Nowadays, thyroid nodules are becoming more and more common. Today, I have summarized the 7 most common questions about nodules and given professional answers, hoping to clear your doubts.
A. Why do thyroid nodules grow?
The definite cause of hyperplastic thyroid nodules is not clear, but it may be related to several factors: high or low iodine intake, consumption of goitre-causing substances, consumption of goitre-causing drugs or defective thyroid hormone synthetase. It is more common in middle-aged women. In the presence of a relative deficiency of thyroid hormone in the body, the pituitary gland secretes increased TSH. Under the long-term stimulation of this increased TSH, the thyroid gland undergoes repeated or continuous hyperplasia resulting in uneven enlargement and nodule-like changes in the thyroid gland. There may be bleeding, cystic changes and calcification in the nodules.
What are the health risks of thyroid nodules?
Whether thyroid nodules are harmful to the body depends on the benignity, size and function of the nodules.
Benign and malignant nodules: Benign nodules are basically harmless and need to be reviewed every 6 to 12 months. Malignant nodules, i.e. thyroid cancer, need to be treated promptly, otherwise it may lead to death. Of course, most patients with thyroid cancer can survive for a long time with timely and reasonable treatment.
Size: If the nodule is too large or grows rapidly, it may press on the surrounding tissues and organs, resulting in hoarseness, difficulty in breathing, difficulty in swallowing, etc.
Function: Some nodules can secrete thyroid hormones on their own, which can lead to hyperthyroidism, manifested as fear of heat, excessive sweating, panic, hand tremors, insomnia, weight loss, diarrhea, menstrual disorders, etc.
Some nodules may be accompanied by hypothyroidism, which may manifest as fear of cold, dry skin, edema, weight gain, drowsiness, lack of energy, bloating, constipation, and menstrual disorders.
Is there a high possibility of thyroid nodules becoming malignant?
Eighty to 90 percent of thyroid nodules are benign. Some nodules are benign when they are first discovered, but they may become malignant at a later stage, but the probability of this is very low. Therefore, it is very important to review the nodules regularly after they are found. If the nodule is just found, it should be reviewed once every six months, and if there is no change, it should be reviewed once a year.
What can be done to reduce the size of thyroid nodules?
If the nodule is malignant, early surgery is required; if the nodule is benign, the following methods can be tried to shrink the nodule.
1, drugs: that is, oral treatment with thyroxine preparations. However, the efficacy of medication is very poor, only a small percentage of people have nodule shrinkage after taking medication, most people have little effect.
2, surgery: Considering the risk of surgery and other issues, unless the nodules are very large or have recurrent bleeding, benign nodules are generally not selected for surgical treatment.
3, ablation: including thermal ablation, anhydrous ethanol injection, iodine 131 treatment. However, ablation has been introduced for a relatively short period of time, and its safety, applicable population, adverse effects, risk of recurrence and other issues are not very clear. Therefore, ablation is not recommended by the mainstream medical community, and more time and research are needed to verify this treatment method.
The above analysis shows that there is no good way to shrink nodules. Therefore, for benign thyroid nodules, doctors usually only instruct patients to have regular reviews (every 6 to 12 months).
Special warning: If a benign nodule appears to be malignant during the review process, it needs to be operated early.
V. Which thyroid nodules require surgery?
Surgery needs to be considered in the following cases.
1. nodules that are proven to be malignant by puncture biopsy.
2, nodules that are growing rapidly and are highly suspected to be malignant.
3, nodules that are very large and have symptoms of pressure.
4, nodules with combined hyperthyroidism.
5.Nodules with recurrent bleeding.
Can thyroid nodules recur after surgery?
If the surgery is not complete and there are residues, there is a possibility of recurrence after surgery. The risk of recurrence is 5 to 10 times higher than the initial surgery. This requires that the surgeon try to remove the nodule as completely as possible during the surgery, which is more difficult.
7. Should I eat non-iodized salt if I have thyroid nodules?
1. If thyroid nodules are combined with hyperthyroidism, or if thyroid cancer is treated with iodine 131 after surgery, you should eat non-iodized salt, and you should not eat foods with high iodine content such as seaweed, nori, shrimp and shellfish.
2. If thyroid nodules are combined with Hashimoto’s thyroiditis: you do not need to eat non-iodized salt, you can eat normal iodized salt, but you should eat less seaweed, nori, shrimp and shellfish and other foods with high iodine content.
3. If it is a simple benign nodule: there are no special requirements for diet, as long as you do not eat a lot of seafood every day, it does not matter. After all, people without thyroid problems can eat a lot of seafood every day and have problems.