Thyroid nodules are the most common disorder involving the endocrine system, but when you feel a lump in your throat or it’s detected during a routine physical exam, it’s normal to feel worried.
Although thyroid nodules may seem scary, about 90–95 percent of them are non-cancerous growths that develop in an otherwise normal thyroid gland. But in some cases, these nodules may cause thyroid problems and compressive symptoms that affect the way you eat and speak. And 5–10 percent of thyroid nodules turn out to malignant.
So how do you know when to worry about thyroid nodules? And if it’s not thyroid cancer, what’s causing this lump in your throat? Read on to get some answers about thyroid nodules causes and even natural remedies for thyroid health.
What Are Thyroid Nodules?
Thyroid nodules are growths that develop within the thyroid gland, which is located in your throat, just behind your Adam’s apple. When thyroid tissue grows abnormally, it creates a nodule, or lump. Thyroid nodules can occur as a single lump or as multiple nodules, and they can be solid or fluid-filled.
Thyroid nodules are actually quite common, affecting up to 65 percent of the general population. The estimated annual incidence of thyroid nodules in the U.S. is approximately 0.1 percent, which is equal to about a 10 percent lifetime probability of developing one.
According to research published in JAMA, most thyroid nodules are benign and clinically insignificant, but about 10 percent of nodules harbor a clinically significant cancer, 5 percent cause compressive symptoms and 5 percent progress to a functional disease. (1)
Signs and Symptoms of Thyroid Nodules
The development of thyroid nodules symptoms is not common; in fact, nodules are usually found incidentally when other imaging studies are performed and not because a patient had any signs. But some people with thyroid nodules, around 11–22 percent, experience what’s called compressive symptoms, which can include the following:
- Neck fullness: Sometimes thyroid nodules can be felt when examining the neck and throat, and even seen, which is from swelling at the base of the neck.
- Dysphagia: Dysphagia, or difficulty swallowing, may be a symptom associated with thyroid nodules because the lump is causing a sense of mass in the esophagus or it is impeding the normal passage of food. This can cause pain while swallowing, being unable to swallow or having a sensation of food being stuck in the throat.
- Odynophagia: This is a medical term used for when swallowing causes pain in your mouth, throat or esophagus. Because larger thyroid nodules are creating pressure in the throat and neck, it can be painful in these areas.
- Choking: Because large or swollen thyroid nodules make it difficult to swallow, they can lead to choking.
- Dyspnea: Dyspnea, or difficulty breathing and shortness of breath, may occur with larger thyroid nodules.
Sometimes, thyroid nodules can cause the body to produce additional thyroxine, which is a hormone that’s secreted by the thyroid gland. This may lead to symptoms of hyperthyroidism, including nervousness, anxiety, sleep troubles, racing heart, unexplained weight loss, excessive sweating and muscle weakness. (2)
These symptoms can occur in both benign and malignant thyroid nodules, so they do not indicate an increased risk of thyroid cancer. Researchers at Rutgers in New Jersey found that thyroid nodule size and lobe size are directly correlated with compressive symptoms. Their study indicates that of patients with compressive symptoms and a thyroid nodule size greater than 1.5 centimeters, 97 percent of them experienced improvement in symptoms after surgery. (3)
Thyroid Nodules Causes and Risk Factors
Thyroid nodules are very common and there are several conditions that can cause them to develop in your thyroid gland, including the following: (4)
- Iodine deficiency: Low iodine levels are associated with an increased risk of developing goiters or an enlarged thyroid gland. (5)
- Hashimoto’s disease: Hashimoto’s disease causes inflammation of the thyroid gland and can cause the thyroid gland to become enlarged. This disorder results from the underproduction of thyroid hormone and can lead to the gradual destruction of the thyroid gland itself.
- Overgrowth of thyroid tissue: Sometimes there’s an overgrowth of normal thyroid tissue, which is called a thyroid adenoma. It’s unclear why this happens, but it can lead to lumps in the thyroid gland and an overproduction of thyroid hormones.
- Thyroid cyst: A fluid-filled cyst can develop in the thyroid, which may be the result of abnormal thyroid tissue growth. These cysts are often a mix of solid and fluid components and are usually benign. Sometimes, however, solid components in a cyst can be malignant.
- Thyroid goiter: A goiter an abnormal enlargement of the thyroid gland that causes a bulge in the neck. This can occur when there’s an overproduction or underproduction of thyroid hormones.
