​Thyroid Nodules

Thyroid is a small gland located at the base of the neck, right above the breastbone, which produces the thyroid hormones. When solid or fluid-filled lumps (nodules) develop in this gland, it causes the disorder known as thyroid nodules. In most cases, thyroid nodules are non-cancerous.

Thyroid nodules are classified cold, warm, or hot, depending on whether they produce thyroid hormones or not. Cold nodules are those that do not produce thyroid hormones, warm nodules produce thyroid hormones like normal thyroid cells, while hot nodules overproduce thyroid hormones.

Iodine deficiency is one of the reasons leading to thyroid nodules. Other causes include overgrowth of thyroid tissue, chronic inflammation of the thyroid gland, enlargement of the thyroid gland due to iodine deficiency or any other thyroid disorder (goitre) and thyroid cancer, though chances of that are slim. 

Some thyroid nodules can be felt as a lump in the throat, but some may be hidden deep in the thyroid tissue, making them difficult to feel. They may also be seen as a lump in the front of the neck of thin individuals. The incidence of thyroid nodules increases with age and it is more common in women than in men, and in people who have a diet low in iodine.

Most thyroid nodules do not cause any symptoms and therefore go unnoticed by people. Thyroid nodules are often discovered incidentally during a routine physical examination or imaging testing such as a Computerized Tomography (CT) scan or neck ultrasound. 

Some patients may discover thyroid nodules themselves when they notice a lump around their neck, such as while wearing a necklace or adjusting a collar. In other cases, abnormal results of thyroid function tests, such as excessive thyroid hormone production, will make your doctor suspect the presence of thyroid nodules.

In general, the following symptoms may be identified by you:

  • Lump in the throat or neck that can be felt.

  • Swelling at the base of the neck.

  • Pain in the neck, jaw or ear.

  • Difficulty breathing or swallowing if a nodule is large enough to compress the windpipe or oesophagus.

  • Hoarseness.

  • Additional thyroxine (thyroid hormone) production, which can lead to weight loss, irregular heartbeat and nervousness.​

If you notice any unusual swelling or lumps in your throat or neck, get yourself evaluated by a ENT (Eye-Nose-Throat) specialist working with the Eye and ENT Service Line at The Aga Khan University Hospital. It is also important to get yourself checked by the doctor to assess the possibility of a thyroid cancer.

You must also seek professional medical help in case you notice signs of overproduction of thyroxine, such as unexplained weight loss, pounding heart, muscular weakness, trouble sleeping, nervousness or irritability. 

Doctors working with the Internal Medicine Service Line can provide you with additional information and medical advice.​

Your time with your doctor may be limited, so make sure to prepare for your visit beforehand. Here are some tips to help get you started.

Questions about your medical history, including whether you have a family history of thyroid disorders, including thyroid cancer will be asked by your doctor. A physical examination to feel the nodules or the lump will also be conducted. These are important for making an initial diagnosis.

Once the nodule has been discovered, further tests will focus on checking how much of the thyroid gland has been affected, whether your thyroid is producing too much thyroxine (hyperthyroidism) or too little (hypothyroidism), and specialized tests to check for cancerous nodules. Some of these tests include:

  • Thyroid function tests, conducted as a blood test, which help assess the level of thyroxine in the body.

  • Thyroid ultrasound to see if a nodule is solid or fluid filled, and to determine the size of the nodule. It can also help identify suspicious nodules since some ultrasound characteristics of thyroid nodules are more frequent in thyroid cancer than in noncancerous nodules.

  • Thyroid FNA (Fine-needle Aspiration) biopsy to find cancerous cells if they are present. This is a simple procedure where the doctor uses a fine needle to withdraw samples of cells from the thyroid nodules which can be checked for being cancerous.

  • Thyroid scans for the evaluation of rare nodules that cause hyperthyroidism.

These tests will help your doctor make an accurate diagnosis about your thyroid nodules.​

Your treatment plan will depend on the cause of the thyroid nodules and their nature.

For benign nodules, your doctor may only recommend regular follow-up check-ups and thyroid function tests to watch your symptoms. If the nodule appears to be growing, however, further biopsy may be requested, or surgery may also be suggested for a benign nodule that has been growing.

In case your thyroid nodule is producing thyroxine, causing symptoms of hyperthyroidism, anti-thyroid medications and radioactive iodine may be used to help sub side the symptoms of hyperthyroidism. In case these methods do not work, surgery may be an option.

A thyroid nodule that has been diagnosed as being cancerous will have to be surgically removed, along with other thyroid tissue (near-total thyroidectomy). This is a critical procedure and you must discuss all associated risks and life-long treatment options post-surgery before surgery with your doctor.​

The Aga Khan University Hospital offers various support services to help with managing or recovering from the disease or condition. These include but are not limited to nutrition, physiotherapy, rehabilitation, specialized clinics and some patient support groups. Your doctor or nurse will advise you accordingly.

The Aga Khan University Hospital offers financial assistance to those who are in need and fulfil the eligibility criteria. For further information, you can contact the Patient Welfare Department. You can find the contact number of the Patient Welfare Department in the ‘Important Numbers’ section on the website homepage.

The financial counselling staff is available during office hours, at the main PBSD (Patient Business Services Department), to answer your financial queries on treatments’ costs and authorize admissions on partial deposit as per hospital policies allow. The financial counsellor in the emergency room is open 24/7. You can find the contact number of the Patient Business Services in the ‘Important Numbers’ section on the website homepage.​

Your doctor and or nurse will give you specific instructions about the prescribed medication. Please ensure that you take or use the prescribed medicine as advised. It can be dangerous to your health if you self-prescribe. Please inform the doctor or nurse beforehand if you have experienced any adverse reactions to any medications in the past. If you experience any symptoms of drug poisoning, overdose or severe reaction please contact the Pharmacy Service at The Aga Khan University Hospital immediately. You can find the contact number of the Pharmacy Services in the ‘Important Numbers’ section on the website homepage.

​The information provided on our website is for educational purposes and not intended to be a substitute for medical advice, diagnosis or treatment. You should always seek the advice of your doctor or other healthcare professional provider.