thyroid nodule is not treated for a long period of time. A malignant thyroid nodule spreads further metastases which, if left untreated, lead to death.
Surgical removal of a thyroid nodule can cause bleeding, inflammation, and occasionally damage to the thyroid gland. Radioiodine therapy can cause side effects such as loss of appetite, nausea, sore throat and temporary irritation of the gastric mucosa. Finally, there is a risk that the agents and materials used will cause allergic reactions.
When should you go to the doctor?
If you have a thyroid nodule, you should always see a doctor. This disease cannot heal itself, so medical treatment is always necessary. The doctor should be consulted if the person concerned suffers from swallowing difficulties. These usually occur for no particular reason and, above all, permanently.
Furthermore, persistent hoarseness can also be a strong indicator of thyroid nodules and should also be examined if it occurs over a longer period of time without any particular reason. Furthermore, the thyroid nodules can also lead to diarrhea, constipation or a very strong tiredness of the affected person. These symptoms also indicate thyroid nodules and should always be examined. In some cases, severe dizziness or severe hair loss can also indicate the thyroid nodules and should be examined.
The first examination and consultation can be carried out by a general practitioner or by a family doctor. For further examination or treatment, a specialist is usually necessary. Whether the life expectancy of the affected person is reduced by the thyroid nodules cannot be universally predicted.
Treatment & Therapy
There are basically two main procedures used in the treatment of thyroid nodules. On the one hand, surgical removal is recommended, especially if the knot has already reached such a size that it presses on the trachea and esophagus.
This is carried out without exception in the event of a cancer finding, although experts still disagree as to whether a complete removal of the thyroid gland is necessary or a selective removal of the affected tissue is sufficient. In the case of very large cold nodules that are already causing symptoms, surgery is also usually recommended to prevent damage to the sensitive esophagus and trachea.
The other variant of the fight, which only works with hot knots, is the use of radioiodine therapy. The patient is given radioactive iodine, either in the form of injections or capsules, which is deposited in the thyroid nodule and leads to decomposition and death of the newly formed tissue.
The best prevention of a thyroid nodule is a balanced, iodine-rich diet that provides the thyroid with enough iodine to perform its functions at a satisfactory level. An additional intake of iodine in the form of tablets is a supplement worth considering, especially for children, to protect against thyroid nodules, but cannot replace a balanced diet.
A thyroid nodule is usually a relatively harmless phenomenon, but it can certainly lead to more serious complications and symptoms and therefore – also with regard to a rare but quite possible cancer – should definitely be examined by a doctor.
A diagnosis of a thyroid nodule is not always a cause for concern. Unobtrusive thyroid nodules measuring less than one centimeter often do not require annual follow-up. A check-up every five years is sufficient for these nodules. In the case of more pronounced thyroid nodules, on the other hand, regular checks are advisable in order to differentiate between ‘hot’ and ‘cold nodules’.
In addition, the size of the knots is checked during the investigations and the development of potentially dangerous cold knots is counteracted. If the nodules grow excessively, surgery may be necessary. Alternatively, in mild cases, the specialist will prescribe medication to curb the enlargement. Another reason for aftercare is the early detection of malignant changes in the cell tissue of the thyroid gland.
If the patient suffers from pain or difficulty swallowing due to changes in the thyroid gland, a doctor’s visit is recommended. If necessary, a biopsy is taken to examine the structure of the cell tissue more closely and to rule out malignant changes or to detect them at an early stage.
Such growths are rare in small nodules. For this reason, such a precautionary measure only makes sense in the case of conspicuous knots from a size of one centimeter. Even in this group of patients, the risk of cancer is very low, at a rate of approximately 1.5 percent in women and 0.5 percent in men.
You can do that yourself
The thyroid nodule cannot be reduced by self-help in everyday life. The only help here is an operation or possibly indicated radioiodine therapy. If the thyroid nodule has proven to be benign after careful diagnostics, it can remain in the throat and be observed. In this context, self-help in everyday life also means accepting a part of this observation, but not constantly touching the knot. Difficulties in swallowing or breathing that are newly occurring are another reason to see a doctor, along with increasing size. Regular monitoring of the thyroid hormones in the patient’s blood is also useful.
The knot is often associated with a feeling of tightness in the neck area. This may be better managed if the patient is not wearing tight neckerchiefs and scarves. Difficulty swallowing is also possible due to the mechanical obstacle of the knot in the neck area. Here it helps to eat food in small bites, to chew well and to ensure that you drink enough fluids. Anyone who takes thyroid hormones should definitely pay attention to regularity.
Having a lump in the neck area is often a psychological problem for patients. This can have aesthetic reasons for visible lumps, but also the fear of undetected cancer. In many cases, surgery is the right decision.