- Thyroid cancer: Most thyroid nodules are benign and are caused by other factors, but sometimes a nodule is caused by cancerous cells in the thyroid. If a nodule is hard, large and painful, there is a greater risk of malignancy.
Here are some facts about the risk factors associated with thyroid nodules: (6)
- They are four times more common in women than men.
- Increasing nodule size and new development are related to hormonal changes of both estrogen and progesterone, which is why nodules are often found in pregnant women.
- Their frequency increases with age
- They are linked to low iodine intake.
- Exposure to ionizing radiation (which can happen in childhood or due to occupational exposure) is associated with an increased risk of developing thyroid cancer. The amount of radiation exposure needed to increase the risk of cancer is higher than that produced by routine x-rays.
Diagnosis of Thyroid Disease
The vast majority of thyroid nodules are non-cancerous, but in order to determine whether or not the nodule is malignant, a doctor familiar with this field will have to run tests to make a diagnosis.
Ultrasound is the most common imaging tool for thyroid nodules, along with a fine-needle aspiration biopsy, which provides a tissue sample for testing whether the nodule is malignant. Because only about 10 percent of nodules turn out to be malignant, the decision to operate on patients is only made after diagnosis with ultrasonography.
An ultrasound will identify nodules that are too small to be detected by a simple neck examination and the presence of multiple nodules. Plus, an accurate measurement of the nodules can be taken with ultrasonography.
If the results of an ultrasound call for a fine-needle aspiration biopsy, it’s usually performed with ultrasound guidance. A health care provider will take cells from the thyroid nodule and examine it under a microscope to detect whether it’s cancerous or benign.
Performing a biopsy to determine the risk of malignancy has dramatically decreased the number of thyroidectomies performed. If the biopsy shows a benign lesion, it will be followed with yearly ultrasound examinations and repeated fine-needle aspiration if the nodule increases in size or development. If the lesion is malignant, total thyroidectomy is recommended.
To make a diagnosis, your doctor may also perform a thorough head and neck exam, at which time he or she will feel the nodule for firmness and evaluate your vocal fold movement. The following findings during a physical exam increase the concern for malignancy: (7, 8)
- nodules that are larger than 4 centimeters in size
- nodules that are firm when touched
- nodules that are fixed to adjacent tissues
- disease or inflammation of the lymph nodes (called cervical lymphadenopathy)
- vocal fold immobility, which can cause issues with your voice and swallowing
- nodules found in young children, who have a higher malignancy rate than adults.
Treatment for thyroid nodules depends on the initial risk estimate that’s based on an ultrasound or cytology report. Doctors will formulate a treatment plan based on the estimated risk of malignancy and the presence and severity of symptoms.
If a thyroid biopsy suggests that the nodule is benign, then the most appropriate treatment plan is simply observation. This usually involves repeated thyroid blood tests, ultrasounds and physical examinations every year. If the nodule increases in size, then another biopsy may be necessary. (9)
If the enlarged nodule is causing compressive symptoms, the following types of therapy can be used to treat benign thyroid nodules: (10)
- Thyroid hormone therapy: Thyroid hormones are often used to reduce the size of a nodule. Although more research is needed, thyroid hormone therapy is meant to lower the production of thyroid stimulating hormone and decrease the growth of thyroid tissue.
- Surgery: If a benign thyroid nodule is making it difficult to swallow or breath, becoming larger and creating a mass in the neck, or producing too much thyroid hormone, it can be removed with surgery.
- Radioactive iodine treatment: Radioactive iodine (RAI) therapy is meant to destroy the cells that make up the thyroid gland, thereby reducing the size of the gland. RAI therapy is not usually recommended for patient with low or even moderate risk of thyroid cancer. (11)
- Laser or radiofrequency ablation treatment: Radiofrequency ablation treatment is much more common in European and Asian countries. It’s meant to reduce the nodule volume in large, steadily growing and benign nodules, without affecting thyroid function. (12)
Malignant nodules warrant surgical removal. There are two surgery options — total removal of the thyroid gland, which is called a total thyroidectomy, or removal of half the thyroid gland, called thyroid lobectomy.
7 Natural Remedies for Symptoms of Thyroid Disease
1. Avoid Iodine Deficiency
It’s well known that iodine status is a key determinant of thyroid disorders. Iodine deficiency can cause hypothyroidism and goiters because the mineral helps to convert and release thyroid hormones. Thyroid disorders that are caused by low iodine levels can cause heart complications, sluggish metabolism, weight fluctuations and mood changes. (13)
There are a few ways to avoid iodine deficiency, with the most important step being eating iodine-rich foods like seaweed, wild-caught cod, organic yogurt, raw milk and eggs. Iodine supplements are also available and when taken in low doses, can help to normalize the production of thyroid hormones. But only use iodine supplements under the care of your doctor and make sure you are being monitored for side effects. High doses of iodine can actually aggravate thyroid disorder symptoms.
