Thyroid disease affects approximately 200 million people worldwide, and if left undiagnosed and untreated it can cause conditions such depression, tremors, muscle weakness and constant fatigue. Experts at the Head and Neck Institute at Mount Sinai Health System encourage the general public to perform regular thyroid neck self-exams and examining your neck can in some cases help you find lumps or enlargements that may point to thyroid conditions, including nodules, goiter and thyroid cancer.
The thyroid is responsible for producing hormones that help the body regulate its metabolism. When not working properly it can cause the body’s system to speed up (hyperthyroidism) or slow down (hypothyroidism). The thyroid gland is a small, butterfly-shaped gland located in the base of the neck just below the Adam’s apple. Although relatively small, the thyroid gland influences the function of many of the body’s most important organs, including the heart, brain, liver, kidneys and skin.
Some patients who have an enlarged thyroid gland may also produce too much or too little thyroid hormone. Because many symptoms of thyroid imbalance may be hard to recognize and may be mistaken for symptoms caused by other conditions, the best way to know for sure about your thyroid health is to ask your doctor for a TSH (thyroid-stimulating hormone) test, a simple blood test that measures whether your thyroid gland is functioning normally. If you have a family member with thyroid disease, are over the age of 60, or have any symptoms or risk factors associated with thyroid disease, you should talk to your doctor about getting a TSH test.
Thyroid nodules are growths that form on or in the thyroid gland. The causes are not always known but can include iodine deficiency and Hashimoto’s disease. The nodules can be solid or fluid-filled. Most are benign, but they can also be cancerous in a small percentage of cases. As with other thyroid-related problems, nodules are more common in women than men and the risk in both sexes increases with age. Most thyroid nodules do not cause any symptoms. However, if they grow large enough, they can cause swelling in the neck and lead to breathing and swallowing difficulties, pain, and goiter.
Most nodules are detected during a normal physical exam. They can also be detected during an ultrasound, CT scan, or an MRI. Once a nodule is detected, other procedures — TSH test and a thyroid scan — can check for hyperthyroidism or hypothyroidism. A fine-needle aspiration (FNA) biopsy is used to take a sample of cells from the nodule and determine whether the nodule is cancerous. Benign thyroid nodules are not life threatening and usually don’t need treatment. Typically, nothing is done to remove the nodule if it doesn’t change over time. Your doctor may do another biopsy and recommend radioactive iodine to shrink the nodules if it grows.
Cancerous nodules are pretty rare — according to the National Cancer Institute, thyroid cancer affects barely 4 percent of the population. The treatment your doctor recommends will vary depending on the type of tumor. Removing the thyroid through surgery is usually the treatment of choice. Radiation therapy is sometimes used with or without surgery. Chemotherapy is often required if the cancer spreads to other parts of the body. Make sure to discuss the diagnosis and treatment options with your doctor if you have a thyroid condition. Take any medication as prescribed. You should also report any serious side effects or symptoms.