A. Over two percent of adults have nodules in their thyroid gland Thyroid nodules are very common. Doctors can feel thyroid nodules by hand in 3-7% of our population. In contrast, if an ultrasound is done, about 20% or more of normal people can find nodules in the thyroid gland. There are more women than men, about 4:1, and middle-aged and elderly people are more common than teenagers. Despite this high incidence, the majority of thyroid nodules are benign, with malignancy accounting for only 5%. So how can we not only spare the few “bad elements”, but also not to misunderstand the benign tumors that can coexist peacefully with people? If cancer is basically ruled out, then medicine can be taken for observation. The specific method is: for multiple nodules or single nodule less than 1 cm, you can take levothyroxine tablets 50~100ug orally once a day (half an hour before breakfast). 3~6 months to review ultrasound to understand the changes of the lump. If the lump becomes smaller, you can continue to take it for 6 months and then slowly reduce the dosage. The above methods are usually less effective for tumors over 2 cm, and they are prone to recurrence after stopping the medication. For those who are ineffective in taking medication and the lump is persistently growing, surgery is recommended. Given the relatively low malignancy of papillary thyroid cancer, the 3-month observation period will not affect the long-term efficacy. Regular review is essential For thyroid nodules detected by ultrasound but not palpable, they can also be reviewed by regular ultrasound follow-up without medication, and CT or MRI examination is feasible if necessary. Solid or cystic nodules should be reviewed every six months. For solitary cystic nodules, review once a year and pay attention to the signs of hyperthyroidism and blood T3, T4 and TSH levels. If the nodule is significantly enlarged or exceeds 1.5 cm during the follow-up period, surgery may be considered. If possible, ultrasound-guided biopsy with fine needle aspiration can be performed, and surgery is required for suspected malignancy or hyperthyroidism.