With the popularity of medical checkups, more and more people are found to have “thyroid nodules”. Many people are baffled by the report. What is “thyroid”? Where does it grow? I don’t feel any discomfort, so why do I have a “nodule”? Is this “nodule” the same as a “tumor”? Do I need surgery? …… is a series of questions that often distress patients, and they do not know how to further examine or treat them. Today, let’s get to know about “thyroid” and “thyroid nodules”. The thyroid gland is the largest endocrine gland in the body and is located about 2 to 3 cm below the “laryngeal node” and can move up and down with swallowing movements. The thyroid gland is small, weighing only about 20-30 grams, but the thyroid hormones it secretes, such as T3 and T4, can play a very important role in increasing the body’s metabolism, improving the excitability of the nervous system and cardiovascular system, and are also related to growth and development. Thyroid disease is a common endocrine disorder and epidemiological studies have found that the number of people with the disease has exceeded 300 million worldwide and is increasing every year, but 50% of these patients are unaware of their disease. Thyroid disorders can be divided into: (1) hyperthyroidism, which is the excessive production of thyroid hormones resulting in hyperthyroidism; (2) hypothyroidism (more common than hyperthyroidism), which is the opposite of hyperthyroidism, which is the insufficient production of thyroid hormones resulting in hypothyroidism; (3) thyroid nodules (most common in clinical practice), which are abnormal masses of one or more benign or malignant tissues in the thyroid gland; and (4) other thyroid disorders, such as subacute thyroid disease. Other thyroid diseases, such as subacute thyroiditis, autoimmune thyroiditis, etc. According to the “First Epidemiological Survey of Thyroid Diseases in Urban Communities in China”, the prevalence of thyroid nodules in urban China is 18.6%, which means that nearly 1 in 5 people have thyroid nodules. Therefore, “thyroid disease” is as common as “cold”, if you find yourself with hyperthyroidism, hypothyroidism or thyroid nodules, you do not need to panic, as long as you go to a regular hospital or specialist outpatient clinic. Outpatients are often advised to undergo thyroid function tests (including T3, T4, FT3, FT4, TSH and related antibodies), thyroid ultrasound and, if necessary, needle smear cytology (FNA). These tests are not like routine blood and urine tests, which can take up to a week to get the results, but they are very important for the diagnosis and treatment of thyroid disease, so please be patient. One thing to remember is that thyroid function tests, ultrasound or cytology tests do not require fasting, so patients can eat without having to wait for a consultation or test on an empty stomach. Hyperthyroidism and hypothyroidism can be diagnosed through thyroid function tests and ultrasound, and these two tests are also important for thyroid nodules to help clinicians determine the nature of the nodule and whether there are indications for surgery. In this case, a comprehensive judgment of the clinician is required. In cases where there is a strong suspicion of malignancy or where the puncture is clearly malignant, we recommend surgery as soon as possible; in cases where benign thyroid nodules are considered to be malignant or where the patient has concerns and does not want to have surgery right away, we recommend regular follow-up, usually with a thyroid ultrasound once every three to six months. Although thyroid surgery requires general anesthesia, it has become a routine procedure with minimal physiological impact on patients (they can eat and go to the bathroom 6 hours after surgery), and many patients can be treated through the “day surgery” route, which means that preoperative tests are completed on an outpatient basis, and postoperative hospitalization is required for only 1 to 2 days, after which patients are observed for no special conditions. The patient is discharged from the hospital. Therefore, if you hear your outpatient doctor tell you that you need surgery, you should not be afraid or refuse, but should actively cooperate with the treatment. Except for these cases that require surgery, most of the cases in the clinic do not require surgery for the time being, however, there is another important question that often troubles patients and their families, and that is “What can I eat?” In the clinic, many patients and their families say, “I heard that I can’t eat seafood because I have thyroid nodules, and I have to eat non-iodized salt. In fact, whether or not you can eat seafood and iodized salt is a matter to be discussed according to different conditions, not to be generalized, and not to listen to other people’s experience to deal with your own situation. In my clinical practice, I have met many hypothyroid patients who listened to their “neighbors”, “colleagues” and “friends” and turned themselves into “hypothyroid patients”, or their nodules became bigger and bigger, missing the best time for surgery. To put it simply, we can divide “thyroid nodules” into the following cases: ①Graves hyperthyroidism with thyroid nodules, these patients need to strictly avoid iodine, forbid seafood such as kelp, seaweed and sea fish, and consume non-iodized salt; ②High-functioning adenomas that secrete thyroid hormones, these patients also need to strictly avoid iodine and are advised to consume non-iodized salt. (3) patients with Hashimoto’s thyroiditis with nodules do not need to buy iodine-free salt, but it is not advisable to eat a lot of seafood, for example, patients who like to eat raw fish should moderate their consumption; (4) patients with non-functional nodules do not need to avoid iodine, in other words, even if you do not eat seafood or iodized salt, the nodules will not shrink or disappear. At this point, the majority of patients must be saying, “How do I know which type of nodule I have?” My advice is simple: don’t trust other people’s experience or prescriptions, go to a regular hospital’s specialist clinic or expert clinic, and let a professional doctor give you dietary advice based on your condition, so you can “eat the right food”. Finally, let’s briefly talk about thyroid cancer. When it comes to “cancer”, people always have a sense of fear, and malignant tumors always seem to be accompanied by words like “spread”, “metastasis” and “5-year survival rate”. It seems that malignant tumors are always accompanied with nerve-racking words such as “spread”, “metastasis” and “5-year survival rate”. In fact, more than 90% of thyroid cancer are less malignant types such as papillary, follicular and medullary carcinoma. Most patients can survive for a long time or even be cured. However, the surgeon will often ask the patient to take thyroxine tablets for a long period of time in order to suppress the thyrotropin in the body and reduce the possibility of recurrence in the future. A friendly reminder to patients who need to take thyroxine for a long time, do not feel that regular blood tests or long-term medication is troublesome, this is to better control your condition and improve the prognosis, arbitrarily increase or decrease the dosage is to your own detriment. In addition, there are a few cases with high malignancy such as undifferentiated carcinoma, which are prone to metastasis earlier and have significantly shorter survival; some patients with differentiated carcinoma may be recommended by clinicians to undergo iodine 131 internal radiotherapy due to their condition, which will not be discussed here. In summary, thyroid gland is a small but very important endocrine organ that everyone has, and thyroid diseases are very common. “It is better to go to a regular hospital’s specialist clinic or expert clinic for standardized treatment as soon as possible. The best way to have a good life is to have a healthy thyroid!