Thyroid Nodules: When To Worry, Causes, and How To React

3 Reasons to Pay Attention to Thyroid Nodules

If you’ve been diagnosed with a thyroid nodule, it’s normal to feel anxious. However, the majority of thyroid nodules are benign, don’t cause symptoms, and don’t require surgery. In fact, you may be able to resolve your thyroid nodules with simple treatment and lifestyle options. In this article, we’ll discuss thyroid nodules, when to worry, and applicable treatments.

That said, there are three main reasons to pay closer attention to a thyroid nodule:

  1. You have a thyroid nodule that is larger than 1 cm or is growing.
  2. Your thyroid nodule is painful.
  3. You have signs or symptoms of hyperthyroidism or hypothyroidism.

We’ll discuss each of these possibilities. But first, we’ll review what thyroid nodules are.

What Are Thyroid Nodules?

Thyroid nodules when to worry: A healthy thyroid is next to a thyroid with a nodule

Thyroid nodules are lumps inside the thyroid gland, a butterfly-shaped organ located in the front of the neck. According to the American Thyroid Association, roughly half of the population will have a thyroid nodule by age 60.

The majority of thyroid nodules don’t cause symptoms unless they are very large.

Thyroid nodules can be solid or filled with fluid, which is called a thyroid cyst. If small nodules are less than 1 cm or filled with fluid, they are almost always benign. 

Thyroid Nodules: When To Worry

If your doctor finds a nodule in your thyroid, it’s a sign of an underlying health condition that deserves attention. However, most nodules aren’t a serious concern. Here’s when you should pay attention to a thyroid nodule:

  • Solid nodules larger than 1 cm: These should be evaluated by an endocrinologist, via thyroid ultrasound or fine needle aspiration biopsy (FNA) to rule out thyroid cancer. It makes sense to get it tested for cancer for your own peace of mind, but only 7-15% of thyroid nodules are cancerous. [1 Trusted SourcePubMedGo to source]
  • Thyroid pain: It’s especially important to have your thyroid gland or thyroid nodule assessed if you experience any thyroid pain. Thyroid cancer is one of the few thyroid conditions that cause pain.
  • Symptoms of hyperthyroidism or hypothyroidism: In most other cases, benign nodules aren’t an emergency but may signal an underlying thyroid condition that needs to be addressed.
  • Difficulty swallowing, hoarseness, or shortness of breath: For large thyroid nodules, when to worry is if you experience these symptoms. This may indicate the nodule is affecting your windpipe or esophagus. In this case, you should seek immediate medical attention.

What Causes Thyroid Nodules?

In a majority of cases, thyroid nodules are caused by Hashimoto’s thyroiditis, an autoimmune attack on the thyroid gland that causes scarring. This thyroid tissue damage can lead to underproduction of thyroid hormones, leading to hypothyroid symptoms such as:

  • Fatigue
  • Weight gain
  • Dry skin
  • Depression

In some cases, benign thyroid nodules produce additional thyroxine, a hormone secreted by your thyroid gland. The extra thyroxine can cause an overproduction of thyroid hormones (hyperthyroidism), leading to symptoms such as:

  • Unexplained weight loss
  • Increased sweating
  • Tremor
  • Nervousness
  • Rapid or irregular heartbeat
  • Palpitations

If you have a thyroid nodule, your doctor or endocrinologist may follow up with blood tests to check for hypothyroidism or hyperthyroidism. To rule out cancer and visualize the nodules, physical examination, thyroid scans, radioactive iodine uptake testing, fine-needle aspiration biopsy (FNA), or thyroid ultrasound may be used.

Ways To Improve Thyroid Nodules

If your thyroid nodule is benign, there are two main natural treatment options to improve your thyroid nodules:

  1. Improve your gut health.
  2. Optimize your iodine levels.

Reduce Thyroid Nodules by Improving Gut Health

One of the most common reasons for thyroid nodules is thyroid autoimmunity, especially Hashimoto’s thyroiditis. Research indicates thyroid health is closely connected to your gut health. [2 Trusted SourcePubMedGo to source, 3, 4 Trusted SourcePubMedGo to source, 5 Trusted SourcePubMedGo to source, 6 Trusted SourcePubMedGo to source] In several studies, improving gut health by treating infections or supporting digestion improved thyroid lab markers and (in some cases) thyroid antibodies. [7 Trusted SourcePubMedGo to source, 8 Trusted SourcePubMedGo to source, 9 Trusted SourcePubMedGo to source]

Here are two research-backed steps you can take to improve your thyroid health.  

1. Eat an Anti-Inflammatory Diet

Research shows an anti-inflammatory diet such as the Paleo diet, gluten-free and dairy-free diets [10 Trusted SourcePubMedGo to source, 11 Trusted SourcePubMedGo to source, 12 Trusted SourcePubMedGo to source], or the Autoimmune Paleo diet [13 Trusted SourcePubMedGo to source] may support your thyroid health.

A Paleo diet template is low-carb, dairy-free, and gluten-free, and could be a good place to start.

2. Take High-Quality Probiotics

Probiotics are an effective way to balance your gut microbiome with few side effects. [14 Trusted SourcePubMedGo to source, 15 Trusted SourcePubMedGo to source, 16 Trusted SourcePubMedGo to source, 17 Trusted SourcePubMedGo to source] One study showed probiotics decreased thyroid symptoms and the needed dose of levothyroxine. [18 Trusted SourcePubMedGo to source] For more about how to use probiotics, see our Probiotics Starter Guide.

Reduce Thyroid Nodules by Optimizing Iodine Levels

Some health care providers recommend iodine supplementation to support thyroid health, sometimes in very high doses. The logic here is that since the thyroid hormone is partly made of iodine, supplementing will help increase thyroid hormone levels. This logic falls apart in light of research that connects excessive iodine with an increase in thyroid autoimmunity, goiter, and hypothyroidism. [19 Trusted SourcePubMedGo to source, 20 Trusted SourcePubMedGo to source, 21 Trusted SourcePubMedGo to source]

Though the American Thyroid Association states, “Iodine deficiency, which is very uncommon in the United States, is…known to cause thyroid nodules,” it’s important to only supplement with iodine if you are certain you are deficient. In some cases, you may need to decrease your iodine intake by using a low-iodine diet.

For more on how to assess and optimize your iodine, see How Should I Use Thyroid Supplements?

The Bottom Line

Most thyroid nodules aren’t serious. However, you know with thyroid nodules, when to worry is if they are larger than 1 cm or painful. If you have thyroid nodules, you should also be checked for hyperthyroidism or hypothyroidism. You can likely reduce your thyroid nodules by making a few targeted diet and lifestyle changes, including focusing on your gut health and optimizing your iodine levels.

➕ References
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