1.Regular follow-up Mildly enlarged thyroid gland with no pressure symptoms can be treated with regular follow-up. 2.Thyroid hormone suppression therapy Exogenous thyroid hormone can suppress the secretion of endogenous TSH and cause the enlarged thyroid gland to atrophy. However, the effect cannot be maintained for a long time after stopping the medication, so it needs to be taken for a long time. Hormone therapy is effective for young people with mild goiter or newly diagnosed goiter. The side effects are mainly bone loss and effects on the heart due to overdose, but long-term use does not lead to these side effects as long as serum TSH is suppressed in a certain range and overdose is avoided. 3.Surgical treatment Surgical treatment is not preferred and is mostly used to relieve local pressure symptoms when local pressure is evident. Thyroid hormone should be given after surgery to prevent recurrence of goitre. 4.131I therapy is mainly used for patients who are too old to tolerate surgery. The incidence of hypothyroidism increases significantly with time. Regarding the regression of goiter and thyroid nodules, the results of a large prospective study published online in JAMA on March 3, 2014, showed that only 0.3% of thyroid nodules that were benign based on both cytology and ultrasound transformed into thyroid cancer during the 5-year follow-up period. Dr. Cosimo Durante and colleagues at the University of Rome, Italy, reveal that “the detection rate of thyroid nodules is increasing with advances in diagnostic imaging, but the vast majority of thyroid nodules are benign. Dr. Durante et al. recruited 992 patients with one to four asymptomatic thyroid nodules less than 1 cm in diameter that were suggestive of benignity based on ultrasound and cytology, and gave them annual thyroid ultrasound examinations. Of the 1567 primary nodules, 174 (11.1%) showed significant growth (20% increase in diameter in at least two directions and at least 2 mm), with an average increase of 4.9 mm. 93 (9.3%) patients developed new nodules, including one case of carcinoma.” According to Durante, “For For patients with thyroid nodules, nodular growth was less likely to occur in nodules ≤7.5 mm in maximum diameter; however, multiple nodules were more likely to show nodular growth than single nodules; in addition, nodular growth was more likely to occur in patients younger than 45 years compared with male patients ≥60 years of age”. In addition, older patients with a body mass index ≥28.6 kg/m2 had a more than twofold increased risk of developing thyroid nodule growth, consistent with the recently reported association of obesity and insulin resistance with nodular thyroid disease. “These findings suggest that the first follow-up interval for review of thyroid ultrasound can be safely extended to 12 months for most patients with thyroid nodules. Thereafter, thyroid ultrasound may be considered every 5 years if there is no significant change in thyroid nodule size. 85% of patients at low risk of disease progression may be considered for this option. However, in younger patients and older overweight patients, close monitoring of nodule changes is required if multiple nodules, large nodules (>7.5 mm maximum diameter), or multiple large nodules are present. Since the majority of thyroid nodules are compensatory thyroid epithelial hyperplasia resulting from the relative lack of thyroid function as the body ages and declines, and the prognosis is good, the current treatment of “surgical excision” for many thyroid nodules that do not yet show symptoms of pressure and do not show signs of malignancy is “Overtreatment”. The nodules that do not affect the “health” of the thyroid gland and do not produce more serious hyperplasia in the short term or even for a longer period of time, and rarely have the potential for malignant changes, are treated by taking advantage of people’s concerns about “nodules”, “adenomas” and “lumps”. The fear of “nodules”, “adenomas”, and “lumps”, and the fear of “malignant changes” that lead to premature and excessive removal of thyroid nodules, are more likely to result in a relative lack of thyroid function and more significant compensatory hyperplasia. The result is a more pronounced compensatory hyperplasia, or even an inability to fully compensate for hypothyroidism, which can have irreversible effects on human health! This should be an event that we medical professionals need to avoid at all costs.