What are thyroid nodules?

Can thyroid nodules cause pain? 

Thyroid nodules are typically not painful and often go unnoticed unless they are detected during routine medical exams or imaging studies conducted for other reasons. However, in some cases, thyroid nodules can cause pain, especially if they become large enough to press on surrounding structures in the neck. This pressure can lead to discomfort or a feeling of fullness in the neck, pain that radiates to the jaw or ear, or tenderness when touching the area around the thyroid. 

Additionally, if a nodule grows rapidly or if there is bleeding into a cystic nodule, it can cause acute pain. Chronic inflammation from conditions like thyroiditis can also result in painful nodules. Despite these possibilities, the majority of thyroid nodules are asymptomatic and painless.

Who is at risk of thyroid nodules in Singapore? 

In Singapore, certain individuals are more likely to develop thyroid nodules due to a combination of genetic, environmental, and lifestyle factors.

• Gender: women are more likely to develop thyroid nodules than men.
• Age: middle-aged and older individuals have a higher risk.
• Family history: a close relative with thyroid nodules or thyroid cancer increases the likelihood.
• Radiation exposure: high levels of radiation exposure, especially during childhood.
• Iodine deficiency: lack of iodine in the diet.
• Medical conditions: conditions such as Hashimoto’s thyroiditis, an autoimmune disorder causing chronic inflammation of the thyroid.
• Lifestyle factors: smoking and maintaining a diet low in iodine can contribute to the development of thyroid nodules.

How are thyroid nodules diagnosed in Singapore? 

At NC Tan Surgery, we conduct a thorough diagnosis by utilising a combination of advanced diagnostic methods to evaluate and understand the nature of thyroid nodules. Here are the primary techniques we use:

• Ultrasound scan: this is often the first step in diagnosing thyroid nodules. An ultrasound provides detailed images of the thyroid gland, which helps us determine the size, shape, and composition of any nodules. It allows us to distinguish between solid and cystic nodules and identify any suspicious features that might indicate malignancy.
• Thyroid Function Tests: these blood tests measure levels of thyroid hormones (T3 and T4) and thyroid-stimulating hormone (TSH) in your bloodstream. They help us assess whether the thyroid gland is functioning normally, overactive (hyperthyroidism), or underactive (hypothyroidism), which can be crucial in understanding the nature of the nodules.
• Fine-Needle Aspiration Cytology (FNAC): FNAC (link to service page) is a minimally invasive procedure where a thin needle is inserted into the nodule to collect a small sample of cells. These cells are then examined under a microscope to determine if the nodule is benign or malignant. FNAC is a critical tool in the diagnosis of thyroid cancer.
• Radioiodine scan: this imaging test involves swallowing a small amount of radioactive iodine, which is absorbed by the thyroid gland. A special camera then captures images of the thyroid, highlighting nodules that absorb more or less iodine than normal thyroid tissue. This helps in determining whether the nodules are hyperfunctioning or hypofunctioning.
• CT Scan or MRI: in some cases, a CT scan or MRI might be necessary to get a more detailed view of the thyroid and surrounding structures, especially if the nodules are large or if there are concerns about their impact on nearby tissues.
• Thyroid Antibody Tests: these tests check for the presence of antibodies that might indicate an autoimmune thyroid condition, such as Hashimoto’s thyroiditis, which can be associated with thyroid nodules.

By combining these diagnostic methods, we can accurately diagnose thyroid nodules and develop a personalised treatment plan according to your specific needs.