2. Eat Foods High in Selenium, Zinc and B Vitamins
To improve symptoms of thyroid disease, make sure you are getting enough selenium, zinc and B vitamins in your diet. These nutrients are needed for proper thyroid function and will help to balance your thyroid hormone levels.
Did you know that the thyroid is the organ with the largest content of selenium? The mineral is needed for the conversion of hormones T4 and T3. Some of the best selenium foods that can be added to your diet to improve thyroid function include Brazil nuts, sunflower seeds, pinto beans, halibut, grass-fed beef, wild-caught salmon and organic oats. (14)
Foods high in zinc and B vitamins (especially vitamin B12) are also important for thyroid health. This includes lamb, grass-fed beef, cashews, spinach, chicken, eggs, mushrooms, chickpeas and asparagus.
3. Avoid Inflammatory Foods
One possible cause of thyroid nodules and other problems related to the thyroid gland is inflammation. Inflammation can actually slow down the conversion and production of your thyroid hormones. For this reason, it’s important to avoid inflammatory foods that will only make these issues worse. That means staying away from processed foods, foods with added sugars, and other possible trigger foods like those containing gluten. In fact, research shows that the prevalence of thyroid disease in higher in patients with celiac disease, so for these people, avoiding gluten is mandatory. (15)
4. Reduce Stress Levels
Research shows that both physical and mental stress can cause changes to your thyroid hormone levels. To keep the endocrine glands from becoming overloaded, which can cause damage to the body by suppressing immune function and altering the function of your adrenal and thyroid glands, it’s important to manage stress levels and get enough rest.
You can do this by trying natural stress relievers, such as exercising, getting 7–9 hours of sleep per night, putting time aside in your day to do something fun and relaxing, and joining a faith community or supportive group. (16, 17)
5. Try Ashwagandha
Ashwagandha, an adaptogen herb and traditional medicine in Ayurveda, is often used for thyroid dysfunctions. A double-blind, randomized placebo-controlled trial published in the Journal of Alternative and Complementary Medicine evaluated the efficacy of ashwagandha root extract in hypothyroid patients. When patients took 600 milligrams of ashwagandha extract daily for eight weeks, their T4 levels improved significantly compared to placebo. (18)
Other adaptogen herbs that can be used to improve symptoms of thyroid disease, especially hypothyroidism, include holy basil, ginseng and licorice root.
6. Take Probiotics
New research has linked hypothyroidism to disorders of the small intestine, like SIBO (small intestinal bacterial overgrowth). Researchers found that overgrowth of certain bacteria can increase the risk of thyroid dysfunction. In fact, it was reported that SIBO may be present in more than half of patients with hypothyroidism. (19)
7. Reduce Toxic Exposures
Exposure to chemical toxins can cause inflammatory reactions that hinder proper thyroid function. Certain medications, hormonal birth control pills and commercial beauty or cleaning products should be avoided when possible. It’s also worth mentioning that heavy metals like mercury and amalgam fillings can disrupt hormone balance, which is why it may be helpful to see a holistic dentist and remove silver fillings. (20, 21)
- Thyroid nodules are growths that develop within the thyroid gland. When thyroid tissue grows abnormally, it creates a nodule, or lump.
- Most thyroid nodules are benign and clinically insignificant, but about 10 percent of nodules are malignant.
- Although most thyroid nodules don’t cause symptoms, some people experience neck fullness, trouble swallowing, trouble breathing, pain in the mouth, throat or esophagus, and shortness of breath.
- Ultrasound is the most common diagnostic tool for thyroid nodules, along with a fine-needle aspiration biopsy, which provides a tissue sample for testing whether the nodule is malignant.
- Conventional thyroid nodules treatment may involve thyroid hormone therapy, radioactive iodine therapy, radiofrequency ablation treatment and surgery. If the nodule is cancerous, the entire thyroid gland, or half of the thyroid gland, needs to be removed.
7 Natural Remedies for Symptoms of Thyroid Disease:
- Avoid iodine deficiency
- Eat foods rich in selenium, zinc and vitamin B12
- Avoid inflammatory foods
- Reduce stress levels
- Try ashwagandha and other adaptogen herbs
- Take probiotics
- Reduce toxic exposures