Thyroid nodules are collections of enlarged tissue in the thyroid. They are three times as common in women as in men, and among women, the chances correspond to age (50% risk over 50 years old, 60% over 60, 70% over 70, etc). But they’re benign (non-cancerous) 95% of the time. For this reason, the conventional approach to most nodules is to “watch and wait.” But there are still a few other things you can do.
Naturally, the most effective approach is to find out why the nodule is present in the first place.
Diagnosis of Nodules
You might get a thyroid ultrasound to start if you or your doctor observes or palpates a possible goiter, though it’s a good idea to get an ultrasound yearly if you have Hashimoto’s Thyroiditis regardless. This is because Hashimoto’s is the most common cause of thyroid nodules, and (perhaps for this reason), Hashimoto’s patients are at an increased risk for thyroid cancer compared to non-Hashimoto’s patients.
Biopsies (or Fine Needle Aspirations: FNAs) are typically only recommended when the nodule is large (over 1 cm), and/or it shows calcification, irregular borders, or increased vascularity.
Causes of Nodules
As mentioned before, the most common cause of nodules these days is Hashimoto’s Thyroiditis. It used to be iodine deficiency, but since adding iodine to salt, this is no longer very common. Now, it’s far more likely that excess iodine can cause nodules, in those with Hashimoto’s especially. Treating Hashimoto’s is a comprehensive process.
Other possible causes include:
- Radiation exposure, though apparently levels of radiation need to be extreme for this relationship to exist.
- Vitamin D deficiency. This is one nutrient in which nearly everyone is deficient, to some degree.
- Selenium deficiency — possibly because selenium helps counterbalance iodine.
- Pregnancy. Many hormonal changes occur in pregnancy, so it’s no surprise that thyroid nodules can form or grow during pregnancy as well. Along those lines…
- Estrogen dominance. Hypothyroidism and estrogen dominance are mutually reinforcing, so it’s also not too surprising that high levels of estrogen can encourage nodule formation.
- Insulin resistance. Blood sugar imbalance also encourages thyroid nodules to grow.
- Endocrine disrupting chemicals. This list reviews chemicals known to cause thyroid disruption. They can also therefore cause thyroid nodule formation.
- H. Pylori. This very common bacteria, which can sometimes cause ulcers or GI distress and can sometimes be asymptomatic, has also been linked to thyroid nodules.
Nodules are most often benign, and asymptomatic—but they can (rarely) grow large enough to cause discomfort, or they can (also rarely) produce thyroid hormone, causing thyroid disruption. And the presence of even benign and asymptomatic nodules can suggest an underlying imbalance or toxicity. It’s always best to address these before they become a problem.