There are more and more people around who have thyroid nodules. With the increasing technology of screening devices, when the resolution of ultrasound reaches 1mm, 60-70% of Chinese people can detect thyroid nodules. This means that 2 out of 3 Chinese people have nodules. This makes it seem like thyroid nodules are not even a disease anymore.
We often hear about people who go for medical checkups and find out that they have multiple thyroid nodules. Whoever has a nodule in the thyroid gland that was detected during a physical examination at work has to undergo surgery. Yes, thyroid nodules are so painless and insidious. More and more people are suffering from thyroid nodules, does it matter or not?
Of thyroid nodules, 85-95% are benign nodules. Of the malignant thyroid nodules, more than 90% are low-grade malignant.
1. Is ultrasound or CT or MRI better to check the thyroid?
Ultrasound is the most accurate imaging test for the thyroid, but CT and MRI are not as good. Unless you want to see the details of the surrounding tissues, you can have another MRI.
2. How do I look at thyroid ultrasound results?
Ultrasound looks at 3 points: in order of weight: border – calcification – blood flow.
(1) “Poorly defined borders”.
Benign nodules generally have clear borders, while malignant ones are invasive to surrounding tissues. The boundary can be unclear. However, inflammatory lesions, which are not malignant because it can have exudation, also have unclear borders.
(2) “Dotted strong echogenicity”.
It can be seen in two conditions: one is colloid, which is a sign of benign. One is calcification, malignant generally have calcification, and mostly microcalcifications; however, the presence of calcification is not always malignant.
(3) “Internal blood flow disturbance”.
Blood flow is divided into internal blood flow and external blood flow. Malignant ones have more internal blood flow disorders.
These 3 points, if there is no point, do not worry, the possibility of benign. If you have 1-2 points, do a puncture if you are not sure. 3 points are all there, the possibility of malignancy is high.
To identify benign and malignant nodules, in addition to the above three points, we can also look at: whether there are adhesions with the surrounding tissues, whether there are lymph node metastases, whether there is rapid growth within a short period of time, the growth pattern (malignant nodules with longitudinal growth are more likely), the size of the nodule (surgery is also recommended for nodules >50px), and so on.
It is worth noting that the experience of the ultrasound doctor and the resolution of the machine may have a great impact on the judgment of the ultrasound results, and the ultrasound results are a particularly important reference for determining the nature of the nodule, so it is recommended that those who need to clearly identify the nature of the nodule can go to a large hospital to find an experienced ultrasound doctor to do the examination.
3. What about benign nodules?
High thyroid stimulating hormone (TSH) can cause thyroid nodules to grow, so people with nodules require a low TSH of between 0.5 and 1.0.
There is a feedback relationship between thyroid stimulating hormone (TSH) and triiodothyronine (T3) and tetraiodothyronine (T4). High TSH can promote higher T3 and T4 levels; and higher T3 and T4 will in turn feed back to make TSH levels lower.
People with nodules should lower their TSH levels appropriately. What are the methods? The first choice is dietary therapy.
What foods shrink nodules?
Seafood. Yes, read that right, seafood. People with benign thyroid nodules eat more seafood, not seafood as people think they can’t eat if they have nodules, and if TSH is >2.5, they need to take Eugenol to control the nodules.
What foods will grow nodules?
Cruciferous foods: cabbage, white radish, etc., because it can make T3, T4 synthesis is blocked, thus raising TSH, so it is long nodules, eat less, but is not contraindicated, after all, you can not eat too much a day.
In addition, it is worth noting that patients with thyroid nodules, as long as TpoAb, TgAb, TRAb these antibodies are negative, no need to avoid iodine; if TpoAb, TgAb, TRAb positive, it is necessary to eat less kelp, nori type high iodine food.
Benign nodules can be reviewed periodically by ultrasound. It is normal for the size of the nodule described on the result report to deviate by a few millimeters due to the difference in the ultrasound probe section each time. Although benign nodules can be treated with dietary therapy, there are no measures that can significantly reduce the size of nodules. There is also no need to be demanding, as benign nodules need not be of much concern at all as long as they are not significantly larger, do not hurt, and do not affect thyroid function.