What are thyroid nodules?

Thyroid nodules are solid or fluid-filled lumps that form within the thyroid gland, a small butterfly-shaped organ located at the base of your neck, just below the Adam’s apple. The thyroid gland produces hormones that regulate your metabolism, heart rate, and body temperature.

Nodules can vary in size and may be single or multiple. They are often discovered during routine physical exams or imaging tests for other health issues. While most thyroid nodules are benign (non-cancerous) and asymptomatic, a small percentage can be malignant (cancerous) or cause symptoms by pressing on surrounding structures or by producing excess thyroid hormones, leading to hyperthyroidism.

Common types of thyroid nodules include:

  • Colloid nodules: benign overgrowths of thyroid tissue.
  • Thyroid cysts: fluid-filled sacs that can be either entirely fluid-filled or have solid components.
  • Inflammatory nodules: result from thyroiditis (inflammation of the thyroid gland).
  • Multinodular goitre: an enlarged thyroid gland containing multiple nodules.
  • Thyroid adenomas: benign tumours that can sometimes cause hyperthyroidism.
  • Thyroid cancer: malignant nodules, though rare, require prompt medical attention.

What causes thyroid nodules?

Thyroid nodules form when there is an abnormal growth of thyroid cells, leading to the development of lumps within the gland. This growth can occur due to various mechanisms. For instance, iodine deficiency can trigger the thyroid to overcompensate by enlarging and forming nodules, as iodine is vital for thyroid hormone production. 

In some cases, mutations in the DNA of thyroid cells can cause these cells to proliferate uncontrollably, leading to benign adenomas or, less commonly, malignant tumours. Chronic inflammation from autoimmune conditions like Hashimoto’s thyroiditis can also stimulate nodule formation by causing ongoing damage and repair cycles in the thyroid tissue. 

Additionally, hyperfunctioning nodules, known as toxic adenomas, result from a localised area of the thyroid producing excess hormones independent of the gland’s regulatory mechanisms, leading to nodule growth. These processes, driven by cellular and molecular changes, contribute to the formation and enlargement of thyroid nodules.

What are the symptoms of thyroid nodules? 

Thyroid nodules often do not cause symptoms and are frequently discovered incidentally during routine physical exams or imaging tests for other conditions. However, when symptoms do occur, they can vary depending on the size, location, and nature of the nodule. Common symptoms include:

  • Visible lump
  • Difficulty swallowing
  • Breathing problems
  • Hoarseness or voice changes
  • Pain in the neck, jaw, or ear
  • Hyperthyroidism symptoms:
    • Unexplained weight loss
    • Increased appetite
    • Nervousness or irritability
    • Tremors
    • Heat intolerance
    • Increased sweating
    • Rapid or irregular heartbeat.
  • Hypothyroidism symptoms:
    • Fatigue
    • Weight gain
    • Cold intolerance
    • Constipation
    • Dry skin
    • Hair loss 

It is important to consult with a healthcare provider if you notice any of these symptoms, as they can help determine the cause and appropriate treatment for 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.

What are the treatment options for thyroid nodules in Singapore? 

At NC Tan Surgery, we offer a variety of treatment options for thyroid nodules, depending on the nature and characteristics of your thyroid nodules. Here are the primary treatment methods we use:

  • Regular monitoring: for benign and asymptomatic thyroid nodules, our doctor may recommend regular monitoring with periodic ultrasound and thyroid function tests. This approach allows us to track any changes in the nodule’s size or characteristics over time without immediate intervention.
  • Radioactive Iodine Therapy: for hyperfunctioning thyroid nodules that cause hyperthyroidism, radioactive iodine therapy can be effective. This treatment involves swallowing a small dose of radioactive iodine, which selectively destroys overactive thyroid tissue, thereby reducing the size and activity of the nodule.
  • Thyroid Surgery (Thyroidectomy): for nodules that are large, symptomatic, suspicious for cancer, or confirmed malignant, surgical removal may be necessary. Depending on the extent of the condition, we may perform a lobectomy (removal of one thyroid lobe) or a total thyroidectomy (link to service page) (removal of the entire thyroid gland). Surgery is a definitive treatment that provides immediate results and allows for a thorough pathological examination of the removed tissue.
  • Medication management: in cases where thyroid nodules are associated with underlying thyroid conditions such as hyperthyroidism or hypothyroidism (link to service page), appropriate medication management is essential. This includes antithyroid drugs for hyperthyroidism or thyroid hormone replacement therapy for hypothyroidism.

At NC Tan Surgery, our specialist will work closely with you to determine the most appropriate treatment plan based on the specific characteristics of your thyroid nodules, your overall health, and your personal preferences. Schedule an appointment with us to discuss your treatment options and develop a personalised care plan.

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Frequently Asked Questions

Most thyroid nodules are benign, but a small percentage can be malignant. Regular monitoring and evaluation by a healthcare provider are crucial to detect any changes early.

The frequency of check-ups depends on the nature and size of the nodules, but typically, benign nodules are monitored every 6 to 12 months with ultrasound and thyroid function tests.

While there’s no specific diet for thyroid nodules, ensuring adequate iodine intake and maintaining a balanced diet can support overall thyroid health. Consult your doctor for personalised dietary advice.

Large nodules or those pressing on the nerves to the vocal cords can cause hoarseness or voice changes. If you experience these symptoms, it’s important to seek medical evaluation.

If a thyroid cystic nodule bursts, it can cause sudden pain and swelling in the neck. Immediate medical attention is needed to manage symptoms and prevent complications.

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    #14-02 Connexion Singapore 217562

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