Thyroid Nodules

A thyroid nodule is a solid or fluid‑filled lump that forms within the thyroid gland at the front of your neck. Most nodules are harmless and do not change how the thyroid works.

Thyroid nodules are very common. About 1 in 10 adults have a detectable nodule, and they are even more common when picked up by ultrasound. Only a small percentage (about 5–10 %) are cancerous.

Most nodules cause no symptoms and are found during a routine exam or scan. Possible symptoms include:

• A painless lump in the neck
• A feeling of fullness or pressure in the neck
• Difficulty swallowing or a 'lump in the throat' sensation
• Hoarseness (rare)
• Symptoms of over‑active thyroid (palpitations, weight loss) or under‑active thyroid (tiredness, weight gain) if the nodule affects hormone levels
  

Causes vary and include benign (non‑cancerous) over‑growth of thyroid tissue, fluid‑filled cysts, inflammation (thyroiditis), iodine deficiency, and - less commonly - thyroid cancer.

Your doctor may recommend:

• Blood tests to check thyroid hormone levels
• Ultrasound scan to look at the size and appearance of the nodule
• Fine‑needle aspiration (FNA) biopsy – a thin needle takes cells from the nodule for analysis
• Occasionally, a CT, MRI, or radioiodine scan
  

Most nodules are benign. Ultrasound features and biopsy results help decide whether further surgery or follow‑up is needed.

Treatment depends on the test results:

• Watchful waiting – regular ultrasound and exams for benign nodules
• Thyroid hormone tablets in specific cases to suppress growth
• Radiofrequency or laser ablation for selected benign nodules causing symptoms
• Surgery (partial or total thyroid removal) if the nodule is suspicious, confirmed cancer, or causing troublesome symptoms
• Radioiodine therapy for certain kinds of over‑active nodules or thyroid cancers
  

• Attend follow‑up appointments and ultrasound scans as advised
• Report any rapid growth, pain, or new swallowing/voice changes to your doctor
• Ensure adequate dietary iodine (iodised salt or as advised)
• Stop smoking and maintain a healthy weight
  

• Sudden swelling or pain in the neck
• New or worsening difficulty breathing or swallowing
• Hoarseness lasting more than two weeks
• Any rapid increase in the size of the lump
  

• Your GP or endocrinologist
• British Thyroid Foundation: www.btf-thyroid.org
• NHS website: www.nhs.uk